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

A new study published in Archives of Sexual Behavior reports that sexual strangulation is a prevalent practice among young Australians, with positive perceptions influenced by beliefs about its safety, social normative factors, and exposure to depictions in pornography.

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

A total of 4702 Australian participants between ages 18-35. Participants provided their demographics, including gender, sexual orientation, relationship status, education status, and ethnicity. They completed survey items assessing their awareness of sexual strangulation, sources of information, and discussions with peers.They responded to questions about their experiences with being choked or choking a partner during sex, the frequency of these experiences, the method used (e.g., one hand, two hands, belt, rope), and the pressure exerted on 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 engaged in sexual strangulation provided additional details about the context and consequences of their experiences, including whether consent was given, how it was communicated, and any positive or negative outcomes.

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

Similarly, 51% of participants reported ever strangling a partner, with men (59%) and transgender or gender diverse individuals (74%) more likely to have engaged in this behavior compared to women (40%). The most frequent method of choking reported was one-handed, followed by two-handed. The pressure applied was most often reported as moderate (level 4 out of 7), with some participants indicating minimal pressure.

Positive perceptions of sexual strangulation were associated with the belief that it could be done safely and social normative factors. Exposure to depictions of strangulation in pornography and prior experiences predicted positive perceptions of both being choked and choking a partner.

Participants who perceived strangulation as an expected part of sex, believed it could be done safely, and discussed it with peers were more likely to have positive perceptions of the practice. Interestingly, the impact of pornography exposure on positive perceptions was mediated by these beliefs and social discussions.

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

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

The study, “Prevalence of Sexual Strangulation/Choking Among Australian 18–35 Year‐Olds,” was authored by Leah S. Sharman, Robin Fitzgerald, and Heather Douglas.