Choking

My advice on why it’s not a good idea to choke someone during sex.

Take care reading this. I don’t go into detail about injury or anything, but it might not be easy for you to read.

My job as a sex educator is not to tell people whether a sex act is ‘wrong’ or ‘normal’ and whether you should do it or not. Instead, my job is to tell people how to make things safer, more consensual and more enjoyable. But it’s different with ‘choking’, or strangulation to be more accurate, because it can be very hard to do it safely and consensually. Here I’ll explain why this is, why my advice is ‘maybe don’t do this one’, but also some pointers towards other things you could do. It’s long so if you want to skip to the advice go here.

What is choking though? 

This is someone putting their hand around the neck of the other person. For some people it’s about restraining someone in place and playing around with power dynamics. As this literature review points out “both young women and men interviewees describe choking as a form of sexual exploration, an opportunity to play with power and domination/submission, and as a reflection of intimacy”. People also do it because they find the potential danger exciting. We don’t know for sure, but it’s thought that this has become an increasingly popular activity. It could just be that more people know about it, ask about it and talk about it now. 

Harms and pleasure

We need more research on this but it seems like (with everything) there’s a scale. At one end it being a deliberately violent act where they are trying to injure someone, and at the other end an act where the people doing it say that it was consensual. There’s a difference between putting pressure on someone’s neck and simply just resting the palm of the hand around the neck with no pressure at all. With small amounts of pressure for even a brief amount of time, some harm can be caused. With increased pressure, over a longer period (even seconds), significant harm can be caused, even death. 

Most people doing it report that it was consensual and report that it was somewhat pleasurable (if not very pleasurable) and that they were aiming for it to be pleasurable, playing around with different pressures. But 1 in 5 people doing it have experienced an altered consciousness (lightheadedness, dizziness, passing out), which can cause physical and psychological harm. Some of this you might not spot at the time. As we know, it’s very hard to continually and actively consent to things if your consciousness is altered. Just in my own experience of talking about this, people often say ‘well it was consensual’ in that they weren’t forced to do something they didn’t want to. However, that level of consent isn’t enough for people to enjoy it, and in this case it might not be enough consent to prevent harm from happening.  

Choking and BDSM

I’ve written about choking over at my article about kink and BDSM. There I point out that “ People do practice what is known as ‘breath play’ but that is strictly for people who know what they are doing. They go for training on it and even learn first aid. That’s how seriously people in BDSM communities take it. Even then it can still be really dangerous”. In kink communities (at parties and dungeons for example) they will have people who are trained in these things, who can be an observer to what is going on. Even then, kinksters are extremely cautious about it. I’ve had many conversations over the last few years about this with people who know more about kink than me and they basically say to me, ‘yeah it’s very difficult to do this safely’. So I’m saying this again here so that you are aware of what we’re talking about. Playing around with blood flow and breathing is serious, which can lead to short and long term harms and, in some cases, it can kill people. 

Here’s some actual advice

Communicate

You can’t do choking casually, or in the middle of other kinds of activities without talking about it. This is one of those things where you really do have to talk about it first. The good news is that I’ve got a fuck tonne of resources that help you communicate about sex. You should definitely read them carefully. A helpful thing to talk about is ‘what difference it will make’ –  what do you want to get out of it? Once you answer that question, it can open up lots of other possibilities for doing it without any pressure at all, or to do something else entirely. For example, you could hold your own breath for a bit, or put your hand on their mouth (allowing for a gap where they can breathe through). 

How much do you want to do it?

You could also check in with each other about how keen you both are to do this by giving it a number: 10 is super keen, 0 is not keen at all. If there’s a big gap between you both, you’re going to have to try something else. It’s important to remember that some people really want to have someone’s hand on their neck, it’s not just the other way around. Whichever way round it is, you both need to be getting close to 10. What will we need to do in order for this to be as enjoyable for us both as possible, is a key question for you to answer. 

Slow and gentle please

If you are both really into doing this, just go very lightly, slowly and very gently. Just stroking the neck with your hand as if you were gently stroking a cat, chinchilla, a hyrax or some other fun furry creature. You could do this yourself with your own hand on your neck, or take the other person’s hand in yours and do it to them. If you sense any tension here (in the hand, neck, jawline), stop and check in. How is this feeling for both of you? This gives the person being held the chance to tell you how it feels. Keep the lights on and the music low, because you need to really really pay very close attention to each other. Lie or sit next to each other and don’t do anything else which is stimulating or sexual at the same time. This is because you want to be able to understand what you are both reacting to – it can get confusing if (for example) you are masturbating each other too. 

I really don’t want you to be putting any pressure on each other’s necks, but if you do it should be very low and for very short periods of time. The reason for this is that a low amount of pressure might be harming you even if it feels nice or enjoyable. Sorry to be a killjoy, but I promise to update this once more research comes out about this. 

Choking and media

I’m not one for blaming media (TV, film, porn, socials) for making us do things. It’s not as simple as ‘people see choking in porn so they choke each other when they have sex’. Just as watching wrestling didn’t make everyone choke each other and perform figure four leg-locks, and listening to songs about peace and love didn’t lead to the beautiful utopia we now don’t live in. Media gives us ideas, can inform us of possibilities. It can even be part of telling stories of what is normal or okay (should stories). However, media and porn studies show that we ‘bring ourselves’ to any media we engage with and it’s a complex entanglement where we filter, critique, alter, fantasise about, what we see. In short: when someone chokes someone during sex, porn has not made them do it, they wanted to do it. 

However it’s important to remember, porn is not sex education. They are showing you what exciting sex might look like, but they are not showing you how to have exciting sex. Maybe it could be their job to teach people how to have enjoyable sex, but it isn’t. That’s the job for people like me. So when you see someone putting their hand on someone’s neck, whilst they are on top of them, with their full weight on them, that is not safe. Just grabbing someone’s neck until their face goes red, that is not safe. They might have agreed to this before the scene started and they may have taken loads of precautions, but they aren’t showing that. 

Here’s an educational guide to porn. Which also features in my new BISH Ebook, which you could buy for your teenage kids if you are a parent / carer who can’t face the idea of talking to them about sex and relationships.

Behind the scenes in porn and TV / film

I spoke to someone I know who has worked in porn and also in TV and film, doing and coordinating sex scenes. According to them, in TV and film, if there is a choking or strangulation scene, they take it incredibly seriously. They will have stunt-people, intimacy coordinators, and health and safety people standing by. In porn, they might have an intimacy coordinator (someone standing by to help facilitate the scene between the performers and the crew) but often not. 

This is down to money. In porn, because of capitalism and the profit motive, the money available for shoots has been cut. Some porn producers take this very seriously (feminist, ethical, and post-capitalist studios), but others perhaps don’t or can’t afford to. (If you’re a porn producer who disagrees, please get in touch and tell me about what you do to ensure safety and I’ll include it here). Also a lot of porn is now made by amateurs (or pro-amateurs) and who knows what kinds of precautions they are making. 

Consent and money go hand in hand. If there’s more money for shoots, more money for performers and more crew, there is more freedom to choose to agree to do things. Money increases people’s capacity to act. If there’s less money for workers, there’s less consent and more potential harm. This is why we should all be in unions. Sidenote: you should see how much sex and relationships educators get paid, it’s shockingly low. 

Here’s my guide to porn and capitalism and how porn treats viewers and performers.

Why we should all be cautious

I’ve been really cautious about writing this, even though lots of people have wanted me to. I nearly wrote this article a couple of years ago but I decided just to have the bit in the Kink / BDSM article. The reason is, it’s very difficult to write about and I don’t think there’s been enough research about it yet. Also, I don’t want to make it any more of ‘a thing’ than it is. You know what happens by now, someone makes a thing a thing (like with post-nut clarity, gooning, and prinding), then there’s a reaction to the thing. You can see this in the research, young people are trying choking / strangulation because it’s risky. 

So am I doing any good writing this? Will it backfire and have the opposite effect? Particularly if some right wing men on the internet say ‘let’s do the opposite of what this soy left wing do-gooder says’, what then? Also, last time I wrote about kink and rough sex, I got a deluge of people telling me that I shouldn’t be teaching young people about this at all. These same people will also be saying that we should ban porn. So I can’t win, really. I just hope that this will help to inform you, give you some ideas on how to navigate this, and to help you have a nice time. Anyway, I hope you find this helpful!

More resources and references

If you are finding sex to be boring you might want to learn how to do it really well! My guide on how to have sex is a great start, and here is a guide on how to enjoy sex more. Here are some interesting academic papers I’ve read about this that formed the background for this.

Woodley, G. and Jaunzems, K. . (2024) “Minimising the Risk: Teen Perspectives on Sexual Choking in Pornography”, M/C Journal, 27(4). doi: 10.5204/mcj.3088. Useful on harm minimisation and an overview of some of the harms from choking, but also the literacy and the third person effect of porn discourse. Good overview on the prevalence papers below (US and Australia).

Sprott, R. A., Randall, A., Smith, K., & Woo, L. (2021). Rates of Injury and Healthcare Utilization for Kink-Identified Patients. The journal of sexual medicine, 18(10), 1721–1734. https://doi.org/10.1016/j.jsxm.2021.08.001 Drawing attention to how BDSM injuries might be hidden from healthcare because of the stigma surrounding it and how this may be problematic

Holt, K. (2016) ‘Blacklisted: Boundaries, Violations, and Retaliatory Behavior in the BDSM Community’, Deviant Behavior, 37(8), pp. 917–930. doi: 10.1080/01639625.2016.1156982. How communities handle violations.

Daniel Cardoso, Choking Autoerotic Asphyxiation: For a Reconfiguration of Discourses Around Breath Play, The Journal of Sexual Medicine, Volume 19, Issue 7, July 2022, Pages 1069–1072, https://doi.org/10.1016/j.jsxm.2022.03.535 Really interesting article about how the discourses around AeA are formed and what that does to produce the ‘bizarre’ and ‘tragic’ outcomes of AeA deaths. Like learning about driving from road traffic accidents. Interesting comparison to freediving and how the consensus there is that it’s actually good for you. Article asks that we move towards ‘breath play’.

Herbenick, D., Patterson, C., Wright, P.J. et al. Sexual Choking/Strangulation During Sex: A Review of the Literature. Curr Sex Health Rep 15, 253–260 (2023). https://doi.org/10.1007/s11930-023-00373-y Overview of sexual choking / strangulation. This article is the one I’ve used as the basis for this article. It has a review of all the dangers but also talks about the importance of non-stigmatising RSE around it.

Sharman, L.S., Fitzgerald, R. & Douglas, H. Prevalence of Sexual Strangulation/Choking Among Australian 18–35 Year-Olds. Arch Sex Behav 54, 465–480 (2025). https://doi.org/10.1007/s10508-024-02937-y

Bows, H., & Herring, J. (2024). Non-Fatal Strangulation: An Empirical Review of the New Offence in England and Wales. The Journal of Criminal Law, 88(5-6), 332-346. https://doi.org/10.1177/00220183241277005 (Original work published 2024) Very interesting paper which goes into some of the harms around this (not just visible injury). Also problematises the consent defence which is interesting.

© Justin Hancock, 2026 Find out more about me and BISH here. If you’re an educator, head to my website BISH training, to find out about my resources for SRE and training for practitioners. This website is funded by me (and I am not rich) and my supporters, please see how you can Support BISH here.

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