A 16-year-old girl’s death in Sydney has brought new attention to a sexual behavior that has become increasingly normalized among young people: choking. Research suggests it is remarkably common, often misunderstood, and capable of causing serious neurological injury—even when everyone involved considers it consensual.
On Sunday evening, emergency services responded to a home in Sydney’s northern beaches after receiving a welfare concern report.
Paramedics found a 16-year-old girl unresponsive. They treated her at the scene and airlifted her to a hospital in critical condition. Two days later, she died.
According to reporting from The Guardian, New South Wales police are investigating the teenager’s death. A source familiar with the case told the publication that investigators believe she may have lost consciousness from asphyxiation during sexual activity involving what people commonly call “choking.” At the time of reporting, police had made no arrests and the investigation remained ongoing. Buckley, P. (2026, August 27). Police investigate death of teenage girl, 16, two days after alleged ‘sexual choking’ act in Sydney. The Guardian. https://www.theguardian.com/australia-news/2026/aug/27/sydney-16yo-girl-death-suspected-sexual-choking-asphyxiation-ntwnfbCopy
Because police are still investigating, it would be irresponsible to draw conclusions about exactly what happened in this teenager’s case. But her death has focused attention on a much larger public-health issue.
Sexual choking has become remarkably common among young people. Many encounter it before adulthood. And emerging research suggests that the behavior people casually call “choking” can produce neurological effects even when participants consent and no catastrophic injury occurs.
“Choking” Is Actually Pressure on the Neck
The language surrounding this behavior can obscure what physically happens. People commonly call it “choking,” and it also appears online under terms such as “breath play.” Medical and legal researchers frequently use the term strangulation because the behavior generally involves external pressure on the neck.
Choking technically refers to an internal airway obstruction, such as food lodged in someone’s throat. Strangulation involves external pressure to the neck that can interfere with blood flow, airflow, or both.
In a 2025 study, researchers surveyed Australians ages 18 to 35 about what they believed made sexual choking or strangulation safe. Many participants believed precautions such as applying “light” pressure, avoiding the airway, communicating, using safe words, or pressing particular areas of the neck could make the practice safe.Sharman, L. S., Fitzgerald, R., & Douglas, H. (2025). Choking/Strangulation During Sex: Understanding and Negotiating ‘Safety’ Among 18-35 Year Old Australians. Archives of Sexual Behavior, 54, 483–494. https://doi.org/10.1007/s10508-025-03097-3Copy
But those beliefs can create a dangerous illusion of control.
As experts recently explained to The Guardian, there is no established amount of pressure on the soft tissue of someone’s neck that makes strangulation safe. Serious consequences can include loss of consciousness, brain injury, stroke, and death.Gorman, A. (2026, August 29). Choking is sold to teens as a safe sexual practice. The research says it never is. The Guardian. https://www.theguardian.com/society/2026/aug/29/choking-sexual-strangulation-research-no-safe-pressure-ntwnfbCopy
That means the question shouldn’t simply be whether someone “knows how to choke safely.” The evidence doesn’t provide a reliable technique, location, duration, or level of pressure that eliminates the possibility of harm.
More Than Half of Young Australian Adults Surveyed Had Experienced Sexual Strangulation
The scale of this trend surprised even researchers studying it. In a large Australian study, researchers surveyed 4,702 people between ages 18 and 35. Fifty-seven percent reported that someone had strangled them during sex at least once. Fifty-one percent reported having strangled a partner, while 43.9% had experienced both sides of the behavior. Researchers also found substantial gender differences. Sixty-one percent of women reported having been strangled, compared with 43% of men. Meanwhile, 59% of men reported strangling a partner, compared with 40% of women.
Rates were particularly high among trans and gender-diverse participants: 79% reported having been strangled and 74% reported strangling a partner.Sharman, L. S., Fitzgerald, R., & Douglas, H. (2025). Prevalence of Sexual Strangulation/Choking Among Australian 18–35 Year-Olds. Archives of Sexual Behavior, 54(2), 465–480.Copy A potentially dangerous behavior involving pressure to one of the body’s most vulnerable areas has moved far enough into mainstream sexual culture that more than half of these young adults reported experiencing it.
Researchers in the U.S. Are Seeing the Same Generational Pattern
Australian young adults aren’t alone. Researchers surveyed a representative sample of 4,254 undergraduate and graduate students at a large U.S. university in 2021. About 40% reported having been choked during sex. The average age when participants first choked someone or were choked was approximately 19. Undergraduate students reported beginning younger than graduate students, and some reported their first experiences during adolescence.
