Laura Yuen
See more of the story

Add sexual strangulation to the list of all the things you wish you never had to talk to your teenage kid about, but probably should.

Known as "choking," in heterosexual encounters it's when a partner (usually male) wraps his hands around the throat of his partner (usually female) and squeezes, restricting blood or air flow.

Sexual choking is no longer a practice reserved for adults deep into kink.

Indiana University professor Debby Herbenick, a leading researcher on sexual behavior, surveyed about 5,000 students at a large Midwestern university and found that two-thirds of women had been choked during sex, according to an excellent opinion piece by Peggy Orenstein in the New York Times.

That this dangerous behavior — asphyxiation is never safe — has suddenly become mainstream should be a concern to anyone with a young person in their lives. Sexual norms have been shaped by the wide accessibility of certain kinds of graphic porn among minors, porn often based on male fantasy and misogyny. Young people who are just becoming sexually active, whether they've seen graphic videos or not, may come to believe this is what is realistic, expected or desired.

It doesn't help that social media videos offer instructions on how to do it "safely," despite emerging evidence that interrupting the blood flow to the brain for even a short time can lead to lasting damage.

While some women say they enjoy being choked, others say they did it mostly to please their sexual partner, according to another study led by Herbenick.

That leads me to think that even if consent is established, rough sex that prioritizes male gratification at the risk of harming young women has been so normalized that some women don't question why they are consenting. The median age of first being choked or choking someone else is 19, with women and gender minorities significantly more likely to be on the receiving end, according to Herbenick's findings.

I wanted to know how a trusted youth health mentor might broach this topic, so I called Haven Davis, a health educator for the city of Minneapolis, who has taught sex education at Southwest High School. Her federally funded work has led her to have meaningful conversations with teens as part of school-based clinics over the years.

First, some context: Davis reminded me that sexual activity among teens has been on the decline for the past decade; the 2022 Minnesota Student Survey shows that only 29% of 11th-graders reported ever having sex.

Still, when she reads the studies on choking among young people, she finds the trend lines "shockingly high."

Davis said the first time she heard about young people engaging in sexual choking was in an anonymous survey about four or five years ago. A student asked Davis, "If a girl asks me to choke her, what should I do?" she recalled. "It's definitely something that young people are thinking about and noticing. The question for me is: How did it make the leap from an activity that's seen as more extreme to a behavior young people are normalizing?"

She says just as health educators are trying to get ahead of this troubling trend, parents and other caring adults also play a huge part.

Davis offered some suggestions for these adults:

• First, strive for a conversation that leads to further communication and connection. How can you keep this person in your life talking to you? Let them know you're not going to judge them for their choices. For people who are experiencing sexual harm, having a trusted adult in their corner is a "powerful protective factor," Davis said.

• It's perfectly fine to state your values around sexual health and what you would expect from a healthy sexual interaction. Break down rigid gender stereotypes of male domination and women being coerced. Speak early and often about consent and the importance of setting boundaries. You can bring up the trend of choking and say, "I don't think this is OK. What do you think?"

• Present them with accurate and science-based information. Researchers are beginning to see links between choking and cognitive impairments and worse mental health. Strangulation can lead to brain damage. It's not enough to tell kids to abstain from certain behaviors without explaining the reasons behind it.

Finally, don't sweat it if you aren't sure what to say.

"A lot of adults go into these conversations thinking, 'I need to have all the answers,' " Davis said. "But you can have some really amazing conversations just starting with, 'What do you think about that?' "

Many teens today may think choking is normal. But as adults, we can help shift the norm back and keep young people safer — one conversation at a time.