More than two in five sexually active under-18s in the UK have either been strangled or strangled someone during sex, research has found, despite the serious dangers of the practice.
“Choking”, as it is commonly known, has become normalised in young people’s sexual habits, the study by the Institute for Addressing Strangulation (Ifas) showed, with 43% of sexually active 16- and 17-year-olds having experienced it.
More than half of people under the age of 35 have experienced it, with nearly a third wrongly believing there are safe ways to strangle someone.
The survey also revealed a crisis of distress among those on the receiving end, with 36% saying they felt scared during the experience and 21% suffering dangerous physical symptoms, including dizziness and even loss of consciousness.
It also showed a consent gap, with more perpetrators of strangulation believing their partner had consented to it in advance than those who had experienced it, with 1% saying they had explicitly not agreed to it the last time it happened.
Though both genders were fairly equal in having been on the receiving end, at 47% men and 52% women, men were considerably more likely to have carried it out. Of those who had strangled someone else, 5% said they had done it more than 50 times.
In recent years, “choking” has become part of a dangerous drift towards increased violence in mainstream pornography, which was cited as the biggest source of information about the practice among the respondents.
Pornography featuring strangulation and suffocation is to be outlawed in the UK at the end of this year, with a legal requirement placed on tech platforms to prevent users from seeing such material.
Clare McGlynn, a professor of law at Durham University and the author of Exposed: The Rise of Extreme Porn and How We Fight Back, said strangulation in pornography was a recent phenomenon.
“Depictions of strangulation and suffocation are brutal and graphic, often involving belts tied around necks, plastic bags over women’s heads, and two hands gripping the neck.”
She called for a national campaign to raise awareness of the real risks and harms of the practice, which could occur even when there was no visible injury.
More than a fifth of respondents to the survey by Ifas, part of the Faculty of Forensic and Legal Medicine of the Royal College of Physicians, said they had suffered physical effects, including pain in the neck, dizziness and coughing.
One in 50 people said they had lost consciousness and the same number experienced incontinence of the bladder during or after the strangulation, with one in 100 respondents saying they lost bowel control.
Most respondents who experienced physical symptoms did not get medical help afterwards because they were unaware of how serious the problems could be.
Numerous studies have shown brain changes in women who have been repeatedly “choked” during sex, including markers for brain damage and disruptions in brain hemispheres linked to depression and anxiety.
Nearly half (47%) of the survey respondents said they had experienced anxiety during or after being strangled.
Prof Cath White, a medical director at Ifas, said even a “fleeting moment” of strangulation could lead to lifelong health problems.
She added: “Respondents in the survey often linked strangulation during sex to ‘enhanced orgasms’ or ‘pleasure’, but in reality that sensation may be the result of brain cells being deprived of oxygen – and once those cells die they cannot regenerate … The truth is that strangulation – and especially repeated strangulation – increases the risk of nerve damage, damage to the brain, stroke and even death. What might feel like a fleeting moment can have consequences that last a lifetime.”
Among those who had engaged in strangulation only 38% said they had done it because they enjoyed it, with the most common reason being their partner’s enjoyment, at 46%. Sexual partners were the greatest source of encouragement for the practice among those surveyed.
Harriet Smailes, the author of the report and research manager at Ifas, said the research should “raise questions around influences and feelings of choice in practising strangulation during sex”.
She added: “There are still many individuals who believe strangulation to be a ‘normal’ part of sex, worry about what their partner or friends will say if they don’t engage in it, are strangled during sex without prior agreement and are physically or psychologically harmed during the practice.”
Non-fatal strangulation was introduced as a stand-alone criminal offence in 2021 and the law recognises that someone cannot consent to the infliction of a serious level of harm or to their own death for the purposes of sexual gratification.
This was in response to a rise in the use of the “rough sex” defence among men who murdered women during sex or rape to escape justice or receive a lesser sentence.
Strangulation was the cause of death in 27% of cases where women were killed, according to the Ifas femicide census. A total of 550 women in the UK have been strangled to death since 2014.
