An unhealthy bedroom habit

Autoerotic strangulation has become a much more common sexual practice in Australia, despite its potentially fatal consequences.

A new survey by the universities of Melbourne and Queensland found that 56% of Australian undergraduates reported ever being strangled during sex and 51% ever strangling a partner. 

In total, 17% of participants reported being strangled and 13% strangling a partner during their last sexual experience. 

Lead author, Professor Heather Douglas from the University of Melbourne, said that higher frequency, wanting, and positive perceptions of strangulation were associated with more liberal sexual attitudes. 

“However, there were differences depending on gender,” she said. 

“Participants generally did not perceive strangulation to be harmful and had limited knowledge about its criminalisation, and a brief education intervention on strangulation harms revealed reductions in positive perceptions of strangulation that were pronounced among women.” 

Women with a same-sex partner were more likely to report being strangled compared to women with a partner of the opposite sex, while men were more likely to strangle partners when reporting feelings of love and higher levels of wanting to engage in sex.  

Conversely, men were more likely to strangle partners if they reported one partner disliked the other or if they were in a same-sex relationship. Further, being strangled was somewhat more prevalent among men with sexual partners who they were not in a relationship with.   

“The use of strangulation during sex has been commonly discussed in health and fashion magazines and is one of the most common types of physical aggression against women depicted in pornography,” Professor Douglas said. 

“Despite media coverage and pornographic depiction of this activity, the consequences of strangulation are wide-ranging and may not be well known to the general public.” 

Strangulation within the context of intimate partner violence and sexual assault harms can encompass short- and long-term physical and mental health issues, including loss of (or change in) voice, difficulty in swallowing or breathing, bruising around the neck, loss of consciousness, depression and anxiety, miscarriage, and problems with memory and concentration, many of which can occur weeks or months after the event. 

Research has also identified that the likelihood of developing neurological problems including memory problems and early dementia increases with repeated strangulations.  

On the other hand, investigations of harms from strangulation during sex outside contexts of IPV and sexual assaults have primarily drawn from investigations of deaths and significant injuries because of the activity. 

“While consent can be given to be strangled, we suggest consent cannot be free and voluntary if the person is not aware of the potential risk and harm of the behaviour,” Professor Douglas said. 

“Furthermore, regarding assault generally, a person cannot legally consent to serious bodily harm such as unconsciousness during sexual activities, so purported consent would not be a defence in circumstances where the person strangled suffered serious harm or death. 

“It is unknown whether there is a recognition and understanding of harms among the wider community now engaging in it. This is particularly concerning given recent evidence that many online articles represent those forms of strangulation, via stopping the blood or breath, can be done safely.”

There is currently no public education about strangulation during sex in Australia.