Currently, Patient works as an independent “escort,” specializing in sadomasochistic role-play. According to patient’s own account, her clientel... are mostly men, and are evenly divided between submissives and dominants. She self-divulges that she enjoys her work, and gains sexual pleasure from playing both the dominant or submissive role (301.50 Histrionic Personality Disorder). Patient self reports sexual arousal from object insertion, vaginally, anally, and orally during role-playing (302.9. She was back working on my neck and happened to look down. “Oh my, what have I done? I do apologize, I’m really not that type of girl,” she stammered. “It's okay honey, This happens all the time as I don’t have much of a social life with my work and my size makes me seem obvious. No harm, no foul.” “It must be tough on you, I mean, you are constantly on the go and can’t form any relationships.” “Well at my age, it isn’t that important. I’m sixty-five and will work another year or two and retire. More

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