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

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

Open Access: Yes


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.


Young people often learn ‘choking,’ which is medically known as “nonfatal sexual strangulation,” from viewing online pornography. Among the study sample of over 2,600 undergraduate students, 37% had sexually strangled a sexual partner; almost twice as many men had done so compared to the women. Almost one-quarter of these students had first strangled someone when they were 17 and younger – some as young as age 13. 42% of the undergraduates had themselves been sexually strangled – twice as many women as men – and 25% had first been strangled between the ages of 10-17. The average number of sexual partners they had strangled was 2.8; the average number of partners who strangled them was 3. Furthermore, “a greater percentage of TGNB+ students (14.7%) compared to women (3.9%) and men (8.6%) reported having choked six or more people.” Women and TGNB+ students reported being sexually strangled at a “much higher intensity” than the men. The most common responses included feeling like they could not breathe, difficulty swallowing, unable to speak, watery eyes, gasping for air, and alteration in consciousness such as blurry vision and loss of consciousness. These effects were reported by more women and TGNB+ than men. Some women reported anxiety attack, crying, and extreme fear. One finding was, “We must grapple with what it means for large proportions of young women to be choked/strangled so often.” Also, “If a person does not realize—perhaps due to inexperience, substance use, the room being dark, or the sexual position in use—that their partner has lost consciousness, and if they continue to choke their partner, then a full cardiac arrest may be imminent.”



Herbenick, D., Fu, T.-c., Eastman-Mueller, H., Thomas, S., Valdivia, D. S., Rosenberg, M., Guerra-Reyes, L., Wright, P. J., Kawata, K., & Feiner, J. R. (2022). Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students. Archives of Sexual Behaviuor, 51, 3121–3139.

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