# Should I tell my GP or therapist?

> When a GP genuinely needs to know and how to say it in one line, why they ask about safety, how records work, and how to find a therapist who will not flinch.

- Canonical URL: https://consensualspanking.co.uk/questions/should-i-tell-my-doctor/
- Section: Questions
- Updated: November 2026 (2026-11-01)
- Audience: consenting adults over 18 only. Everything on this site concerns consenting adults over 18.

Plenty of people put off an appointment for weeks rather than say one sentence. The sentence is shorter than you think and the reaction is usually duller than you fear. A doctor who has been told the truth can treat you properly, and one who has been given a cover story cannot.

---

## In short

- A GP needs the mechanism of an injury, not the story. One plain sentence that includes the word consensual covers it.
- Consensual activity between adults is not something a GP is required to report. Being asked about safety and coercion is good practice, not judgement.
- You never have to raise kink with a therapist. If you want to, [Pink Therapy](https://www.pinktherapy.com) and [COSRT](https://www.cosrt.org.uk) list experienced practitioners.
- Your GP record is shared with clinicians involved in your care. An employer or insurer needs your written consent before anything is sent to them.

Everything here concerns consenting adults over 18. I am not a doctor or a therapist, and none of it is medical or legal advice. The short version: tell a GP when it bears on what they are treating, in one plain sentence, and leave it there. With a therapist it is entirely your choice whether to bring it up. If you want to, pick one who already works with kink, so you are not spending your sessions explaining it.

## When a GP genuinely needs to know

- An injury from a session, such as skin that has split and will not close, or numbness still there the next day. The mechanism changes the treatment, so they need it. What needs seeing, and how soon, is on [marks and bruising](https://consensualspanking.co.uk/guide/marks-and-bruising/).
- Marks they will see while examining you for something else. Cervical screening, say, or a physiotherapist looking at your back. You are not obliged to say anything, but one line in advance saves you both a pause. Moving a routine appointment by a week until the marks fade is perfectly reasonable. Moving an urgent one is not.
- Questions about bruising itself. Ask why you bruise so easily and leave out the cause, and you may end up with blood tests for a clotting problem you do not have. Equally, if you bruise far more than the force would explain, say what happened and let them judge, because easy bruising can be a sign of something real.
- Medication. Anything that thins the blood changes the picture, and [health and medication](https://consensualspanking.co.uk/guide/health-and-medication/) says what to ask before arranging anything. For a new prescription, "does this affect bruising or bleeding?" gets the answer from a GP or pharmacist without any context.

Outside those, there is no reason to bring it up.

## How to say it

At the start, before they find it. Plainly, with no apology and no joke. And with "consensual" and "I am safe" in the first breath, because that answers the question they would otherwise have to ask.

- "These bruises are from consensual spanking at the weekend. I am safe. I am here because this one has not gone down."
- "I was hit with a cane on Saturday, consensually. The skin split and it is not healing."
- "Before you examine me, there are some marks. They are from something consensual and they are not why I am here."

That is a complete disclosure. You do not have to say who with, or why you enjoy it. If saying it aloud is beyond you, type it on your phone and turn the screen round. You can also ask for a chaperone, or for a clinician of a particular sex, and practices will usually try to arrange it.

What I would avoid is the cover story. An explanation that does not fit the injury is one of the things clinicians are trained to notice, and "I slipped in the bath" over a set of straight parallel lines sends the appointment somewhere you did not want it to go. The truth gets you out of the room fastest.

## Will they report it?

Consensual activity between adults is not something a GP is required to report to anyone, and yours is unlikely to be the oddest explanation for a bruise they hear that week.

What they will quite probably do is ask whether you are safe, and whether anyone is hurting you, possibly after asking whoever came with you to step outside. That is not a judgement on you. Some abuse first comes to light in a consulting room as an injury with an explanation attached, and the question is there for the patient who cannot raise it unprompted.

I would think less of a GP who did not ask. Answer it straight and that is usually the end of it.

Confidentiality does have limits. A clinician can share information without your agreement in narrow circumstances, mainly where they believe someone else is at serious risk of harm, or where the law requires it. An adult explaining a consensual bruise and saying plainly that they are safe is not that situation. If you are not safe, though, this is a good room to say so in.

## If a clinician reacts badly

Most will not. Some do: a lecture, or a refusal to believe you that carries on after you have answered the safety question clearly.

In the room, "is that clinically relevant?" is a fair and polite question. Afterwards, you can ask to see a different GP at the same practice without giving a reason. Every practice has a complaints procedure, and you can register elsewhere if it comes to that. Just do not let one bad appointment stop you going back the next time you need to.

## Therapists: you do not have to raise it

You can spend a year in therapy for grief or work stress and never mention it. That is not a failure of honesty.

