He began working as a busboy at 15 at McMaster University in Hamilton, Ontario and, due to his parents' ill health, became the family's breadwinner at age 23.
During this time, Hofsess produced 1967's Palace of Pleasure (which had a brief David Cronenberg cameo) and Columbus of Sex, which were praised by avant-garde critics.
Columbus of Sex, which Hofsess made for US$3,000 while attending McMaster, was re-edited with new footage and retitled as My Secret Life for U.S. release in the early 1970s.
In 1991, Hofsess created the Right to Die Society of Canada which targeted laws that made assisting suicide a crime.
[4] After assisting in the suicide of others in at least eight instances, Hofsess took his own life at a clinic of the Eternal Spirit Foundation, near Basel, Switzerland.