We need to talk about sexual strangulation because it has become common faster than accurate education about it. Many young people are seeing it in pornography or experiencing it with a partner before anyone explains what pressure on the neck can do to the body. When education is missing, normalization fills the gap. A dangerous act begins to look like an expected part of sex, and young people may agree to it without having the information needed to make a fully informed decision.
Part of that education must begin with the language we use. We need to call it strangulation, not “choking.” Choking happens when something becomes lodged inside a person’s airway. When hands are placed around someone’s neck and pressure is applied, it is strangulation. Calling it “choking” makes it sound playful or harmless. Calling it strangulation makes the danger harder to ignore. The pressure can restrict air or blood flow to the brain, and there is no risk-free way to do this, regardless of how lightly it happens or how quickly someone lets go (Brown University, 2025).
The study Prevalence of Sexual Strangulation/Choking Among Australian 18–35-Year-Olds surveyed 4,702 people and found that 57% had been sexually strangled. This included 61% of women and 79% of transgender and gender-diverse participants. The first experience most commonly happened between ages 19 and 21, but participants often learned about it earlier, between ages 16 and 18. Their most common source was pornography (Sharman et al., 2025). Pornography shows the hand around the neck, but it does not show the headache or difficulty swallowing afterward. It makes strangulation look expected while leaving the consequences outside the frame.
Consent education often responds by telling young people to “ask first.” Consent matters, but asking “Can I choke you?” is not enough if neither person understands what the act can do. Consent cannot prevent unconsciousness or brain injury. A yes cannot be fully informed when the risks have been hidden by normalization. A hand around someone’s throat should also never be a surprise. Consent to sex is not consent to strangulation, and previous consent does not create permanent permission.
The body does not get a clean slate after each experience. In Prevalence of Sexual Strangulation/Choking Among Australian 18–35-Year-Olds, participants who had been sexually strangled reported experiencing it an average of 5.6 times by more than three partners (Sharman et al., 2025). Each incident may expose the brain to another period of reduced oxygen or blood flow. The study Structural Brain Morphology in Young Adult Women Who Have Been Choked During Sex found that repeated experiences may be associated with changes in brain structure, although researchers are still working to understand the full long-term effects (Hou et al., 2023). Feeling fine afterward does not prove that no injury occurred. The absence of visible marks does not mean the body was unharmed, and surviving it before does not make the next time safe.
This conversation is not about shaming anyone who has wanted or participated in sexual strangulation. Shame makes people less likely to ask questions or seek help. But sex positivity cannot require silence about brain injury. People deserve honest information about what is happening to their bodies. We also need to ask why the risk is so gendered. If sexual strangulation is simply a mutually desired form of exploration, why are women and gender-diverse people so often the ones placed in danger? How many people genuinely want it, and how many agree because they do not want to seem “vanilla”?
Sexual strangulation has become common, but common does not mean safe. Consent does not remove the physical risk, and surviving it once does not make the next time safe. We owe young people more than softened language and vague warnings. If we want them to make informed decisions, we have to tell the truth about what pressure on the neck can do to the body, even when that truth makes us uncomfortable.
Sources
Brown University. (2025). Sexual Strangulation.
Hou, J., et al. (2023). Structural Brain Morphology in Young Adult Women Who Have Been Choked During Sex.
Sharman, L. S., Fitzgerald, R., and Douglas, H. (2025). Prevalence of Sexual Strangulation/Choking Among Australian 18–35-Year-Olds.