The Dangers Of Choking During Sex: A Conversation Parents and Caregivers Need to Have With Their Son’s and Daughter’s
- The White Hatter
- 8 hours ago
- 17 min read
Caveat: This article discusses sexual behaviour, strangulation, pornography, consent, and the recent death of a 16-year-old girl. We recognize that these topics can be uncomfortable for parents and caregivers to discuss, especially when it comes to our own children. However, discomfort should not prevent us from having conversations that could potentially prevent serious injury or even save a life. This article is not about shaming young people, creating fear around sexuality, or suggesting that all teens are engaging in this behaviour, It’s about giving parents and caregivers evidence based information about a sexual practice that research from several countries suggests has become increasingly normalized among some young people.
There are some news stories that should cause parents and caregivers to stop, pay attention, and perhaps have a conversation with their teen that they never expected they would need to have. A recent story out of Australia is one of them. On August 28, 2026, ABC News reported that police in New South Wales were investigating the death of a 16 year old girl whose death was being examined in connection with a suspected consensual sexual choking incident. Given that this remains an active investigation, it is important not to speculate beyond what police and credible reporting have established. However, the tragedy has drawn renewed attention to something researchers, physicians, sexual health educators, and violence prevention specialists have been discussing with increasing urgency, namely the normalization of what is commonly referred to as “choking” during sex among some adolescents and young adults. (1)
We believe parents and caregivers need to be part of that conversation, not because every teenager is engaging in this behaviour, and not because teen sexuality should be approached through fear, but because young people deserve accurate information about practices that may be presented to them online, by peers, or within relationships as normal, expected, exciting, or harmless.
First, Let’s Call It What It Actually Is
Although the word “choking” is commonly used in pornography, social media, online discussions, popular culture, and among young people themselves, the medically more accurate term is “strangulation”. Choking generally refers to something blocking the airway from inside the throat, such as food becoming lodged in the airway. Strangulation involves external pressure being applied to the neck, which can interfere with breathing, blood flow to the brain, or both. That distinction matters because language can shape how risk is perceived, and the casual word “choking” can make the behaviour sound far less serious than what is actually happening physiologically.
The neck contains critical structures, including the airway, major blood vessels, nerves, and tissues that support the delivery of oxygenated blood to the brain. Applying pressure to those structures can lead to loss of consciousness, neurological injury, vascular damage, stroke, seizures, brain injury, and, in rare circumstances, death. A 2026 medical paper examining sexual choking among young people emphasized that breath control practices are physiologically unpredictable and can result in rapid unconsciousness, brain injury, or death. More importantly, the authors noted that there is no medically safe method for intentionally restricting oxygen during sexual activity (2).
This is why teens, parents, caregivers, and educators should be cautious when they encounter online content suggesting there is a particular hand position, location on the neck, amount of pressure, or number of seconds that can make sexual strangulation “safe.” There may be circumstances where risk is greater or lower, but lower risk is not the same thing as no risk. When pressure is being applied to the neck and breathing or blood flow may be compromised, the underlying danger cannot simply be engineered away.
This Behaviour Appears to Be More Common Than Many Parents Realize
Some parents and caregivers reading this may understandably wonder whether this is really something many young people are encountering. Research from several countries suggests that sexual strangulation has become surprisingly common among some adolescents and young adults, although the exact prevalence varies depending on the population being studied, the age group, how the behaviour is defined, and the country where the research is conducted.
Why has it become more popular, some people report that sexual strangulation intensifies the euphoric or “high” sensation that can accompany cerebral hypoxia during sex. Research involving university students found that 81.7% of those who had been strangled during sex reported pleasurable sensations or euphoria, while 43.8% reported experiencing a “head rush.” More concerning, however, these sensations are associated with disruption of normal oxygenated blood flow to the brain, the same physiological process that can result in unconsciousness, neurological injury, or death. (12)(13)
One of the largest recent studies comes from Australia, where researchers surveyed 4,702 people between the ages of 18 and 35. They found that 57% reported having been sexually strangled at least once, while 51% reported having strangled a sexual partner. Women were more likely than men to report having been strangled, while men were more likely to report strangling a partner (3).
Those numbers are striking, but there is an important qualification. Those are Australian statistics, not Canadian statistics. We should not simply take research from another country and assume Canadian teenagers and young adults are behaving in exactly the same way. Different countries have different cultural norms, sexual-health education systems, media environments, and patterns of pornography and social media use. It would therefore be irresponsible to present Australian prevalence figures as though they describe Canadian youth.
