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Americans have been feeding their sexual appetite with BDSM far more than the rest of the world. Thirty-six percent of adults in the U.S. use masks, blindfolds, and bondage tools during sex, according to a survey by Durex, compared to only 20 percent worldwide. Although the American Psychological Association's Diagnostic and Statistical Manual (DSM-5) considers the elusive fiefdom practice a disorder if it causes people stress or dysfunction in their lives, it can actually enhance overall well-being.