Sexual strangulation can mean ‘minutes to death’, yet half of young people do it

Sexual strangulation has become so popular that more than half of Australian young people have used it for pleasure, though it can cause lasting brain damage in seconds and death within minutes.

Known as sexual “choking”, the practice has taken off because it is mainstreamed in contemporary pornography, researchers say, but new national data shows it is so widespread that 57 per cent of those aged 18 to 35 have been strangled during sex at least once.

More than half (51 per cent) had strangled a partner during sex, according to a study of 4702 young people around Australia by the University of Melbourne Law School and the University of Queensland.

Dr Jo Parkin, a forensic physician, examines those with injuries from sexual strangulation and says there is no safe way to do it.Credit: Jason South

Close to one-third of those who had been strangled by a sexual partner were aged between 19 and 21 when it first happened. Respondents who had been strangled had it done an average of five times, by three partners, the research, published on Tuesday in Archives of Sexual Behavior, found.

Police, physicians and the researchers, led by Professor Heather Douglas, say there is no safe way to use choking during sex. They say understanding of the dangers is so lacking that even those who consent to it are not aware of the grave risks to their brain health and life.

Douglas said brain injury from repeated strangulation could build up, like the impact of concussion among sportspeople. Symptoms, including stroke, could occur up to many months later.

Strangulation in sex is the second most common cause of stroke in women under 40, UK research suggests.

“It [sexual strangulation] is happening incredibly frequently, people are doing it regularly … and half the people are doing it at least several times,” said Douglas, who has been researching non-lethal strangulation for several years.

“Brain injury accumulates – the more times you are strangled, the greater the impact on the brain. I suspect there are probably a lot of young people with impacts on their brain as a result of this behaviour and that’s incredibly concerning.”

Blood clots, “thyroid storm” – increased heart rate, blood pressure, and body temperature that could be fatal – and miscarriage might happen in the weeks or months after strangulation, Douglas said.

Consent campaigner Chanel Contos has warned that choking is considered normal in her age group even though it is highly unsafe.Credit: Alex Ellinghausen

Pressure on young women not to be vanilla in their sexual practice was contributing to the rise in the popularity of choking, the experts said, though many young women in the new research were comfortable giving consent.

Women’s safety experts have long warned that strangulation is an indicator of potential future homicide. Consent advocate Chanel Contos has been warning since 2022 that choking, though never safe, has been normalised from kink to “not out of the ordinary” in her age group.

Forensic physician Dr Jo Parkin said sexual strangulation was exceptionally dangerous, and sexual choking memes were being promoted in social media hashtags.

“In terms of what [young people are] seeing, it’s not just the hands around the neck; it can be a ligature, clothing, it can be rope or just a forearm across the neck,” said Parkin.

“It can be legs used in what is being promoted as a playful hold, but it isn’t. There is no safe level of neck compression in a community setting.”

She said it was not possible to give informed consent because people did not understand the risks, “which are in seconds a loss of consciousness and minutes to death”.

“They don’t understand the anatomy of the neck and the risk of compression of the vital structures,” Parkin said. “Within seconds, once you’ve lost consciousness, you can have seizures, and ongoing compression leads to death.”

There have been documented cases where serious impacts to the brain from sexual strangulation have not appeared until one year after the incident. But in 40 to 50 per cent of cases that Parkin and her colleagues examine at the Victorian Institute of Forensic Medicine, there are no external symptoms or signs of it at the time.

Jackie McMillan, senior project officer at Women’s Health NSW, said it was important for those using choking to understand you could acquire a brain injury without losing consciousness, and other symptoms were an indication urgent medical help should be sought.

“More serious choking involves loss of consciousness and sometimes urination and sometimes defecation; so if you engage in sexual choking and one of these things happens, you definitely need to seek medical advice,” she said.

Violence-prevention educator Maree Crabbe said that as well as pornography influencers, mainstream TV was showing sexual strangulation as “a relatively normal part of the sexual script”.

Young people she had interviewed for a forthcoming campaign around sexual strangulation, Breathless, said they believed it could be done safely.

Maree Crabbe says pornography companies are promoting strangulation during sex, which can be deadly.Credit: Eddie Jim

“People from different places, cultural backgrounds and socioeconomic groups all talked about strangulation being normal; our team was shocked,” she said.

“What was really concerning was the way it was framed as about being adventurous … and if they express lack of enthusiasm, or resistance, to engaging in strangulation or other rough sex, they are seen as vanilla and that’s shameful.”

Crabbe said the fact porn was promoting consent of very dangerous practices “raises questions about having multibillion-dollar industries shaping our sexual experience in ways that put other people’s lives at risk”.

More support for young people was required to help define who they want to be in their sexual roles.

A Victoria Police spokeswoman said if someone consented to sex, it did not mean they consented to other acts, and that non-consensual strangulation during sex was assault.

“There needs to be clear and affirmed consent before and during the act. We want to make it clear that there is no safe way to strangle someone.”

Support is available from the National Sexual Assault, Domestic Family Violence Counselling Service at 1800RESPECT (1800 737 732).

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