What Do We Know Here in Canada?
Researchers with Canada’s Strangulation Prevention and Research Centre are currently conducting research specifically examining “consensual” sexual strangulation among university students in British Columbia. What caught our attention was how plainly the researchers describe the current evidence gap, stating that “there is currently no information available on this subject in Canada.” (4)
That means we currently do not have reliable Canadian prevalence data telling us how many Canadian teens or young adults are participating in sexual strangulation. That is an important limitation and one that should be acknowledged openly rather than filled with assumptions borrowed from Australia, the United States, or elsewhere. At the same time, the absence of Canadian prevalence data should not be confused with evidence that the behaviour is not occurring here, it simply means we presently do not know how common it is. Anecdotally we spoke with some teens who follow us on social media, and privately they stated that is is something that is happening here with Canadian youth as well.
Canadian research does, however, tell us something about the medical seriousness of strangulation itself. A study published in the Canadian Journal of Emergency Medicine examined non-fatal strangulation among patients presenting to a tertiary hospital’s Sexual Assault and Partner Abuse Care Program and trauma program. The researchers described non-fatal strangulation as a dangerous mechanism of injury among survivors of intimate partner violence and sexual assault. (5)
Canadian paediatric research has also demonstrated how serious oxygen deprivation and strangulation can become. One study examined 41 paediatric hanging or strangulation cases. Of the 19 children who were found without a pulse and required CPR, 16 died and the three survivors were severely disabled. Among the 22 children found with a pulse, 18 made a full recovery. (6)
To be very clear, that study was not about sexual strangulation and should never be used to imply that Canadian teens are engaging in sexual choking at any particular rate. What it does demonstrate is the seriousness of interfering with oxygenation or blood flow to the brain.
Taken together, the Canadian evidence allows us to make a careful and evidence based statement. We cannot currently say how common sexual strangulation is among Canadian teenagers, but we can say that the behaviour is being documented internationally, anecdotally Canadian teens have told us that this is happening, Canadian researchers believe the issue warrants study here, and Canadian medical literature confirms that strangulation itself can result in serious injury. That is a more responsible position than either assuming the problem is widespread among Canadian teens or dismissing it because Canadian prevalence data are still limited.
Where Are Young People Learning About This?
This is where the conversation becomes particularly relevant to our work here at The White Hatter. The Australian research found that 61% of participants reported first learning about sexual strangulation through pornography, while movies were reported by 41%, friends by 32%, social media by 31%, and current or potential partners by 29% (7).
Those findings do not mean pornography single handedly “causes” young people to engage in sexual strangulation. Human sexual behaviour is far more complicated than that, and reducing the issue to a simple cause and effect relationship would go beyond what the evidence can support.
What pornography can do, however, is contribute to what researchers sometimes describe as sexual scripts, the ideas people develop about what sex is supposed to look like, what partners are expected to enjoy, what behaviours are considered normal, and what someone is supposed to do to be seen as sexually experienced or desirable. Young people have always learned about sex partly through culture and media, but what has changed is the accessibility, intensity, and sheer volume of sexual content available to them.
A teenager today can be exposed to sexual practices online long before they have the biological understanding, relationship experience, or sexual health education needed to properly assess the potential risks involved. In our conversations with teens, Pornhub is frequently mentioned as one of the better-known free pornography sites they are aware of or have encountered. A simple search for the term “choking” on the platform illustrates just how visible and normalized this behaviour has become within online pornography. Here is what that search produces:
This is why one of the simplest messages parents can give their teens is also one of the most important, “Pornography is adult entertainment, not sex education.” The fact that a sexual behaviour appears repeatedly in pornography does not make it safe, healthy, expected, or something every partner should be comfortable participating in. The fact remains that if we don’t talk to our kids about what the difference is between pornography and healthy human sexuality, we are leaving it to the porn industry to do it for us, which is a recipe for disaster (14).
Social Media Can Normalize It Too
Pornography is not the only digital influence worth discussing. A 2025 study examined both entertaining and supposedly educational videos of sexual choking content on TikTok. Researchers found content portraying choking as desirable and normalized, while also identifying problems with the quality and accuracy of some educational information being presented (8).
Sexual strangulation is no longer something young people may encounter only in pornography. References to it are increasingly appearing in popular music, television, social media, and other forms of mainstream entertainment, where it can be normalized, romanticized, or portrayed as an expected or desirable part of sexual intimacy. As an example here’s two of many examples we found on TikTok
Here’s another example of how sexual strangulation has entered mainstream popular culture. In the 2023 song “One of the Girls” by The Weeknd, JENNIE, and Lily-Rose Depp.
