Study finds strangling during sex common, but understanding is low

More than half of young people are using strangulation during sex.

A study of 4702 young people aged from 18 to 35 found that 57% had been strangled during sex at least once and 51% had strangled a partner at least once.

While strangulation that causes serious harm is a criminal offence across Australia, most of those surveyed did not know that even consensual strangulation could be seriously harmful, and few knew that it was a criminal offence in their State or Territory.

The study, by researchers from Melbourne University Law School and The University of Queensland, has been published in the Archives of Sexual Behavior.

The researchers found that young people called sexual strangulation “choking” and that:

• The first time someone was strangled by a partner (31%) and/or strangled a partner (30%) was usually between the ages of 19-21.
• On average, people reported they had been strangled 5 times, by 3 partners.
• Across the sample, only 6.3% of people reported both being strangled by, and strangling, a partner.

More men (59%) than women (40%) said that they had ever strangled their partners, and nearly three-quarters (74%) of trans and gender-diverse participants reported that they had strangled their partners.

More women (61%) than men (43%) reported ever being strangled, with a high proportion of people who identified as trans or gender-diverse (78%) reporting ever being strangled.

People said they found out about sexual strangulation through various sources, most commonly pornography (61%), but also through movies (40%), friends (32%), social media (31%) and discussions with current or potential partners (29%).

“We are concerned that the findings suggest that many young Australians may consent to strangulation during sex without understanding that it could seriously injure them,” says study co-author Professor Heather Douglas, of Melbourne University Law School.

Choking a person during sex can cause brain injury, even when the person remains conscious. The more often people are strangled, the more likely they are to experience brain injury - including memory loss and difficulties problem-solving -  and the worse the brain injury will become.

“It doesn’t matter if there are no apparent injuries, or whether the person consented,” Professor Douglas says. “Brain injury can also be incremental – getting a bit worse with each choking -  and the person may not know they have suffered a brain injury. The effects of repeated strangling are insidious and build over time, like the effects of repeated concussions on footballers.”

She says other injuries can include bruising, sore throat, neck pain, a hoarse voice, a cough, difficulty swallowing, swollen lips, nausea and vomiting.

More serious impacts include miscarriage of pregnancy and death.  Miscarriage and death can occur weeks or months after the initial strangulation.

People can be injured quickly, with around:

• 10 seconds to being rendered unconscious
• 17 seconds to having a fit from lack of oxygen
• 30 seconds to loss of bowel control
• 150 seconds to death

Professor Douglas says people cannot always rely on having a “safe word” or “safe gesture” to let their partner know to stop a stranglehold. This is because being choked can prevent a person from indicating that they want it to stop.

“Earlier US research found that many people respond to being strangled by freezing, a common trauma response, leaving them unable to move or speak. This means the person being strangled might not be able to use a pre-agreed ‘safe word’ or ‘safe gesture’, even if they want it to stop.”

The researchers recommend improved community education about the physical risks of sexual strangulation and about the importance of fully informed consent.

Two other researchers leading the study are Dr Leah Sharman and Associate Professor Robin Fitzgerald, both of the University of Queensland.