Choking during sex: A discussion of a more common practice

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This is the most horrifying thing I have read in some time:

Nearly two-thirds of women in [Indiana University’s Debby Herbenick’s] most recent campus-representative survey of 5,000 students at an anonymized “major Midwestern university” said a partner had choked them during sex (one-third in their most recent encounter). The rate of those women who said they were between the ages 12 and 17 the first time that happened had shot up to 40 percent from one in four [from four years ago] (Orenstein, 2024).

Nearly two-thirds of the women at this “major Midwestern university.”

Let’s say that your students are no different than these “major Midwestern university” students. Let’s say you have 500 students a year. About 60% of college students are women (National Center for Education Statistics, 2023a). During the 2020-2021 academic year, 80% of bachelor’s degrees went to women (National Center for Education Statistics, 2023b). If you teach mostly Intro Psych, the number of women in your classes may be closer to 60%. If you teach mostly upper division courses for the psych major, the number of women in your classes may be closer to 80%. For illustration purposes, let’s split the difference and say that 70% of your 500 students are women. That means that you teach 350 women each year. If “nearly two-thirds” of those women have been choked during sex, that comes out to 231 of your students.

“Nearly” half of your students. Are being choked.

Actually, the number is likely higher than that. “[W]hile undergrads of all genders and sexualities in Dr. Herbenick’s surveys report both choking and being choked, straight and bisexual young women are far more likely to have been the subjects of the behavior; the gap widens with greater occurrences” (Orenstein, 2024). Men, too, have been choked, just not in the same numbers.

“[W]hile the act is often engaged in with a steady partner, a quarter of young women said partners they’d had sex with on the day they’d met also choked them” (Orenstein, 2024). I had just gotten accustomed to a world where apps like Tinder make it easy for complete strangers to have sex—and that many young people were, indeed, using those apps to do just that. But 25% of the women in those same-day sexual encounters are being choked?!

“No wonder that, in a separate study by Dr. Herbenick, choking was among the most frequently listed sex acts young women said had scared them, reporting that it sometimes made them worry whether they’d survive” (Orenstein, 2024). No wonder, indeed.

Also, oxygen deprivation is bad for the brain.

According to the American Academy of Neurology, restricting blood flow to the brain, even briefly, can cause permanent injury, including stroke and cognitive impairment. In M.R.I.s conducted by Dr. [Keisuke] Kawata [an early researcher on NFL concussions and CTE] and his colleagues (including Dr. Herbenick, who is a co-author of his papers on strangulation), undergraduate women who have been repeatedly choked show a reduction in cortical folding in the brain compared with a never-choked control group. They also showed widespread cortical thickening, an inflammation response that is associated with elevated risk of later-onset mental illness. In completing simple memory tasks, their brains had to work far harder than the control group, recruiting from more regions to achieve the same level of accuracy (Orenstein, 2024).

And while we’re here, despite what students might have seen on TikTok, “There is no safe way to strangle someone” (Orenstein, 2024). Believing that there is a safe way to choke would be an Internet fact, not an actual fact (Frantz, 2024).

“Among girls and women [Orenstein had] spoken with, many did not want or like to be sexually strangled” (Orenstein, 2024). I guess that’s the good news. But why is it so dang common—and becoming more popular?

Here’s where I suggest we turn this article into a class or small group discussion (in person or online) as part of the social psych chapter in Intro Psych.


Read this New York Times opinion piece of April 12, 2024 titled “The Troubling Trend in Teenage Sex” by Peggy Orenstein, and then answer the following questions.

  1. From the article, quote a sentence that illustrates the social pressure women feel to allow choking during sex. Have you seen this social pressure within your own friend group? If so, give an example.
  2. From the article, quote a sentence that illustrates the social pressure men feel to engage in choking during sex. Have you seen this social pressure within your own friend group? If so, give an example.
  3. From the article, describe how choking during sex became popularized through observational learning, starting with its beginning in porn.
  4. The article describes how oxygen deprivation can negatively impact the brain. Identify at least five of those effects. Which one do you find the most concerning? Why?
  5. The article suggests language that sexual partners can use to make clear what is okay and what is not okay during sex. What is that language? Consider a friend of yours. Do you believe they would be comfortable saying that to a sexual partner? Why or why not?
  6. In BDSM, consent—and the ability to withdraw consent (commonly with a safe word)—is paramount. Is choking someone because you think they want to be choked enough to establish consent? Why or why not? If someone gives their consent to be choked but then decides to withdraw their consent, can they do that if they cannot breathe and are losing consciousness? Why or why not?
  7. If someone has not given their consent to be choked, can the person doing the choking be charged with assault? Why or why not? If the person being choked experiences permanent damage to their brain or dies, can the person doing the choking be held liable? Why or why not?
  8. What was the most surprising thing you learned from this article? Explain.




Frantz, S. (2024, March 22). “Internet fact or actual fact?” Macmillan and BFW Teaching Community.

National Center for Education Statistics. (2023a). Postbaccalaureate enrollment. Condition of Education.

National Center for Education Statistics. (2023b). Undergraduate degree fields. Condition of Education.

Orenstein, P. (2024, April 12). The troubling trend in teenage sex. The New York Times.


About the Author
Sue Frantz has taught psychology since 1992. She has served on several APA boards and committees, and was proud to serve the members of the Society for the Teaching of Psychology as their 2018 president. In 2013, she was the inaugural recipient of the APA award for Excellence in the Scholarship of Teaching and Learning at a Two-Year College or Campus. She received in 2016 the highest award for the teaching of psychology--the Charles L. Brewer Distinguished Teaching of Psychology Award. She presents nationally and internationally on the topics of educational technology and the pedagogy of psychology. She is co-author with Doug Bernstein and Steve Chew of Teaching Psychology: A Step-by-Step Guide, 3rd ed. and is co-author with Charles Stangor on Introduction to Psychology, 4.0.