Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students

Abstract

Although sexual choking is now prevalent, little is known about how people engage in choking in terms of frequency, intensity, method, or potential health sequelae. In a campus-representative survey of undergraduate and graduate students, we aimed to: (1) describe the prevalence of ever having choked/been choked as part of sex; (2) examine the characteristics of choking one's sexual partners (e.g., age at first experience, number of partners, frequency, intensity, method); (3) examine the characteristics of having been choked during sex; and (4) assess immediate responses of having been choked including the extent to which frequency and method (e.g., hand, ligature, limb) of having been choked predicts the range of responses endorsed by participants. A total of 4254 randomly sampled students (2668 undergraduate, 1576 graduate) completed a confidential online survey during Spring 2021. The mean age of first choking/being choked was about 19, with more undergraduates than graduate students reporting first choking/ being choked in adolescence. Women and transgender/gender non-binary participants were significantly more likely to have been choked than men. Participants more often reported the use of hands compared to limbs or ligature. Common responses to being choked were pleasurable sensations/euphoria (81.7%), a head rush (43.8%), feeling like they could not breathe (43.0%), difficulty swallowing (38.9%), unable to speak (37.6%), and watery eyes (37.2%). About 15% had noticed neck bruising and 3% had lost consciousness from being choked. Greater frequency and intensity of being choked was associated with reports of more physical responses as was use of limb (arm, leg) or ligature.

#ChokeMeDaddy: A Content Analysis of Memes Related to Choking/Strangulation During Sex

“…Sexual choking is now prevalent among adolescents and young adults in the USA, UK, and New Zealand, disproportionately affects women and sexual minoritized individuals, and is consequential to health (Beres et al, 2020 ; Coker & Domett, 2022 ; Herbenick et al, 2020 , 2021a , 2021c , 2022a , 2022b ; Savanta Com Res, 2019 ). Although commonly called “choking” (Beres et al, 2020 ; Cruz, 2022 ; Herbenick et al, 2022d , 2022e ), using one’s hands, limb, or a ligature to squeeze or press against the neck to occlude blood flow and/or airways is a form of strangulation (Sauvageau & Boghossian, 2010 ).…”

“…Consequently, what people tend to refer to as sexual choking may share at least some health risks as those arising from strangulation occurring in other contexts, such as the so-called “choking game,” sexual assault, or intimate partner violence (IPV) (Bichard et al, 2022 ; Busse et al, 2015 ). These risks may include neck bruising, neck edema, recurrent headaches, tinnitus, alterations in consciousness, and—in rare cases—death (Herbenick et al, 2022a ; Schori et al, 2022 ). In this paper, we use the term sexual choking to refer to strangulation that occurs during sex.…”

“…A recent review of deaths from partnered bondage and discipline/dominance and submission/sadism and masochism (BDSM) practices found that most case reports (88%) resulted from manual or ligature strangulation (Schori et al, 2022 ). More often, sexual choking leads to euphoric feelings but also to neck pain, neck bruising, and—for nearly 1 in 5 young adults who have been choked—alterations in consciousness, such as feeling dizzy, lightheaded, experiencing visual changes, or losing consciousness (Herbenick et al, 2022a ). Such responses are known to be associated with cerebral hypoxia from neck compression (Kabat & Anderson, 1943 ).…”

“…The 2021 survey found that 1 in 3 US women ages 18–24 had been choked during their most recent sexual event. A 2021 campus representative survey found that significantly more undergraduate students than graduate students had ever been choked during sex (Herbenick et al, 2022a ). Also, about one-quarter of undergraduates who had ever been choked, compared to 4% of graduate students, were first choked during adolescence.…”

Rough Sex: Aktueller Diskussions- und Forschungsstand

“…Beispielsweise hat allein die Sexualforscherin Debby Herbenick von der Indiana University Bloomington (USA) von 2021 bis 2023 rund zwanzig Veröffentlichungen zu harten Sexpraktiken und insbesondere zu Würgen beim Sex vorgelegt (z. B. Herbenick et al 2021 , 2022a , 2022b , 2022c , 2022d , 2022e ). Ein erster Sammelband ist verfügbar, der harten Sex speziell aus strafrechtlicher Perspektive beleuchtet (Bows und Herring 2022 ) und auch einen Forschungsüberblick enthält (Gallagher et al 2022 ).…”