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EveningStandard claims in Masturbation 'kills up to 100 Germans a year', new study shows that up to 100 Germans a year die to masturbation for using risky methods like auto-erotic asphyxiation or electric shock.

Similar claims can be found in these sources, among others:

Are up to 100 Germans per year killed by using risky techniques for masturbating?

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    Here on Wikipedia en.wikipedia.org/wiki/Autoerotic_fatality they have the figure of 0.5 per million per year in Western countries. – GEdgar Feb 10 '18 at 14:26
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    @DanielRHicks: Really? I think you'll be surprised. I'm curious why you think such behaviour would have stopped across the entire US 30 years ago. – Lightness Races in Orbit Feb 11 '18 at 18:18
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    @LightnessRacesinOrbit - I didn't say the behavior had stopped. I just said I've not heard of it in recent times. – Daniel R Hicks Feb 11 '18 at 21:03
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    Doesn't "Up To" imply less than? So, 1 death per year proves this to be correct. Anything over 100 proves this to be incorrect. – Warren Sergent Feb 11 '18 at 23:24
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    "Idiot dies from blow torching cheese all over his body" isn't as salacious as "Man dies of cheese masturbation." What then, did he die from, masturbation or burns? – RonJohn Feb 12 '18 at 6:25
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Even though the article was published by Bild (which is a strong indicator that you have to check the sources yourself) and has no verifiable source, it sounds correct.

In 2009, Sandra Kuhn wrote a dissertation in medicine at the University of Hamburg about "Auto-erotic deaths in Hamburg and Munich 1983-2002" [1]

In the 20 years, she found 101 cases (100 male, 1 female), so around 5 per year. With that data, she got a final number of 0.6 to 1 deaths per year per million. For 82 million people in Germany, this leads to 50-80 deaths per year.

This publication is most likely the source for the articles as EveningStandard as well as Dailymail refer to the 1983-2003 timeframe.

If you take a high dark figure into account (e.g. relatives removing embarrassing evidence) the given figure of 100 is acceptable.

The dissertation also contains a small literature research with different results: [chapter 1.5.1]

Hazelwood et al. (1983): 1-2 cases/year/million for USA/Canada

Flobecker et al. (1993): 0.1 for Sweden

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    Who came up with the ridiculous idea to calculate the average death rate for a 82 million population based on Kuhn's data? As far as I can see, it's not in the dissertation, so I suspect that it might be Bild doing the maths here. In truth, the margin of error will be so inflated that it's quite a stretch to consider "about 100 causalities per year" a correct statement. – Schmuddi Feb 11 '18 at 8:15
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    You can find the 0,6-1 estimate in section 3.1. This number is consistent with other findings and is a lower limit for the actual number of deaths as some deaths are classified as suicide ore are covered up by relatives. – FooBar Feb 11 '18 at 10:30
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    The problem in this is that there can be a significant correlation between the death rate and the fact that it's big cities. Just thinking aloud, in big cities people are more bored in a sense and would more likely experiment; this is just a thought, no evidence, but the problem is that there's no evidence the other way. – yo' Feb 11 '18 at 20:55
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    The munich-dataset contains not only the data of the city of Munich, but also from the less populated area around it as not every smaller town has it's own coroner. – FooBar Feb 12 '18 at 8:05
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    @Schmuddi I believe the point he's making is that the figure falls close enough inline to the extrapolated average that we shouldn't consider it outright preposterous or surprising. However, this does nothing to verify the actual truth of the statement. – BooleanCheese Feb 12 '18 at 17:26
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tl;dr

Possibly. We cannot be sure. There are no official statistics about that.

The origin of this claim is German tabloid Bild:

80 bis 100 Tote jährlich durch Selbstbefriedigung 80 bis 100 Menschen sterben Schätzungen zufolge jedes Jahr bei riskanten Selbstbefriedigungspraktiken in Deutschland. Der Brandenburger Rechtsmediziner Harald Voß geht von ein bis zwei Fällen pro Million Einwohner aus. Die meisten Opfer sind Männer.
Der häufigste Grund für autoerotische Todesfälle sei die Lust durch Sauerstoffmangel, Hypoxyphilie genannt.

It is only an estimate made by a forensic expert Harald Voß that 1–2 deaths per million inhabitants are due to autoerotic mishaps, most commonly by asphyxiation (hypoxyphilia). A personal estimate uttered in an interview, there is no "new study" on this, as many new outlets regurgitating this story claim.

Every unnatural death in Germany is examined and the results are collected in encoded form by the Federal Statistical Office of Germany. They are then published on pages like these:

Gestorbene nach ausgewählten Todesursachen:

W00 bis W19  Stürze                       12 867 
X60 bis X84  Vorsätzliche 
             Selbstbeschädigung (Suizid)  10 078

As you can see, for specific causes of death there are usually very precise statistics. In the example above falls caused 12867 deaths a year and suicides 10078. The code in the front row of this table is ICD-10. That is one major problem for the claim in question.

Autoerotic asphyxia (hypoxyphilia) is a paraphilia and subcategory of sexual masochism characterized by self-strangulation up to the point of loss of consciousness to enhance sexual arousal. This paraphilia is not common enough to be included as a separate paraphilia within the latest editions of the […] International Statistical Classification of Diseases and Related Health Problems (ICD-10). Therefore, it is coded as paraphilia (deviatio sexualis) not otherwise specified. However, it is an accidental lethal sexual practice in which hypoxia (reduced oxygen supply to tissue, in this case brain), is used to enhance orgasm by strangulation, hanging, suffocation/ exclusion of oxygen with plastic bags.
Mahesh Chand Meena & Saloni Chadha: "Accidental Death Due to Autoerotic Asphyxia Coupled With Fetishistic Transvestism." International Journal of Medical Toxicology & Forensic Medicine. 2017; 7(3):189-193.

