Sexual sadism disorder is characterized by taking sexual pleasure from humiliation, fear, or another form of mental harm to a person. Sadistic acts include restraint (such as ropes, chains, or handcuffs), imprisonment, biting, spanking, whipping, or beating. When someone repeatedly practices these sadistic sexual acts without consent from their partner(s), or when sadistic fantasies or behaviors cause social, professional, or other functional problems, sexual sadism disorder may be diagnosed. Extreme sexual sadism can be criminal, and lead to serious harm or even the death of another person.
Sexual sadism disorder falls under the category of paraphilic disorders, which are characterized by sexual interests, preferences, fantasies, urges, and behaviors considered to be "atypical." These interests, preferences, and behaviors are considered symptoms of a disorder only if they are acted upon in ways that have the potential to cause distress or harm to oneself or others, especially others who have not given consent.
Healthy sexual activity can include a wide array of behaviors and activities, which, when fantasized about or experienced between consenting adults can bring people pleasure. The majority of individuals who are active in BDSM (Bondage/Discipline, Dominance/Submission, and Sadism/Masochism) relationships or communities do not express any dissatisfaction with their sexual interests, and their be­havior would not meet the criteria for sexual sadism disorder. In fact, many who engage in BDSM, (sometimes referred to as "kink") within the context of romantic relationships report that it brings them closer to their partner(s) due to increased feelings of trust that result from setting and respecting boundaries, as well as the emotional safety that comes from being able to explore less conventional sexual interests without judgment.