Columbus, Ohio. The victim was a 22-year-old male, who reportedly had been experimenting with asphyxial recreation for a number of years. The victim was hanging by the neck with an electrical cord secured to a 2 × 4 rafter above a ceiling tile, which had been removed to gain access. A scarf was between the ligature and the victim’s neck. His body was discovered by his mother in the basement area of the family home.

Fig.1 The victim was dressed as a woman complete with outerwear and undergarments.

At the time of his death, the victim was wearing a full-length lady’s pink dress, and his hands were cuffed behind his back with handcuffs. He was wearing a brown woman’s wig, women’s shoes and underwear, and high-heel shoes. According to the victim’s mother, her son had been wearing silky things and cross-dressing since he was 15 years of age In 2009, he told his mother that he had been experimenting with autoerotic activities and had nearly lost his life on one occasion. This conversation took place after the autoerotic death of actor David Caradine, who was found hanging naked inside a closet at a Bangkok Hotel.

Fig.2 He was wearing a full-length pink dress and high-heel shoes and had apparently slipped from the chair as he attempted to stop hanging.

Fig.3 The victim had removed a ceiling tile to reach the 2 × 4 rafter and secured an electrical cord noose around his neck with a scarf between his neck and the noose.

The son maintained a room in the basement area where he kept his computer and women’s clothing; detectives described the room as cluttered and filthy with a computer desk and computer. The mother had last seen her son at approximately 5:00 pm the previous evening and discovered him hanging at approximately 10:30 am the next day.

While processing the crime scene, detectives noticed that the deceased had a computer-mounted camera pointed in his direction. The detectives secured a search warrant for the computer, which was brought to their forensic office for review. An examination of this computer revealed five videos dated the evening before his death with short clips of the deceased engaged in autoerotic activity. These clips were recorded at 5:06 pm , 5:16 pm , 5:21 pm , and 5:24 pm.

Fig.4 Note the mirror in the crime scene; the victim could view himself as he engaged in autoerotic activity.

Fig.5 The victim was able to secure his hands with handcuffs behind his back.

The final clip was made at 5:30 pm and recorded his death. This clip ran from 5:30 pm to 11:02 am the next morning The first four recordings showed the deceased wearing a short French maid’s dress as he wore the brown wig and makeup. During these clips, the deceased was depicted cuffing and uncuffing himself while engaging in autoerotic activity. In the last clip, he was wearing the long pink dress with the high-heel shoes. As he attempted to get back up onto the chair, his long dress got caught on the high heels, and he slipped and hung to death.

Fig.6 He was wearing a brown woman’s wig, women’s shoes and underwear, and high-heel shoes.

Fig.7 The deceased used to record his activities with his webcam, which aided detectives in reconstructing the entire events prior to and during his death.

Autoerotic death is a relatively rare phenomenon characterized by unusual sexual behavior through a wide variety of lethal mechanisms that often involve deprivation of oxygen. Autoerotic asphyxia is a self-induced cerebral hypoxia brought about during autoerotic activities, and generally induced by constriction of the neck or obstruction of the respiratory passages by various means.

The basic mechanism of sexual asphyxia is the deprivation of oxygen to the central nervous system leading to a rapid disturbance of the central inhibition mechanisms that control sexual function, thus resulting in augmentation of the sexual response in certain individuals. The depletion of oxygen can usually be achieved by self-strangulation, hanging, suffocation with an object like a plastic bag over the head, chest compression, use of gas (e.g. chloroform and nitrous oxide), or volatile chemicals (e.g. isopropyl nitrite and isobutyl nitrite), or a combination of these.

The majority of deaths resulting from such activities are accidental, due to the unanticipated failure of the means used to produce hypoxia or incorrect estimation of the amount of oxygen restriction. Such activities may also lead to serious brain injury. Autoerotic asphyxiation is estimated to cause 500–1000 deaths per year in the United States.

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