SM play requires a high degree of trust for the Top (giver of the play) by the bottom (receiver of the play). The bottom will be made helpless in bondage, and/or be on the receiving end of sensations ranging from sensuousness to extreme pain. For a bottom to voluntarily put oneself in that position the bottom must be confident the Top is skilled enough in what is being done to do it safely, is sane enough not to want to do real harm, and will not exceed the bounds of the bottom's consent on what is done.
There are no national or world certifying bodies that certify Tops. A Top's ability to find play partners depends much on a Top's reputation which always spreads out much farther than a Top will realize. Bottoms do talk to each other.
The risk of SM play varies according the kind of play being done. But in general any significant amount of play involves greater risk than most everyday activity. It is the responsibility of the Top to be aware of these risks, take them seriously, and do all that can be done to reduce or eliminate them.
In every training seminar or reading of how to play there will be safety warnings given. On rare occasion the information given is not accurate or over cautious. But the vast majority of the time this information is coming from kinky medical professionals who know of what they speak. The are also lessons learned from disasters suffered by BDSM players who have gone before you and you do want to avoid learning these lessons the same way they did. To do so is to make mistakes that many times cannot be reversed. Mistakes causing injuries that result in permanent changes to lives or even death. You can only exist in time before such damage only once. If such disasters happen there is no "I will get it right next time" or going back in time to do it differently. You want to avoid a lifetime of flashbacks and thinking "if only I had known" or "I had done it differently." Before the play is the time to be educated in what can happen and to think proactively beforehand rather than reactively after the fact. By far the vast majority of the disasters that can happen are easily avoided once the dangers are known and the knowledge acted upon.
Most BDSM play requires training to do it in a safe manner.
There is also SM play that risks severe injury and death in spite of how carefully and skillfully done. These are to be avoided. Examples of such plays are Breath Control and Flat Lining.
Anything done by the Top to the bottom is done by the consent of the Top and most especially the consent of the bottom. Before playing with anyone there must be a negotiation over what will be done and who will do it. This must be done before the players get into the roles of Top/bottom Dominant/submissive Master/slave or Mistress/slave. Play is something the Top does for the bottom. The Tops goal and responsibility is to provide a good experience for to the bottom and never do anything to cause the loss of trust.
It is not considered BDSM practice to force it on anyone. It is considered criminal. (example 1, example 2, example 3, example 4). Consent must never be assumed. It must be explicitly negotiated in advance, and safe words must be respected.
When seeing someone else with something desirable, whether it is a material thing or an ability, it is a natural thing to want the same for yourself. And so when seeing an impressive play technique that is new to yourself it is a natural desire to imitate it before being trained in it. It may be a rope tie up you are tempted to reverse engineer. It may be a spectacular fire play scene where the bottom's skin is set briefly on fire. But there is a background of knowledge necessary to do most play safely which is not evident in the displayed scene. In a bondage scene it is not possible to follow the path of every rope. An incorrectly tied knot in a suspension scene can fail with disastrous consequences. A rope routed over the wrong place, such as where the Brachial Nerve is exposed between the muscles on the upper arm, can lead to temporary or permanent paralysis of a limb or numbness of an area of skin. In fire play the wrong alcohol can burn too hot. Even the right alcohol when placed on vertical skin can cause rapid burns due to the natural upward motion of the flame. There are many easily avoided pitfalls like these that are easily fallen into without training. There are no shortcuts around it. Playing safely requires training.
Play training is easily available. In recent years there has been an explosion of interest in BDSM play in the general public and this has lead to a plethora of organizations providing it. Also skilled players are generally very generous with their knowledge. Everyone wants to be the teacher. They consider it an honor to be asked how something is done. This is very different from many years ago when BDSM was more underground, when a skill in a technique was considered and advantage in getting play partners, and so passed on to only a chosen few in a similar way that fighting techniques were kept within samurai families. Most of the time if you ask you will make a friend who will give you the necessary knowledge.
Assault laws are a little bit different in every state. But what they have roughly in common is that any physical threat is considered an assault. Any physically threatening touch, whether or not the touch has enough impact to batter and injure, is assault and battery.
Consent to being assaulted cannot be used as a defense. It seems there is a double standard here because it is an adequate defense for a football player or boxer within the rules of their sports. We think of SM play similarly. But a prosecutor may not.
The laws that make consent an inadequate defense were meant to protect domestic violence victims who are too intimidated to file charges. There has been outreach to law enforcement and medical personnel as to what patterns of body markings are produced by BDSM play so the evidence can be differentiated. For example a herring bone, or rib cage pattern, of red strips down a person's back is indicative of BDSM play. When such differentiation is made a prosecutor may decline to prosecute, or a doctor or nurse may decline to make a report.
But there are no guarantees. Outreach may not have reached such personnel. Or in spite of having been reached they might proceed anyway due to disapproval of SM play. Or in spite of having the outreach education the inability to tell the difference anyway. Prosecutions for consensual SM play, where there are no complaints on the part of the bottom, are very rare. But every time a Top plays even the most careful and honorable of them take a chance as small as it is: reference 1, 2.
The National Coalition for Sexual Freedom keeps an eye on proposed legislation that will adversely affect BDSM practitioners. They have an Action Alert Web page where such issues are announced and a subscriptions for emailed alerts done. Recommendations on what to do are included in the alerts.
There is a list of "Bad Five" practices that are high risk physically for the bottom and legally for the top. This is a List of practices were no degree of training and precautions will eliminate the risk of severe injury, including injury leading to death. If doing these Bad Five goes wrong the Top will be in one of the following liability categories: "Gross Negligence," "Willful and Wanton Misconduct," and "Intentional Acts." There is no defense for the Top that can move the Top to the categories of "Negligence," "Strict Liability," "Pure Accident," or "Act of God" in the first four. The consequences to the Top are severe financially and criminally. This list is:
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