The death of a 16-year-old girl in Sydney has brought back to the center of debate a sexual practice often described with a misleading term: “choking”, suffocation or strangulation during sex. The teenager lost consciousness and was taken to the hospital in critical condition, where she later died. Australian authorities believe the incident may have occurred during sexual intercourse with her partner of the same age, but the investigation is still ongoing and neither the exact sequence of events nor the extent of the injuries have been disclosed.
The case has already had a political impact, however. Australia's Minister for Social Services stated that the government is very carefully considering the possibility of banning depictions of strangulation in pornographic content. The proposal fits into a regulatory framework in the country that also includes new rules on age verification and a ban on social media access for under-16s. In the United Kingdom, a ban covering pornographic scenes showing this practice came into effect a few months ago.
Moving from news events to regulation is delicate. Online pornography is not the sole origin of risky sexual behavior, and a ban on imagery alone does not resolve a lack of relationship, sex, and health education. However, researchers and organizations working against relationship violence have pointed for years to the normalization of conduct that is sometimes portrayed as ordinary, controllable, or harmless when performed with supposed moderation. From a medical standpoint, this safety does not exist.
Why the term “choking” hides the risk
In everyday language, choking suggests a limited or even playful act. From a clinical perspective, however, pressure on the neck can involve airways, arteries, and veins, with consequences that do not always appear immediately. Debby Herbenick, a professor at the Indiana University School of Public Health and one of the leading researchers on the phenomenon, warns that sustained pressure applied to the front or sides of the neck can cause injuries to the carotid arteries, blood clots, strokes, vision damage, and cumulative brain injuries.
The danger does not lie solely in the inability to breathe. Pressure on the front of the throat can cause airways to collapse, while compromised circulation can cause neurological damage even without leaving immediate visible signs. Subtle changes in vision or brain function can go unnoticed. In the most severe cases, the outcome is fatal. This is why public health campaigns prefer the term sexual strangulation and challenge the idea that a universally “safe” level of pressure exists.
The distinction also matters in public debate. A filmed portrayal where the act is simulated or suggested—such as a hand resting on the neck without pressure—is one thing; the actual application of force to the neck is quite another. Non-consensual strangulation in an abusive relationship is different yet again. Lumping every scenario into the same category can make it harder both to recognize abuse and to explain a physical risk that remains real even when the individuals involved describe it as consensual.
A widespread practice among young adults
Data collected in the United States and Australia point to significant prevalence, especially among younger demographics. In a 2021 survey conducted by Herbenick among nearly 5,000 U.S. college students, 58% of women reported having been strangled during sex, and a quarter stated that their first experience occurred by age 17. Australian studies have recorded rates of around 50% among people aged 18 to 35 who have had experiences of this kind.
The findings do not automatically demonstrate a cause-and-effect relationship between pornography consumption and offline behavior. However, they do show how deeply the practice has entered the contemporary sexual imagination. Herbenick notes that, in heterosexual relationships, women are more often on the receiving end of pressure applied by men; sexual and gender minorities also report a higher likelihood of being involved. Many experiences are described as consensual, but stated consent does not eliminate medical risk, nor does it guarantee that boundaries were respected.
From the testimonies gathered in the research, another element emerges: some people report having consented to the act, only to find themselves facing stronger pressure than they had imagined, or with a partner who did not stop after an explicit request. There are also men who report not wanting to choke their partner, but feeling pressured to do so because they perceive it as an expectation. It is an important mechanism: normalisation does not merely impose behaviour on the person subjected to it; it can also make it seem mandatory to the person carrying it out.
The role of porn and the limits of a ban
According to part of the research, pornography has contributed to making the presence of choking familiar in sexual practices, often offering little information about context, simulation, or real-world consequences. The immediate availability of videos on global platforms and specialised websites inevitably makes this a technological issue: it concerns not only what is lawful to produce, but also how to classify content, enforce rules across different jurisdictions, verify users' age, and intervene in distribution across platforms, search engines, and payment systems.
Adult industry representatives, however, dispute the idea that a ban on representation can stop the circulation of this material or replace education. Online, content can be hosted abroad, rapidly re-uploaded, or distributed via less visible channels; a national regulation therefore has obvious practical limits. The very critics of Australia's social media restrictions for under-16s point out a potential paradox: overly broad filters could make it harder for teenagers and young people to find reliable information about risks, including those related to sexuality.
This objection does not erase the issue posed by the commercial portrayal of potentially harmful acts. If anything, it shifts the focus to the quality of the intervention. An effective measure should distinguish between fiction and real violence, avoid relying solely on automated takedowns, and accompany any bans with clear health information, consent education, and genuinely accessible reporting tools. Furthermore, in the case of adult content, age verification is not merely an entry barrier: it involves collecting and processing sensitive personal data, with repercussions for privacy and security.
Consent, violence, and prevention
Non-consensual strangulation remains one of the strongest indicators of homicide risk in violent relationships. It is essential not to confuse this fact with every sexual experience reported as consensual, but it is equally essential not to use the label of consent to downplay potentially severe injuries. Boundaries can shift during sexual activity, they can be ignored, and they can prove difficult to communicate in an already physically dangerous situation.
For Australia, the inquest into the 16-year-old's death will first need to clarify the specific facts. Politically, however, the case will likely accelerate an already ongoing debate over what limits to place on online pornography and how to enforce them. The British precedent offers a reference point, but not a ready-made solution: any choice will have to grapple with the cross-border nature of platforms, the effectiveness of verification checks, and the need to avoid replacing prevention with censorship that fails to reach the murkiest content.
The most immediate lesson is a medical one. Presenting pressure on the neck as a consequence-free variation means ignoring well-established medical evidence. The debate over platforms and regulations can influence what is made visible and normalized; the discussion around education must explain, unambiguously, why harm can occur even when it is not immediately recognizable.
