Nearly half of sexually active teenagers have encountered strangulation during sex—either experiencing it themselves or applying it to a partner. The practice has become routine among young people despite extensive evidence of its dangers. According to research by the Institute for Strangulation Studies at the Royal College of Physicians, 43% of minors have already had such an experience. For many, it proved traumatic: 36% reported fear, 21% experienced serious physical effects ranging from dizziness to brief loss of consciousness. One in fifty reported fainting or losing bladder control, and one in a hundred lost control of their bowels.
Experts stress that non-fatal strangulation poses a greater risk than simulated drowning—the torture method known as waterboarding: it restricts blood flow and access to air, and when repeated, especially among adolescents, can create cumulative harm comparable to repeated concussions. All this points to the need to study the scale and normalisation of strangulation—and to reduce the risks associated with it.
Specialists attribute the rise of the practice to two factors. First, the vast volume of pornography accessible to children: according to the children’s commissioner’s 2023 data, children first encounter pornography at an average age of 13, often much earlier. Second, the ubiquity of strangulation in pornography itself: twenty years ago such scenes were barely recorded, yet this summer the commissioner reported that 58% of teenagers had seen strangulation in porn videos. In effect, pornography has become their source of sex education.
“When I was a teenager, porn existed only in magazines, and that is incomparable with what is available online now,” says The Guardian journalist Anna Moore. “You can click endlessly, and a mass of studies confirms the escalation effect. Teenagers encounter extreme sexual practices before they have even had their first kiss.” In England and Wales, strangulation has recently been designated a separate criminal offence, even when the participants consent.
Anna first wrote about the phenomenon in 2019, and returned to the subject in 2025. The new data “sadden” her, though they no longer surprise. “When I wrote about it the first time, it felt shocking. Now it seems more like an expected part of sexual experience rather than an exception. This is how young people live today. But if you keep talking about it, you’re dismissed as a killjoy.” She recalls a sex-education presentation funded by a Welsh council that included tips on “safe” strangulation such as: “Never start choking someone without asking them first.” It was later explained that the slide was a draft removed after professional review.
Studies show a gender imbalance: men are more often the initiators, and women the victims. Men are strangled too—sometimes by women, but mostly by other men—yet most academic work has focused on the effects on women. A recent report by the Institute for Strangulation Studies makes an exception: men and women had encountered strangulation at roughly similar rates—47% and 52% respectively—although men were more often the initiators.
Particularly telling is the remark by psychologist Jane Meyrick of the University of the West of England, quoted by Anna in her July feature for The Guardian: “I’ve had young people come to me in tears — girls saying, ‘I don’t want to be choked,’ and boys saying, ‘I don’t want to do it’… yet both watch porn where these scenes are presented without criticism, creating the sense that this is how it’s supposed to be.” After the 2019 article was published, Anna was told a story: a girl told her boyfriend, “I don’t want to do this weird thing,” and he replied, “Me neither, I thought you liked it.”
Despite advice circulating online, there is no such thing as “safe” strangulation. The neck — especially in young women — is extremely vulnerable: less pressure than it takes to open a fizzy-drink can is enough to compress the jugular vein. “We’ve long known the harm,” says Clare McGlynn. “If dizziness or loss of consciousness occurs, it’s immediately recognisable — and sometimes that’s exactly what stops it.” Today strangulation is cited as the second most common cause of strokes in women under 40; it is linked to swallowing difficulties, incontinence, seizures, anxiety disorders and miscarriages. MRI studies and blood tests also show long-term changes.
“All of them demonstrate that regular sexual strangulation — four times a month — impairs cognitive function,” McGlynn notes. “It resembles memory loss or the repeated concussions seen in athletes, a cumulative effect. And we don’t yet know the long-term consequences.”
McGlynn and other specialists argue that a large-scale national campaign is needed to warn of the “extremely serious risks”, including strokes and brain injury.