A recent descriptive report from New Zealand also noted that youth tend to think of sexual choking as a mainstream, consensual sex act, and not connected to sexual violence (Beres et al., 2020). However, in a 2020 campus representative survey, 77% of US undergraduates indicated they considered choking to be a form of rough sex (Herbenick et al., 2021a), suggesting societal shifts in how young adults conceptualize choking and rough sex. In a series of 2006–2016 convenience surveys, Burch and Salmon ( 2019) found that about one-third of undergraduate students considered choking to be a form of rough sex. Thus, it is important to understand what young people are learning about choking, including the extent to which it is a normative, pleasurable, and/or desirable sexual practice. Yet, some young people who engage in consensual sexual choking are unaware of the risks involved (Herbenick et al., 2022c, 2022d).Īs women, more often than men, are choked during sex, the growth of this sexual practice may exacerbate existing gendered health disparities as women are already overwhelmingly affected by strangulation in other contexts (Matusz et al., 2020 Strack et al., 2001). Such responses are known to be associated with cerebral hypoxia from neck compression (Kabat & Anderson, 1943). 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). 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). While fatalities from consensual sexual choking/strangulation are rare, they do occur (Schori et al., 2022) and have been documented since at least the 1700s (Tarr, 2016). In this paper, we use the term sexual choking to refer to strangulation that occurs during sex. 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). 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). 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). 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).
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