There are two good reasons to raise it. One is that it is the thing you want to talk about: shame about wanting it, say, or a session that went wrong and has stayed with you. The other is that keeping it out is costing you, because you are editing yourself in the one room where you are not supposed to.

If you do want to, choose the therapist for it rather than hoping.

- [Pink Therapy](https://www.pinktherapy.com) runs a UK directory of therapists experienced with gender and sexual diversity, which includes kink.
- [COSRT](https://www.cosrt.org.uk), the College of Sexual and Relationship Therapists, lists registered sex and relationship therapists.
- The [BACP directory](https://www.bacp.co.uk/search/Therapists) covers counsellors and psychotherapists and can be filtered by specialism and location.

Ask before you book, in the short introductory call many therapists offer: "Have you worked with clients who practise BDSM, and how do you think about it?" A good therapist also explains the limits of confidentiality at the start. If yours does not, ask.

The one to screen out treats the interest as a symptom to be traced back to a cause. The DSM-5-TR does not see it that way: it separates sexual masochism, a preference, from sexual masochism *disorder*, which additionally requires clinically significant distress or impairment. A therapist who does not know that distinction is the wrong therapist, and you can stop after one session without explaining why.

## What good and bad look like

|   | A good response | A bad response |
| --- | --- | --- |
| The safety question | Asked once, clearly, and accepted when you answer | Never asked, or asked again and again after a clear answer |
| Detail | Asks what changes the treatment and nothing more | Asks for detail out of curiosity |
| Tone | Matter of fact, as if you had said you came off a bike | A lecture or a joke |
| Other symptoms | Looked at on their own merits | Everything traced back to the kink |
| In therapy | Interested in what it means to you | Treats it as something to explain away or cure |

## Your records, in general terms

- What you tell a GP may go into your notes, which are shared with the clinicians involved in your care. An employer or an insurer needs your written consent before anything is sent to them.
- You can ask what is being written, and ask for plain wording. "Bruising following consensual activity" is factual and dull, which is what you want.
- You have the right to see your records. If something is factually wrong you can ask for it to be corrected. A clinician's opinion is harder to remove, but you can ask for your own account to be added.
- In England, new entries in your GP record now appear in the NHS App by default, and you can ask the practice to turn that off. If anyone else can get into your phone or your email, think about that before the appointment.
- A private therapist keeps their own notes, separate from your GP record. NHS therapy services may keep your GP informed, so ask what gets shared.

> ## If you are not safe
>
>
>
> If the marks were not agreed, or you agreed under pressure, that is not a kink question, and your GP is one good person to tell. The National Domestic Abuse Helpline is 0808 2000 247, free and 24 hours. The Men's Advice Line is 0808 8010 327. The Samaritans are on 116 123 at any hour, about anything, and Mind has information on finding mental health support at [mind.org.uk](https://www.mind.org.uk). In immediate danger, call 999. See also [getting help and support](https://consensualspanking.co.uk/support/).

## Read next

- [Health conditions and medication](https://consensualspanking.co.uk/guide/health-and-medication/)
- [Marks and bruising](https://consensualspanking.co.uk/guide/marks-and-bruising/)
- [Is there something wrong with me?](https://consensualspanking.co.uk/questions/is-there-something-wrong-with-me/)
- [Getting help and support](https://consensualspanking.co.uk/support/)
- [Mental health and spanking](https://consensualspanking.co.uk/guide/mental-health/)

## Sources

1. American Psychiatric Association, *Diagnostic and Statistical Manual of Mental Disorders*, 5th edition, text revision (2022). Sexual masochism disorder criteria.

## Common questions

### Do I have to tell my doctor my bruises are from spanking?

Only when it bears on why you are there, and even then the doctor needs the mechanism rather than the story. "These are from consensual spanking at the weekend, and I am safe" is a complete answer. It matters most when you are asking about the bruising itself, because an unexplained bruise can lead to tests for a bleeding problem you do not have.

### Will my GP report me for BDSM?

Consensual activity between adults is not something a GP is required to report. Clinicians are trained to ask about safety and coercion when they see injuries, and may ask you on your own whether you feel safe. That is ordinary good practice rather than suspicion, and a plain answer is usually the end of it. Confidentiality does have limits, mainly where a clinician believes another person is at serious risk of harm, or the law requires disclosure.

### How do I find a kink-friendly therapist in the UK?

Pink Therapy runs a UK directory of therapists experienced with gender and sexual diversity, including kink. COSRT lists registered sex and relationship therapists, and the BACP directory can be filtered by specialism and location. Before booking, it is reasonable to ask whether they have worked with clients who practise BDSM and how they think about it.