This stuff was definitely on Barker's mind for a while. He made a short film 11 years earlier called "The Forbidden" with a lot of the same elements. The pins, the flaying, etc.
I recall an interview with Coil, who were working on the original soundtrack, that they handed Clive Barker a BDSM magazine which pointed him in that direction.
Given that gay men's chances of ending up a missing person after picking up the wrong person is nonzero, it's more the "fear of running into the wrong person". The kind that gets homicidal about Romans 1 AFTER the encounter. Clive Barker was once a m4m sex worker - this was a real concern.
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