Researchers also asked about what happened physically. Participants reported responses including difficulty breathing, coughing, dizziness, lightheadedness, head rushes, neck pain, headaches, vision changes, and losing consciousness. A greater frequency and intensity of choking were associated with participants reporting more physical responses. Herbenick, D., Fu, T. C., Eastman-Mueller, H., Thomas, S., Svetina Valdivia, D., Rosenberg, M., Guerra-Reyes, L., Wright, P. J., Kawata, K., & Feiner, J. R. (2022). Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students. Archives of Sexual Behavior, 51(6), 3121–3139. https://doi.org/10.1007/s10508-022-02347-yCopy According to researcher Dr. Debby Herbenick, when her team asks college students when they first learned about sexual choking, the average age is approximately 15.
That means many young people are learning about choking years before researchers ever survey them about actually doing it. And it raises an obvious question: Where are they learning it?
Porn Isn’t the Only Influence, But Researchers Say It’s a Major Part of the Picture
Pornography did not invent sexual violence, strangulation, or aggressive sexual behavior. But today’s young people have grown up in an unprecedented sexual media environment where aggressive acts can appear alongside ordinary sexual behavior with little explanation of physical risk, consent, preparation, injury, or what happens after the camera stops. Porn is one part of that environment.
Research analyzing mainstream pornography has repeatedly documented physical aggression, including behaviors such as spanking, gagging, slapping, hair-pulling, and choking. Aggression appears commonly in mainstream pornography, and consumers can encounter choking as part of sexual scripts rather than as an exceptional behavior. This becomes particularly important when young people use porn to learn about sex.
A sexual behavior doesn’t need to come with an explicit instruction saying, “You should do this,” to communicate a message. Repeatedly presenting a behavior as routine, pleasurable, expected, or consequence-free can contribute to perceptions of what sex commonly looks like.
Herbenick told The Guardian that pornography is just “one piece” of the cultural environment surrounding choking. Social media is another. Young people can also encounter choking in memes, fan fiction, “dark romance,” and other sexualized entertainment. It’s about these pornified sexual scripts.
When young people repeatedly encounter strangulation as something sexy, normal, desirable, or expected—and rarely encounter accurate information about what pressure on the neck can actually do—the cultural message can become dangerously incomplete.
Consent Matters, But Consent Can’t Make a Physiological Risk Disappear
Discussions about sexual choking frequently stop at consent. Did both people agree to it? Did they establish a safe word? Did they trust each other? Consent matters enormously. Nobody should introduce a sexual behavior without another person’s free and specific consent.
But consent and physical safety aren’t interchangeable.
The Australian qualitative study illustrates the problem particularly clearly. Many respondents believed communication, trust, “light pressure,” or prior agreement could make choking safe. Yet some participants also recognized that consent does not eliminate the possibility of physical damage.
Others described experiences in which partners initiated choking without asking. Some participants said they felt pressured to participate or worried about how a partner would react if they said no. One 24-year-old woman told researchers that men “see it in porn,” while describing choking without prior consent as frightening.
You can consent to an activity without becoming immune to its physiological consequences.
Scientists Are Now Finding Measurable Neurological Effects of Choking
Researchers have begun looking beyond surveys to study what may actually happen in the brain. In a 2026 randomized crossover study, scientists recruited 31 women ages 18 to 30 who already engaged in both choking-involved and non-choking partnered sex. Researchers did not randomly assign participants to start choking. Instead, participants completed assessments following sexual experiences that were already part of their lives, allowing scientists to compare outcomes after sex involving choking with outcomes after sex without it.
