Nearly half of sexually active young people in UK have experienced strangulation, study shows | Sexual health

In the UK, more than two in five sexually active young people under 18 have been strangled or have strangled someone during sex, research shows, despite the serious dangers of the practice.

“Choking”, as it is commonly called, has become normal in the sexual habits of young people, according to the study by the Institute to Combat Strangulation (Ifas), 43% of sexually active young people aged 16 and 17 have experienced it.

More than half of people under the age of 35 have experienced it, and almost a third mistakenly believe there are safe ways to strangle someone.

The survey also revealed a distress attack among those who benefited, with 36% reporting they were scared during the experience and 21% suffering dangerous physical symptoms, including dizziness and even loss of consciousness.

The study also showed a consent gap, with more strangulation perpetrators believing their partner had consented to it in advance than those who had experienced it, with 1% saying they explicitly did not agree to it the last time it happened.

Although both sexes were roughly equal in having been victimized, with 47% men and 52% women, men were considerably more likely to have realized it. Among those who strangled someone else, 5% reported doing so more than 50 times.

In recent years, “choking” has become part of a dangerous drift toward increased violence in mainstream pornography, which was cited as the greatest source of information about the practice by those interviewed.

Pornography featuring strangulation and choking will be banned in the UK at the end of this year, with a legal duty placed on tech platforms to prevent users from viewing this type of material.

Clare McGlynn, professor of law at Durham University and 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 the neck, plastic bags over women’s heads and two hands grabbing the neck.”

She called for a national campaign to raise awareness of the real risks and harms of the practice, which can occur even in the absence of visible injury.

More than a fifth of those surveyed in the survey by Ifas, part of the Royal College of Physicians’ Faculty of Forensic and Legal Medicine, said they had experienced physical effects including neck pain, dizziness and coughing.

One in 50 people reported losing consciousness and the same number suffered bladder incontinence during or after the strangulation, with one in 100 respondents reporting losing control of their bowels.

Most respondents who experienced physical symptoms did not subsequently receive medical help because they were unaware of the severity of their problems.

Numerous studies have shown brain changes in women who have been repeatedly “choked” during sex, including markers of brain damage and disruptions in the cerebral hemispheres linked to depression and anxiety.

Nearly half (47%) of those surveyed reported feeling anxiety during or after being strangled.

Professor Cath White, Ifas’ medical director, said even a “fleeting moment” of strangulation could lead to permanent health problems.

She added: “Respondents in the survey often associate strangulation during sex with ‘enhanced orgasms’ or ‘pleasure,’ but in reality, this sensation can be the result of a lack of oxygen to brain cells – and once those cells die, they can no longer regenerate… The truth is that strangulation – and especially repeated strangulation – increases the risk of nerve damage, brain damage, stroke and even death. What may seem like a fleeting moment can have consequences that last a lifetime.

Of those who had engaged in strangulation, only 38% said they did so because they enjoyed it, with the most common reason being their partner’s pleasure at 46%. Sexual partners were the greatest source of encouragement for this practice among those surveyed.

Harriet Smailes, author of the report and head of research at Ifas, said the research should “raise questions about the influences and feelings of choice in the practice of strangulation during sex”.

She added: “Many people still believe that strangulation is 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 criminal offense in its own right in 2021 and the law recognizes that a person cannot consent to serious harm being inflicted on them or their own death for the purposes of sexual gratification.

This followed the increasing use of the “rough sex” argument among men who killed women during sexual intercourse 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 census of femicides. In the UK, 550 women have been killed by strangulation since 2014.