The song, which includes 2 explicit references to choking within a sexual context that are repeated several time are, “Force me and choke me ’til I pass out” and “Hands on my neck while you push it up”, reached No. 51 on the U.S. Billboard Hot 100 and No. 10 on the Billboard Global 200, while eventually surpassing one billion streams on Spotify. This was not an obscure song circulating on the fringes of popular culture. It became an international hit consumed by a massive global audience, including youth and teens.
This raises an important media literacy issue for young people. When a behaviour appears repeatedly within someone’s social feed, or in the music they are listening to, it can create the impression that it is much more common than it actually is. Algorithms are exceptionally good at creating this illusion because their purpose is not to provide a balanced representation of society, but to keep people engaged. If a young person watches, searches for, likes, shares, or even pauses on a particular type of content, the platform may begin serving them more of the same.
Seeing twenty videos about a particular sexual behaviour does not mean twenty of your friends are doing it. It may simply mean an algorithm has learned that the topic keeps your attention. This is one reason why sexual health education today needs to include digital and media literacy alongside more traditional discussions about consent and relationships.
But What If Both People Consent?
Consent absolutely matters, and nobody should engage in sexual behaviour involving another person without that person’s freely given, informed, and ongoing consent, and anyone should be able to change their mind at any point. However, consent does not eliminate physiological risk. Two people can mutually agree to an activity and that activity can still be medically dangerous.
Research examining how young adults understand sexual strangulation has found that some participants associate safety with consent, trust, communication, the amount of pressure applied, or particular techniques. In other words, they may believe that if they trust their partner, discuss boundaries, use a safe word, or carefully control the amount of pressure being applied, the activity can be made safe. Researchers have raised concerns that these beliefs can create a false sense of security (9).
Trust does not change human anatomy, consent does not change human anatomy, and a safe word does not change human anatomy. These things absolutely matter when it comes to respectful relationships, but they cannot remove the physiological risks created when pressure is applied to the neck.
There is another problem that deserves discussion, if someone loses consciousness, they can no longer communicate consent. A person who is unconscious cannot use a safe word, clearly say stop, communicate that something feels medically wrong, or reliably protect themselves. The 2026 medical literature addressing this issue notes that unconsciousness can occur rapidly and that once consciousness is lost, consent can no longer be given or verified (2).
Loss of consciousness during strangulation should therefore never be interpreted as evidence that someone “did it properly.” It is a serious warning that blood flow, oxygenation, or both have been compromised.
There May Not Be Obvious Injuries
Another misconception is that if someone looks fine afterward, everything must be okay. That is not necessarily true. Strangulation can cause internal injury without dramatic external marks, and someone may initially minimize what happened or assume symptoms such as dizziness, headache, confusion, voice changes, memory problems, neck pain, difficulty swallowing, or breathing problems will simply go away. Medical professionals interviewed by ABC News have warned that brain injury can occur even when the person remains conscious and even when there are no obvious external injuries. Some symptoms may also become apparent later (7).
This is particularly important for teens because embarrassment can become a significant barrier to seeking medical help. A teenager may hesitate to tell a parent, physician, teacher, or trusted adult what happened because doing so means revealing that sexual activity took place. Parents and caregivers can reduce that barrier before it is ever needed by making something very clear, that being their child’s immediate health and safety will always matter more than the circumstances that led to the injury.
If strangulation has occurred and there is loss of consciousness, difficulty breathing, seizure activity, severe headache, confusion, weakness, vision problems, difficulty speaking or swallowing, or other concerning neurological or breathing symptoms, emergency medical attention should be sought. Embarrassment or fear of getting into trouble should never delay medical care.
There Is Also a Canadian Legal Dimension
Another aspect parents may not realize is that sexual strangulation has already surfaced within Canadian legal discussions surrounding consent, bodily harm, sexual assault, and what has become known as the “rough sex defence.” Canadian legal scholars Elizabeth Sheehy, Isabel Grant, and Lise Gotell examined Canadian case law from 1988 through 2021 in their paper Resurrecting “She Asked for It”: The Rough Sex Defence in Canada. Their analysis looked at cases where accused persons argued that injuries or death occurred during consensual rough sexual activity (10).
The researchers found that these cases were highly gendered, with men as the perpetrators in the cases they examined and overwhelmingly women on the receiving end. Their analysis also identified themes involving pornography, the trivialization of bodily harm, the mischaracterization of strangulation, and arguments surrounding consent.
The legal issues surrounding consent to bodily harm in Canada can be complex, and this article is not intended to provide legal advice. The larger message for teens is much simpler, “They agreed to it” does not automatically mean an activity was safe, responsible, or legally without consequence.
Don’t Make This Conversation About Shame
This may be one of the most important points for parents and caregivers. Finding out that your teenager has encountered pornography, heard about sexual choking, been asked about it by a partner, or even participated in it may trigger fear, anger, shock, disappointment, confusion, or all of those at once. However, the way we respond in that moment can influence whether our teen ever talks to us about something like this again.
If our first response is, “What were you thinking?”, “How could you be so stupid?”, or “I can’t believe you would do something like that,” we may unintentionally shut down the very communication channel we most need to keep open. The goal is not to pretend we are comfortable with everything our teen tells us, nor is it to remove boundaries or parental expectations. The goal is to make sure fear of our reaction never becomes more powerful than their willingness to seek help when they need it.
A better approach might sound something like this, “I know this is probably awkward to talk about, but I have been reading about choking during sex and I want you to know something important. Research from other countries suggests some young people are encountering or participating in it, although we do not yet know how common it is among Canadian teens. What we do know is that putting pressure on someone’s neck can cause serious injury and there is no medically safe way to completely remove that risk. I don’t want you relying on TikTok, porn, friends, or a partner for medical information about something this serious.”
That does not need to become a two hour lecture. Sometimes the most effective parental conversations are short, calm, factual, and leave the door open for the young person to come back later with questions.
Talk to Both Sons and Daughters
Parents and caregivers should also resist framing this exclusively as a conversation for daughters about protecting themselves. Boys need this conversation too, as do LGBTQ+ youth. The Australian research demonstrates why. Women were more likely to report having been strangled, while men were more likely to report strangling partners, and the study also found particularly high reported participation among transgender and gender-diverse respondents (3).
Young men may encounter sexual scripts suggesting that dominance, aggression, or choking is something a male partner is supposed to initiate. A teen boy may believe a partner expects it because he has repeatedly encountered that behaviour in pornography, social media, popular culture, or conversations with friends. Some young women may encounter the opposite message, that enjoying choking is expected, adventurous, or simply part of contemporary sexual relationships, and neither should be treated as an obligation.
Interestingly, Australian educators interviewed about this issue reported hearing from some young men who felt pressure themselves to strangle partners because it had become expected within their sexual relationships (7). This is an important reminder that harmful sexual expectations can place pressure on both the person being strangled and the person expected to perform the strangulation.
This is why all young people need healthy conversations about sexuality, consent, respect, communication, pornography, boundaries, and the way online sexual culture can influence expectations. Sexual intimacy should never require someone to perform a behaviour simply because they believe it is expected of them.
Teach Teens That They Can Say “No” Without Explaining Why
There is another message worth sharing with our teens, and it extends far beyond sexual strangulation. They do not owe anyone a particular sexual experience simply because that person wants it, or because they believe it is normal. They do not owe it to someone because a previous partner did it, because they saw it online, because their friends are talking about it, because somebody claims “everyone does it,” or because a partner insists they know how to do it safely.
Teenagers also need to understand that saying “no” does not require a courtroom quality explanation. “I’m not comfortable with that” is enough. As we like to say, “No is a complete sentence, and their is no need for an explanation” Healthy consent is not about repeatedly negotiating with someone until they finally surrender and say yes. It means being able to set a boundary without fear, coercion, ridicule, or pressure and having that boundary respected immediately.
The same principle applies in both directions. No teenager should feel pressured to be strangled, and no teenager should feel pressured to strangle somebody else because a partner expects it.
Parents Can’t Outsource This Conversation to the Internet
We understand why many parents hesitate to discuss topics like this. It can feel awkward, especially if conversations about sex were not something we grew up having with our own parents. Your teenager may roll their eyes, tell you they already know, change the subject, or look absolutely horrified that you just used the words “sex” and “choking” in the same conversation, but have the conversation anyway.
There is a research based reason not to wait until late adolescence. Dr. Debby Herbenick, who has conducted extensive research into sexual choking among young adults in the United States, has reported that when college students are asked when they first learned about choking during sex, the average age is approximately 15 years old. That means many young people are becoming aware of the concept well before adulthood (11).
If parents, caregivers, educators, and credible sexual health professionals do not provide young people with accurate, age appropriate information, there are plenty of other sources willing to fill the gap. Unfortunately, those sources may include pornography, TikTok videos, influencers, anonymous online communities, partners, or equally uninformed peers.
This is where we come back to something we discuss frequently here at The White Hatter, “relationship before dependency”. We want our kids coming to us when something confusing, frightening, embarrassing, or uncomfortable happens. That relationship is not built during the crisis itself, it’s built over time by showing our children that difficult topics can be discussed without immediate judgment, humiliation, or emotional explosions.
This Isn’t About Creating Fear Around Teen Sexuality
We do not believe the answer is to tell teenagers that sex is inherently dangerous, that pornography will destroy them, or that social media is responsible for everything wrong with young people today. Fear based messaging may get attention, but it rarely creates the kind of critical thinking and decision making we want our children to develop.
The better approach is to give them the facts and teach them how to think about those facts. Research from several countries suggests that sexual strangulation has become increasingly normalized among some adolescents and young adults. Pornography, social media, peers, popular culture, and partners appear to play roles in shaping awareness and perceptions of the behaviour. Research also suggests that some young people believe trust, consent, communication, or specific techniques can make strangulation safe. (3)(7)(8)(9)
Medical evidence tells us something different. Strangulation involves applying pressure to anatomical structures responsible for breathing and supplying blood to the brain. The effects can be unpredictable, serious, and occasionally fatal, and current medical literature specifically addressing sexual choking states that there is no medically safe way to intentionally restrict oxygen during sexual activity (2).
Here in Canada, we do not yet have reliable prevalence data telling us how common sexual strangulation is among Canadian teenagers or young adults. Canadian researchers are now beginning to investigate that question (4). That uncertainty should be acknowledged rather than filled with fear, assumptions, or imported statistics.
The tragic death of a 16 year old girl in Australia should not become another sensational headline that frightens parents and caregivers for a few days before disappearing from the news cycle. It should prompt thoughtful conversations, better education, more research, and a closer look at how young people are learning about sex, consent, relationships, and risk in today’s onlife world.
This does not mean every teenager is engaging in sexual strangulation, because most aren’t. It also does not mean we currently have evidence showing the behaviour is widespread among Canadian teens, because we do not. It also does not mean pornography or social media automatically causes young people to engage in dangerous sexual behaviour. The research does not support such a simplistic conclusion.
What this issue does highlight is that young people are growing up within a sexual culture shaped partly by online media, pornography, social platforms, peers, algorithms, and rapidly changing social norms. Behaviours that previous generations may have regarded as unusual or extreme can now appear repeatedly within mainstream digital environments and, through repetition, begin to feel ordinary.
That makes sexual health literacy, consent education, media literacy, digital literacy, and critical thinking more important, not less. It also makes further Canadian research essential. We need to know whether the patterns being documented in Australia, the United States, and elsewhere are also occurring among Canadian youth and young adults, how young Canadians understand the risks, where they first encounter these behaviours, and what role pornography, social media, partners, peers, and sexual-health education may be playing. Until that research exists, we should neither exaggerate the problem nor ignore it.
As parents and caregivers, we do not need to know everything our teenagers are doing. What we should make sure they know is that when something confusing happens, when somebody pressures them, when they make a mistake, when something goes wrong, or when they simply have a question they are embarrassed to ask, we want to be one of the people they can come to.
Sometimes parenting in today’s onlife world means having conversations we never imagined we would need to have, and this topic is one of them.
POST SCRIPT:
If you are a parent, caregiver, or educator who has read this article and would like to learn more about this topic from an evidence-based perspective, we encourage you to visit the Breathless Campaign at https://www.breathlesscampaign.com/. This important initiative is spearheaded by Maree Crabbe, an Australian sexuality educator, researcher, and violence-prevention specialist whose work we have followed and respected for many years, and whom we have had the privilege of interviewing in the past. The Breathless Campaign provides research, education, and practical resources designed to help adults better understand sexual strangulation, its increasing normalization among some young people, and how we can have informed and meaningful conversations about it.
Digital Food For Thought
The White Hatter
Facts Not Fear, Facts Not Emotions, Enlighten Not Frighten, Know Tech Not No Tech
References
(7) https://www.abc.net.au/news/2024-07-02/choking-strangulation-sexual-partners-young-people/104043900
(9) https://www.abc.net.au/news/2025-02-08/young-people-choking-during-sex-research-safety/104909998
