Study shows that strangulation during sex is common among young Australians despite known risks

A new study published in Archives of sexual behavior reports that sexual strangulation is a widespread practice among young Australians, with positive perceptions influenced by beliefs in the safety of the practice, societal normative factors and exposure to pornographic depictions.

Dangers of sexual strangulation – a practice often referred to as choking– range from minor injuries such as bruising to severe consequences such as neurological damage, unconsciousness, or even death. In this work, researchers Leah S. Sharman and her colleagues investigated the prevalence and predictors of positive perceptions of this practice.

A total of 4702 Australian participants aged between 18 and 35 years. Participants provided their demographic information including gender, sexual orientation, relationship status, education level and ethnicity. They completed survey questions assessing their awareness of sexual strangulation, sources of information and discussions with peers. They responded to questions about their experiences of choking or strangling a partner during sex, the frequency of these experiences, the method used (e.g. one hand, two hands, belt, rope) and the pressure applied to the neck.

To measure perceptions of sexual strangulation, participants rated their agreement with statements about the safety and normative nature of the practice, as well as their personal enjoyment and desire to engage in it, on a 5-point Likert scale. Those who had experienced sexual strangulation provided additional information about the context and consequences of their experiences, including whether consent was given, how it was communicated, and whether there were positive or negative consequences.

The researchers found that 57% of participants reported having been sexually strangled, with significant differences between genders. Women reported the highest prevalence at 61%, followed by transgender or gender diverse people at 79% and men at 43%.

Similarly, 51% of participants reported having strangled a partner, with men (59%) and transgender or gender-diverse individuals (74%) engaging in this behavior more frequently than women (40%). The most commonly reported method of strangulation was one-handed, followed by two-handed. The level of pressure applied was most commonly reported as moderate (level 4 of 7), with some participants reporting minimal pressure.

Positive perceptions of sexual strangulation were associated with beliefs that it could be performed safely and with social normative factors. Exposure to depictions of strangulation in pornography and previous experiences predicted positive perceptions of both choking and partner choking.

Participants who viewed strangulation as a natural part of sex, believed it could be performed safely, and talked about it with peers were more likely to have positive perceptions of the practice. Interestingly, the influence of pornography consumption on positive perceptions was moderated by these beliefs and social discussions.

The study also identified several negative consequences of sexual strangulation, although these were less commonly reported compared to the positive consequences. These included physical injuries such as bruising and sore throats, as well as more serious consequences such as neurological damage.

A limitation of this study is that it relies on self-reported data, which may be subject to recall and social desirability bias.

Authors of the study “Prevalence of Sexual Strangulation/Choking Among Australian 18–35 Year‐Olds” are Leah S. Sharman, Robin Fitzgerald and Heather Douglas.