About one-third reported neurological symptoms, including head rushes and blurred vision, following choking-involved sex. Researchers also detected greater disruption in a measure of eye convergence following choking-involved sex than after sex without choking. The sample was small, the follow-up period was short, and some measures relied on self-report, so the study cannot establish all the long-term consequences of sexual strangulation. But its findings add to concerns that choking can produce acute neurological effects even outside obvious medical emergencies.Sweeney, S. H., Huibregtse, M. E., Day, H., Buddenbaum, C. V., Recht, G. O., Buehler, B., Herbenick, D., & Kawata, K. (2026). Clinical characteristics of acute sexual strangulation/choking: A randomized cross-over study. The Journal of Sexual Medicine, 23(1), qdaf356. https://doi.org/10.1093/jsxmed/qdaf356Copy
Another 2026 study went even deeper. Researchers recruited 29 young women who already engaged in choking during sex and collected blood following sexual activity involving choking and sexual activity without choking. After choking-involved sex, researchers detected an acute increase in neurofilament light chain, or NfL, a biomarker associated with axonal stress or injury. They also observed changes in an inflammatory marker associated with responses to hypoxic or ischemic stress. These findings provide biological evidence that sexual strangulation may place measurable stress on the nervous system even when participants perceive the experience as consensual and don’t end up in an emergency room.Sweeney, S. H., Recht, G. O., Lima-Cooper, G., Datta, D., Buddenbaum, C. V., Day, H., Buehler, B., Huibregtse, M. E., Herbenick, D., & Kawata, K. (2026). Acute blood biomarker responses to consensual sexual choking/strangulation in young adult women: A randomized crossover study. Frontiers in Global Women's Health, 6, 1717361. https://doi.org/10.3389/fgwh.2025.1717361Copy
Repeated Choking Raises Even More Questions About Brain Health
This becomes particularly concerning when choking isn’t a one-time experience. Herbenick told The Guardian that some participants in sexual choking studies report experiencing it dozens or even hundreds of times. That level of repetition changes the research question.
Scientists aren’t only asking what happens when someone experiences one episode of neck compression. They increasingly want to know what happens when a young brain experiences repeated episodes over months or years. Early neuroimaging studies have already identified differences associated with frequent sexual choking.
One pilot fMRI study compared women with frequent recent histories of being choked during sex with women who had never been choked. Researchers identified differences in brain activation during working-memory tasks. Because the study was observational and involved a small sample, it cannot 100% prove that choking caused those neurological differences.Hou, J., Fu, T. C., Herbenick, D., Rosenberg, M., Svetina Valdivia, D., Guerra-Reyes, L., Wright, P. J., Feiner, J. R., & Kawata, K. (2022). Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks. Frontiers in Behavioral Neuroscience, 16, 881678. https://doi.org/10.3389/fnbeh.2022.881678Copy
Another small neuroimaging study found structural brain differences associated with a history of frequent sexual choking, while again emphasizing that much more research is necessary before scientists can establish causation or determine the clinical meaning of those differences.Hou, J., Huibregtse, M. E., Herbenick, D., Rosenberg, M., Fu, T. C., Guerra-Reyes, L., Wright, P. J., Feiner, J. R., & Kawata, K. (2023). Structural brain morphology in young adult women who have been choked/strangled during sex: A whole-brain surface morphometry study. Brain and Behavior, 13(8), e3160. https://doi.org/10.1002/brb3.3160Copy
Scientists are now conducting larger longitudinal research to better understand whether repeated sexual strangulation produces lasting neurological changes. The evidence already establishes meaningful reasons for concern, but researchers are still determining the magnitude and long-term trajectory of neurological harm. But based on the research we’ve seen so far, it’s safe to say no type of choking is safe.
When Violence Looks Like Pleasure, Young People Can Learn the Wrong Lesson
Porn doesn’t usually pause a scene to explain whether someone’s vision blurred afterward. It doesn’t display blood biomarkers. It doesn’t show a brain scan six months later. And it certainly doesn’t come with a neurologist explaining that there is no scientifically established “safe” pressure for compressing someone’s neck.
Instead, pornographic media can present aggressive behavior as visually pleasurable, consequence-free entertainment.
That’s particularly significant because previous analyses of mainstream porn have found that targets of aggression frequently appear to respond neutrally or positively. This combination can send a powerful sexual script: aggression happens, the person receiving it enjoys it, and nothing bad happens afterward.
Former porn performers have also described a very different reality behind some violent scenes. One former performer recalled being unable to breathe while being hit and choked and said filming continued despite her distress. Personal testimony cannot tell us how frequently experiences like hers occur throughout the industry, but it does expose the gap that can exist between what viewers see on-screen and what a performer actually experiences.
That gap matters whenever porn becomes an informal sex educator. A viewer sees the finished product. They don’t necessarily see the pain, fear, negotiation, coercion, injuries, editing, repeated takes, medical consequences, or experiences that happen after filming. And a teenager, especially, may have no reason to know that anything important has been left out.
