Choking during sex: how it became common and what the research found

Older sexology treated pressure on the neck as a fringe interest, filed with the solitary and often fatal practice forensic pathologists studied. By the early 2020s, campus surveys at a single American university were finding that a quarter of women had been choked at their most recent sexual encounter.

The research behind those numbers comes mostly from one programme, Herbenick's group at Indiana University, joined since by teams in Australia, the United Kingdom and Finland. It answers three questions in turn: how many people do it, where they learned it, and what it does to the body. The catalog adds a fourth, where it sits beside the rest of rough sex.

Choking, strangulation and breath play

Choking, in the everyday sense the word has in sex, means a hand or forearm pressing on a partner's neck. The word is anatomically wrong. Choking blocks the airway from inside; almost all sexual choking compresses the blood vessels of the neck from outside and leaves the airway open, which is why the public-health literature has moved to sexual strangulation. The choking kink entry keeps the vernacular name because it is the one people search.

Three neighbouring terms are often run together. Breath play is the wider family of practices that reduce breathing or blood flow to the brain, from smothering to hoods. Erotic asphyxiation is the solitary form, in which the oxygen restriction itself is the source of arousal and which accounts for most of the deaths in the forensic record. Choking is the partnered, manual, neck-focused part of both.

None of them is a diagnosis on its own. The DSM-5-TR lists asphyxiophilia only as a specifier of sexual masochism disorder, which requires distress, impairment or risk, and the ICD-11 does not name it. Sexual choking is a behaviour with a risk profile, and both manuals leave it outside the list of disorders. The wider question of when an interest becomes a diagnosis is covered in Is a fetish a mental disorder?.

How common choking during sex is

The best population figures come from Herbenick and colleagues' 2025 survey in Archives of Sexual Behavior, a nationally representative sample of 9,029 American adults aged 18 to 94, fielded from December 2022 to January 2023. Overall, 15.8% of women and 7.2% of men had ever been choked during consensual sex. The age gradient is the finding.

Age group	Women ever choked	Men ever choked
18 to 24	31.9%	8.1%
25 to 29	40.6%	17.5%
40 to 49	17.2%	7.6%
60 to 69	1.0%	1.4%

The roles split by gender in the other direction: 15.8% of men and 9.2% of women had choked a partner. An earlier national survey, published in the Journal of Sexual Medicine in 2020, had already found 21.4% of American women aged 18 to 60 reporting having been choked.

College samples run higher. At one large Midwestern university, a random sample of 4,168 undergraduates found 26.5% of women, 6.6% of men and 22.3% of transgender and non-binary students choked at their most recent sexual event. A later campus-representative survey found 45% of women, 61% of gender-diverse students and 25% of men had ever been choked.

The pattern is not American alone. Sharman, Fitzgerald and Douglas surveyed 4,702 Australians aged 18 to 35 in 2024: 57% had been strangled during sex, 61% of women and 43% of men, and 51% had strangled a partner.

Where people learn it

The routes are named in the interviews. In Herbenick's qualitative studies, 21 young men said they had learned about choking in adolescence from pornography, partners, friends and mainstream media, and 24 young women listed pornography, erotic stories, magazines, social media, friends and partners. Many of the women enjoyed being choked. Others did it mainly to please a partner, and the men's reasons included being kinky, being adventurous and the same wish to please.

Pornography has the clearest measured link. Wright, Herbenick and Tokunaga, working with a campus-representative sample of heterosexual men, found a chain: more frequent pornography use meant more exposure to depicted choking, which predicted three beliefs, that choking is pleasurable, that it is safe, and that it does not need the consent of the person being choked. The three beliefs in turn predicted choking a partner.

Believing that choking is safe is itself a predictor of doing it. In the Australian survey, positive views of being strangled and of strangling a partner were best predicted by the rating that it could be done safely and by social norms, after accounting for pornography exposure and past experience. A 2026 synthesis in Archives of Sexual Behavior, written jointly by sex researchers and kink educators, names social media, online pornography and popular media as the likely drivers, and records the rise in Australia, Iceland, Italy, New Zealand, the United Kingdom and the United States.

The appeal people describe is older than the trend. The entry lists power exchange, surrender, trust and intensity, the same motives behind dominance and submission and masochism, and the reasons people enjoy pain are the subject of a separate article.

What it does to the body

Pressure on the neck reduces blood and oxygen to the brain, and loss of consciousness can follow within seconds. A 2026 commentary by Finnish clinicians from a sexual assault centre and forensic medicine adds the point that defines the practice: once a person is unconscious, consent can no longer be given or checked.

The laboratory evidence is recent and small. In a randomized crossover study published in January 2026, 29 women with a mean age of 21.5 gave blood after sex that involved choking and after sex that did not. Neurofilament light, a marker of injury to nerve fibres, rose after the choking session and stayed flat after the other, and an inflammatory marker followed the same pattern. The authors read it as transient axonal stress and call for larger studies.

The survey evidence points the same way and cannot show cause. In a 2022 study of 4,352 undergraduates, 33.6% of women and 6.0% of men had been choked more than five times, and having been choked was associated with depressed mood, sadness, loneliness and anxiety after adjusting for demographics. Forensic literature, summarised in the entry, links strangulation to stroke, carotid artery dissection and death, sometimes delayed and without visible marks.

Organised kink has long agreed. BDSM communities classify breath play as edge play, a practice whose risk no technique removes, and the 2026 call to action was written by kink educators from the National Coalition for Sexual Freedom together with the researchers.

Consent and the law

Consent is often assumed: campus research finds that partners rarely negotiate it. The women Herbenick interviewed in 2022 had rarely looked for safety information, only some had a safe word or gesture, and all of them believed the way they and their partners did it was safe. In the 2025 campus survey, being choked was associated with alcohol use and with a history of partner violence, and so was consensual non-consent, the role-play of non-consent, reported by 10% of students.

Several legal systems now treat strangulation as its own offence. In England and Wales, section 70 of the Domestic Abuse Act 2021, in force since June 2022, made non-fatal strangulation and suffocation a specific crime with a maximum of five years, and section 71 of the same Act confirmed that consent to serious harm for sexual gratification is no defence. Every Australian state and territory has criminalised strangulation. In the United States, the 2026 synthesis records cases where consensual choking that caused injury or death led to criminal or civil charges. Choking someone who has not agreed is assault everywhere.

Where the catalog places choking

The catalog ranks the choking kink 10th of 486 entries, with an estimated 14% of adults, in the very common tier. The rest of its family sits far lower: breath play at rank 132 and 2%, erotic asphyxiation at rank 334 and 0.2%. The narrowest, partnered form of the practice is the one that spread.

Its neighbours in rough sex are the gestures it is often bundled with. Degradation kink ranks 30th at an estimated 11%, face slapping 133rd at 8%, hair pulling 188th at 5%. Collaring, which puts something around the neck as a symbol and compresses nothing, ranks 44th at 5%. A rank measures how widespread an interest is and how much it is searched, discussed and studied; it says nothing about safety. Choking scores highest of the five on prevalence and cultural visibility, and its research-attention score of 72 reflects the public-health literature above. The methodology explains how the five subscores combine, and What is BDSM? places choking within the wider practice.