Are rates of anxiety, depression, or PTSD higher among participants in cuckolding relationships?
Executive summary
There is no reliable, population-level evidence showing that participants in consensual cuckolding relationships have higher rates of anxiety, depression, or PTSD; the academic and popular literature is mixed, with clinical/review papers framing cuckolding as linked to prior trauma and dysfunction [1] [2] while empirical and clinical commentators report many participants experience satisfaction and no psychopathology [3] [4] [5]. The available sources indicate contested interpretations, sampling bias, and a lack of epidemiological studies, so any definitive claim that these mental‑health conditions are more prevalent among cuckold participants is not supported by the provided reporting [1] [2] [3] [5].
1. What the evidence actually measures — small clinical samples versus broader surveys
Several clinical reviews and case-series argue cuckolding and related paraphilias often co‑occur with trauma histories and relational dysfunction, reporting that study samples overwhelmingly endorsed traumatic affective or sexual events in adolescence or early adulthood as antecedents [1] [2], but those papers draw on selected clinical or convenience samples and characterize the phenomenon as a paraphilia or borderline relational form rather than measuring anxiety, depression or PTSD prevalence in a general cuckold population [1] [2]. By contrast, larger survey‑based research and sex‑research commentary finds people who enact cuckolding fantasies often report improved relationship satisfaction and wellbeing, and studies of gay men's cuckolding fantasies describe demographic and thematic patterns without concluding elevated psychiatric diagnoses [3] [5]. The discrepancy traces to different methodologies: clinical case reviews that invite pathologizing interpretations versus community surveys that capture consensual, nonclinical practice [2] [3] [5].
2. Clinical and popular commentators: two competing narratives
Clinical reviewers—such as the Perrotta review and related work—frame cuckolding and troilism as linked to defense mechanisms and psychopathological processes and infer traumatic origins from self‑report in clinical samples [1] [2]. That framing can reflect an implicit agenda to classify non‑normative sexual behavior as pathological. Opposing voices—including practicing clinicians and sex‑research writers—explicitly warn that most cuckolding and swinging do not indicate mental illness and that consensual role play can be healthy when boundaries and aftercare are observed [4] [6] [7]. Psychology Today’s synthesis and sex‑research studies report that many who act on cuckolding fantasies say it improves relationship satisfaction, undermining a simple pathology narrative [3] [5].
3. Emotional risks and real harms — what reporting does document
Several practical sources and self‑help discussions note that cuckolding dynamics can produce intense emotions—jealousy, shame, insecurity—or become distressing when fantasies conflict with values or when consensual rules break down, and in those circumstances individuals report impaired wellbeing or need therapy [8] [9] [7]. These accounts document plausible pathways to anxiety or depression for some participants, but they do not quantify rates or establish causation; they instead describe individual distress, financial harms, or relationship breakdowns in some cases [8] [9].
4. Why it’s impossible to answer yes/no with confidence right now
None of the provided sources present representative epidemiological data comparing rates of diagnosed anxiety disorders, major depression, or PTSD between people who engage in cuckolding and appropriate control populations; the literature is dominated by clinical reviews, opinion pieces, convenience surveys, and qualitative accounts [1] [2] [3] [5]. Given likely sampling biases in clinical samples and self‑selection in community surveys, the reporting cannot sustain a conclusive claim that these disorders are systematically higher in cuckolding participants than in comparable groups [1] [2] [3].
5. Practical takeaway and research needs
The balanced inference from the available reporting is that consensual cuckolding is not intrinsically indicative of anxiety, depression, or PTSD for most participants and can be associated with improved relationship satisfaction for some [4] [3] [5], while a subset—particularly those with prior trauma, covert coercion, shame, or conflicting values—may experience clinically significant distress [1] [8] [9]. Definitive answers require representative, controlled studies that measure psychiatric diagnoses and control for trauma history, consent quality, and relationship context; absent such data, claims of higher prevalence are speculative [1] [2] [5].