It was proposed in 1991: Autoerotic death. A definition. But didn't make it into the official coding system. When a death might have been caused by autoerotic practices then often those relatives finding the body are quite ashamed of the situation and clean up before officials arrive. So somewhere in the categories of unnatural deaths, most probably called accidents, suicides, are many of these cases hidden.

A nice overview of the problems related to classifying them is in Accidental Autoerotic Death:

As many cases of autoerotic deaths show combined aspects of masochism, transvestism, or transvestic fetishism, which disclose different degrees of sexual identification that are fundamental in reaching orgasm, the correct grading of AADs is difficult in both classifications, DSM–IV and ICD–10 (3,34). For these combined paraphilic cases, the term “multiplex paraphilias” was suggested (28, 35).

and with numbers to confirmed accidental autoerotic deaths:

Forensic aspects of 40 accidental autoerotic deaths in Northern Germany. (2005):
Between 1983 and 2003, 40 accidental autoerotic fatalities have been investigated. in the Institute of Legal Medicine in Hamburg. Only 50% (n=20) were autopsied (13 legal autopsies, 6 for scientific purposes and 1 for an insurance company). All the victims were males, aged between 13 and 79 years (among them five children and adolescents, the deceased mainly between 20 and 40 years). The paraphiliacs utilized a great range of devices and props as fetishism, sexual aids or pain-stimulating agents, like intimate feminine garments, ropes, chains, bondages, locks, pornographic magazines, condoms, rubber items, and chemical anaesthetics. The cause of death was strangulation in 20 cases (17 x hanging, 3 x ligature strangulation), 11 x suffocation (8 x under plastic bags, 3 x with face-masks, 2 x thoracic compression, 1 x positional asphyxia, and 1 x cocaine intoxication). Five cases without autopsy remained unclear because of missing morphological and toxicological findings; it could not be differentiated between asphyxiation/intoxication/natural disease, although the scene characteristics seemed to be typical for autoerotic deaths. It is emphasized that the findings at the scene, the morphological and toxicological examination of the dead body (full autopsy as prerequisite) by experienced investigators and the personal history of the deceased have to be evaluated very carefully and intensely to reconstruct the accidental fatal autoerotic course accurately and undoubtedly (to exclude the possibility of sexual homicide, neglected killing, or suicide).

To put this into a better perspective you might need some visuals:

Ungewöhnlich in den Tod: rare causes of death 1 and: rare causes of death 2 Showing that falls from ladders are quite deadly.

Sandra Kuhn estimates in her 2009 dissertation "Autoerotische Todesfälle in Hamburg und München 1983-2002" that 0,6–1 cases per year and per million inhabitants might be a reasonable number.

The new number given by Voß is significantly higher, but still only an estimate. Possible reasons explaining this discrepancy seem absent from this interview with him.

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    Interesting that they decided this didn't deserve an ICD-10 code, but "sucked into aircraft jet" (V97.33) did. There's also one for injuries sustained during a forced landing... of a spacecraft (V95.42.) I imagine that spacecraft forced landings are quite rare. – reirab Feb 11 '18 at 1:02
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    @reirab But perhaps cases of spacecraft forced landing can at least be determined with better confidence than autoerotic deaths – Hagen von Eitzen Feb 11 '18 at 8:51
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The number of auto-erotic asphyxiation deaths is actually assumed to be higher than reported because it is theorized that a good number of auto-erotic asphyxiation deaths are discovered by a family member or loved one who then "clean up" the scene to make it look like a regular suicide by hanging in order to protect the dignity of the departed and the loved ones they are survived by. In many cases even when auto-erotic asphyxiation is determined by a coroner the cause of death will be listed as something more ambiguous like "asphyxiation" or "death by misadventure."

The Coroner Talk podcast explains:

The prevalence of auto-erotic fatalities is difficult to calculate, since a coroner often records a verdict of accident or misadventure. It is under these labels that many auto-erotic deaths lie hidden. Sometimes, however, where uncertainty exists over whether the person intended suicide, the verdict is left open. Bereaved families usually prefer this.

The book Criminal Profiling: An Introduction to Behavioral Evidence Analysis estimates the rate of deaths:

The DSM-IV-TR summarizing data from the United States England, Australia and Canada, offers a range of "one to two hypoxophilia-caused deaths per million population are reported each year." Various authors report autoerotic asphyxial death mortality figures from an apparent low of 250 deaths per year to a higher, yet "conservative," estimate of 5,00 to 1,000 deaths annually."

It includes references and goes on to explain why it is difficult to estimate the rates of death and also the risks involved.

  • I'm a newbie, still getting used to the site, thanks for the advice man! I lost that course material years ago, but I will keep your advice in mind in future posts. – TCAT117 Feb 12 '18 at 8:26
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    Not just a family member. It is in the interests of coroners and the police to avoid the press descending on them, so it may well not actually be listed as "auto-erotic asphyxiation" on the death certificate. "Death by misadventure" covers it adequately, in the same category as falling off a ladder or whatever. Having known someone who did die from this (and I won't give details because I care about the family), I can state from personal experience that this is how it went. – Graham Feb 12 '18 at 10:41
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    @DaveSherohman this answer is not based on personal experience, but on (academic) education material. – Roland Feb 12 '18 at 14:55
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    I have made an edit that should address all the comments above. However, this answer still doesn't address the question: Do 100 Germans die per year from dangerous masturbation methods, including, but not limited to, autoerotic asphyxia? – Oddthinking Feb 13 '18 at 2:03

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