Young People Deserve Better Sex Education Than Porn
This isn’t an argument for shaming young people who have participated in choking. Many have encountered the behavior in a culture that presents it as ordinary sex. Some say they genuinely enjoy it. Some may have requested it. Others may have participated because a partner expected it, because they believed everyone else was doing it, or because the behavior appeared so often in sexual media that it stopped looking dangerous. Shame won’t solve that. Accurate information might.
Young people deserve to understand that “common” doesn’t mean harmless. “Consensual” doesn’t mean physiologically risk-free. And something looking pleasurable on a screen doesn’t make it safe to recreate in real life. They also deserve to hear that healthy sexual intimacy doesn’t require proving how adventurous, experienced, submissive, dominant, or porn-like they can be. No one owes a partner a sexual act because “everyone does it.” No one should have to accept pain, fear, pressure, or violence to seem sexually desirable.
And no partner should assume that something they’ve repeatedly watched in porn is automatically something another person wants.
What Happened in Sydney Shouldn’t Become Just Another Headline
We still don’t know exactly what happened to the 16-year-old girl whose death prompted this renewed conversation. Police are investigating, and her family deserves more than public speculation about the final moments of her life. But we know enough about the broader trend to talk about it now.
Sexual choking has become common among young adults. Many people first learn about it during adolescence. Researchers have documented widespread misconceptions about its safety. Studies have identified acute neurological symptoms and measurable biological changes following choking. Scientists remain concerned enough about repeated exposure to conduct longitudinal studies of young people’s brain health.
And porn, social media, memes, fan fiction, and other sexualized media can all help construct a world in which strangulation looks less like pressure on a vulnerable human neck and more like an ordinary part of sex. It’s not, and it’s not safe.
We understand what consent actually requires. We can talk openly about pressure and sexual expectations. We can explain the difference between entertainment and education, and understand the harms of porn. We can make sure they know that another person’s body isn’t a prop for reenacting something they saw online. We need to be reminded what porn doesn’t show us, healthy intimacy should center on in the first place: mutual care, informed choices, respect, safety, communication, and genuine concern for the person in front of you.
Because nobody’s life should become collateral damage in trying to imitate what porn has taught them sex is supposed to look like.
Your Support Matters Now More Than Ever
Most kids today are exposed to porn by the age of 12. By the time they’re teenagers, 75% of boys and 70% of girls have already viewed itRobb, M.B., & Mann, S. (2023). Teens and pornography. San Francisco, CA: Common Sense.Copy —often before they’ve had a single healthy conversation about it.
Even more concerning: over half of boys and nearly 40% of girls believe porn is a realistic depiction of sexMartellozzo, E., Monaghan, A., Adler, J. R., Davidson, J., Leyva, R., & Horvath, M. A. H. (2016). “I wasn’t sure it was normal to watch it”: A quantitative and qualitative examination of the impact of online pornography on the values, attitudes, beliefs and behaviours of children and young people. Middlesex University, NSPCC, & Office of the Children’s Commissioner.Copy . And among teens who have seen porn, more than 79% of teens use it to learn how to have sexRobb, M.B., & Mann, S. (2023). Teens and pornography. San Francisco, CA: Common Sense.Copy . That means millions of young people are getting sex ed from violent, degrading content, which becomes their baseline understanding of intimacy. Out of the most popular porn, 33%-88% of videos contain physical aggression and nonconsensual violence-related themesFritz, N., Malic, V., Paul, B., & Zhou, Y. (2020). A descriptive analysis of the types, targets, and relative frequency of aggression in mainstream pornography. Archives of Sexual Behavior, 49(8), 3041-3053. doi:10.1007/s10508-020-01773-0Copy Bridges et al., 2010, “Aggression and Sexual Behavior in Best-Selling Pornography Videos: A Content Analysis,” Violence Against Women.Copy .
From increasing rates of loneliness, depression, and self-doubt, to distorted views of sex, reduced relationship satisfaction, and riskier sexual behavior among teens, porn is impacting individuals, relationships, and society worldwideFight the New Drug. (2024, May). Get the Facts (Series of web articles). Fight the New Drug.Copy .
This is why Fight the New Drug exists—but we can’t do it without you.
Your donation directly fuels the creation of new educational resources, including our awareness-raising videos, podcasts, research-driven articles, engaging school presentations, and digital tools that reach youth where they are: online and in school. It equips individuals, parents, educators, and youth with trustworthy resources to start the conversation.
Will you join us? We’re grateful for whatever you can give—but a recurring donation makes the biggest difference. Every dollar directly supports our vital work, and every individual we reach decreases sexual exploitation. Let’s fight for real love:
