“Choking” Isn’t Harmless Kink—And Its Global Spread Tells an Uneasy Story

Monday, July 7, 2025.

Strangling a partner during sex has leapt from niche BDSM play and Japanese shibari clubs to bedrooms and college dorms on nearly every continent.

Large‑scale surveys show that the practice—often marketed online as edgy “rough sex”—is now common in anglophone countries and rising fast elsewhere.

Yet biomedical data keep reminding us of an inconvenient truth: there is no physiologically safe way to compress someone’s airway or carotid arteries for pleasure.

How Widespread Is It?

• United States. A probability survey of nearly 5,000 U.S. under‑ and post‑graduates found that 58 % of women had ever been choked during sex; one in four said it first happened before age twenty (Herbenick et al., 2022).

• United Kingdom. A Home‑Office–funded snapshot showed that over one‑third of 16‑ to 34‑year‑olds had experienced sexual strangulation—more than double the rate among those over 35 (Institute for Addressing Strangulation [IFAS], 2023).

• Australia. A 2024 national study of 18‑ to 35‑year‑olds reported that 57 % had been strangled and 51 % had strangled a partner at least once (Sharman et al., 2025).

• Canada & New Zealand show similar patterns in smaller campus samples (Hou et al., 2023).

• Data gaps. Peer‑reviewed prevalence research is sparse in Latin America, South Asia and most of Africa, where sex‑research funding and open discussion remain limited.

  Nonetheless, clinicians in South Africa and Brazil have begun publishing case reports of throat trauma linked to “asphyxiation play,” and Kenyan online forums now include “#chokehold” threads, suggesting the meme’s reach is global even if the scholarship is not.

Why the Surge?

• Streaming Pornography
  International tube sites rarely geoblock: a teen in Lagos or Lahore can watch the same violent thumbnails as a teen in London. Porn users who see choking depicted frequently are more likely to believe it is pleasurable, safe and does not require explicit consent (Wright & Tokunaga, 2023).

• Social‑Media Copy‑Culture
  Short‑form videos (“POV: when he puts his hand on your neck 😳”) rack up millions of views on TikTok and Weibo. Meme‑driven masculinity accounts in the U.S. and UK openly list “choke her” in dating‑advice bullet points, while Spanish‑language influencers in Mexico hashtag content with #SexoRudo.

• Competitive Non‑Vanilla Signalling
  In many urban peer groups, especially in North America and Australia, saying “I’m into choking” signals adventurousness, while refusing can brand someone prudish (Herbenick et al., 2022).

• Misunderstood BDSM
  Seasoned BDSM circles from Berlin to Bangkok often treat “breath‑play” as edge play requiring training, spotters and medical knowledge—yet those safety norms rarely translate to mainstream hookups.

What Do the Medical Studies Say?

• Brain biomarkers. Women choked four or more times in the past month showed elevated serum S100B, a marker of neural injury, versus non‑choked controls (Huibregtse et al., 2022).

• Structural MRI. Repeatedly choked women displayed cortical thinning in regions tied to working‑memory and emotion regulation (Hou et al., 2023).

• Neurological Symptoms. Surveys document loss of consciousness, seizures, voice changes and strokes in women under forty, making strangulation a leading non‑genetic cause of young‑female stroke across several Western hospitals (Pritchard et al., 2020).

Bottom line: cutting off oxygen or blood to the brain—even “for a few seconds”—carries acute and cumulative risk.

Culture & Law: Same Act, Different Lens

Cultural Framing and Legal Status of Sexual Strangulation by Region

In the United Kingdom and Ireland, sexual choking is often described in public discourse as “rough sex,” but this framing is increasingly challenged by feminist organizations. Legally, non-fatal strangulation was made a distinct criminal offense under the Domestic Abuse Act in 2021. A proposed 2025 amendment aims to ban pornography that depicts choking during sex.

In the United States, cultural attitudes are sharply divided. On college campuses, choking is often viewed as a form of adventurous or “kinky” sex. However, domestic violence advocates consistently flag it as a dangerous act often associated with abuse. Legally, 49 states now classify non-fatal strangulation within intimate relationships as a felony. Despite this, pornography featuring choking remains largely unregulated.

In Australia and New Zealand, sexual choking is rapidly becoming normalized among Gen Z populations. Indigenous health services have reported a rise in related injuries, although broader cultural taboos often limit open discussion about sex. All states and territories now criminalize non-fatal strangulation, and Australia launched a national public health campaign in 2024 titled “Breathless,” warning that there is no safe amount of pressure to apply to someone’s neck.

In Japan, erotic asphyxiation has a long cultural history, especially within the context of kinbaku (Japanese rope bondage). However, newer practitioners often adopt choking practices without adequate training or context, increasing risk. My understanding is that Japan does not have a specific law against sexual strangulation; incidents are typically prosecuted under general assault or bodily injury laws.

In the Nordic countries and German-speaking regions (DACH: Germany, Austria, Switzerland), BDSM communities tend to emphasize “risk-aware consensual kink” and encourage detailed communication and safety protocols.

Among the general population, however, choking is less common—though its popularity is growing, particularly due to exposure to English-language pornography.

In Germany, media regulators restrict access to some violent pornography, and clinical guidelines advise immediate emergency care for anyone who loses consciousness after choking.

In the Middle East, North Africa (MENA), and South Asia, open discussion about sexuality is often considered taboo, making choking an especially difficult subject to address publicly.

Most countries in these regions have strict laws criminalizing extramarital sex, which overshadow any efforts to acknowledge or regulate sexual strangulation.

As a result, incidents are rarely reported, and most academic documentation comes from forensic case studies rather than public health research.

Across all regions, one pattern remains consistent: women are overwhelmingly more likely to be choked during sex, and men more likely to initiate it (Bows, 2024).

A Global Public‑Health Message

Regardless of postcode or porn hub, physiology doesn’t change: the jugular vein collapses under less pressure than it takes to open a fizzy drink. “Safe choking” tutorials give false reassurance; neurological damage can show up days or weeks later.

If you or someone you know experiences pressure to participate—or health after‑effects—seek medical attention and support. In every region, hotlines for domestic or sexual violence are equipped to help, even when the harm was labelled “kink.”

Be Well, Stay Kind, and Godspeed.

REFERENCES:

Bows, H. (2024). Strangulation, gender, and criminal law: A comparative analysis. Durham University Press.

Herbenick, D., Fu, T. J., Patterson, C., & Zounlome, N. (2022). Frequency, method, intensity, and health sequelae of sexual choking among U.S. undergraduate and graduate students. Archives of Sexual Behavior, 51(6), 3121–3139. https://doi.org/10.1007/s10508‑022‑02347‑y link.springer.com

Herbenick, D., Guerra‑Reyes, L., Patterson, C., Rosenstock Gonzalez, Y. R., Wagner, C., & Zounlome, N. (2022). “It was scary, but then it was kind of exciting”: Young women’s experiences with choking during sex. Archives of Sexual Behavior, 51(2), 1103–1123. https://doi.org/10.1007/s10508‑021‑02049‑x pubmed.ncbi.nlm.nih.gov

Hou, J., Huibregtse, M. E., Alexander, I. L., & Kawata, K. (2023). Structural brain morphology in young adult women who have been choked during sex: A whole‑brain surface morphometry study. Brain and Behavior, 13(5), e3160. https://doi.org/10.1002/brb3.3160 pmc.ncbi.nlm.nih.gov

Huibregtse, M. E., Alexander, I. L., Fu, T. J., Fortenberry, J. D., Herbenick, D., & Kawata, K. (2022). Frequent and recent non‑fatal strangulation during sex and its association with fMRI activation during working‑memory tasks. Frontiers in Behavioral Neuroscience, 16, 881678. https://doi.org/10.3389/fnbeh.2022.881678 frontiersin.org

Institute for Addressing Strangulation. (2023). Non‑fatal strangulation prevalence survey: England & Wales (Technical report). ifas.org.uk

Pritchard, A., Muldoon, K. A., & Halpern, M. (2020). Neurological and physiological harms of erotic asphyxiation: A forensic review. Journal of Forensic and Legal Medicine, 72, 101946. https://doi.org/10.1016/j.jflm.2020.101946unilad.com

Sharman, L. S., Fitzgerald, R., & Douglas, H. (2025). Prevalence of sexual strangulation among Australian 18‑ to 35‑year‑olds. Archives of Sexual Behavior, 54(2), 465–480. https://doi.org/10.1007/s10508‑024‑02937‑ypubmed.ncbi.nlm.nih.gov

Wright, P. J., & Tokunaga, R. S. (2023). Pornography consumption, eroticization, and perceptions of safety in sexual choking. Journal of Health Communication, 28(3), 173–182. scilit.com