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A bus driver made me move to the back of the bus the other day because my conversation was “distracting him”. I was on the phone with my mum having a friendly debate about the ethics of strangulation porn (God love her). She’d listened to Woman’s Hour discuss how “there is no safe way to strangle” because restricting oxygen flow carries serious consequences: brain injury, aspiration pneumonia, loss of consciousness, memory impairment and death. What struck her was how normalised choking has become among young people—and how little information is available to support informed consent. What struck me was how easily hard-line language and possible research bias could stigmatise consensual BDSM practices.
UK data makes clear this isn’t a fringe issue. A YouGov poll found that one in eight young adults (18–29) have been choked during sex, rising to around 15% of young women. A third of young women and a fifth of young men said a partner had held their throat during sex. A 2024 pilot survey by the Institute for Addressing Strangulation (IFAS) reported that 35% of 16–34s had experienced strangulation or choking during consensual sex, and 27% had done it to a partner. Importantly, IFAS notes that only about half of people show visible injuries, meaning many assume they’re “fine” despite potential underlying harm, and that frequent non-fatal strangulation during sex was associated with altered brain activation during working-memory tasks (Huibregtse et al., 2022).
What the research rarely foregrounds is that almost all this data comes from clinical, forensic or police samples—contexts in which harm or criminality has already occurred (Patch, 2017; Sharman et al., 2023). This creates a substantial sampling bias. These datasets do not account for the careful management of risk in consensual power play encounters, such as through regular check-ins or pre-determined non-verbal consent cues. Furthermore, the data collapses all neck compression into a single category, largely erasing crucial variables such as method, pressure, duration, communication practices or—fundamentally—consent (Herbenick et al., 2022). What’s strikingly absent is any meaningful involvement of BDSM and kink communities as co-researchers, even though they are often the groups with the most expertise in practising sexual strangulation within carefully negotiated and highly controlled contexts. Without community-based research and better clinical coding, policy debates rest on incomplete evidence (Durham University Research Brief, 2024). In other words: the evidence we rely on already reflects a certain bias, and our interpretations inevitably follow.
This debate is timely as the UK government is preparing to criminalise the depiction of choking in pornography, arguing that any representation normalises violence. My argument to my mum was that banning depictions of certain sex acts has a long and unconvincing track record—where there is a will, there is a VPN—and, more importantly, a blanket prohibition risks further stigmatising BDSM communities. Can we be brave enough to promote ethical pornography where consent education is woven into the dialogue, or advocate for sex-positive education where pleasure is foregrounded and people are taught to listen to and advocate for their body? Don’t hear what I’m not saying: none of this is to suggest that coercion, pressure or confusion count as consent, because of course they don’t. However, treating strangulation as a monolith—one undifferentiated “bad thing”—is not an evidence-based position. It’s a values position, and as I keep discovering on this fellowship, values are an essential issue to navigate.
A major theme in my interviews across Australia has been the unavoidable role that personal values and biases play in sex education. Organisations repeatedly told me: you cannot leave your values at the door if you don’t know what they are.
Melba runs reflective practice workshops where practitioners trace their own sexual education histories before they attempt to design that of others. For parents, especially those from culturally and linguistically diverse backgrounds, starting with their own stories often reveals unexamined assumptions they didn’t know they held.
Sexual Health Victoria mitigates bias by working strictly within legal and human-rights frameworks, grounding decisions in WHO guidance, which mandates that a “positive and respectful approach to sexuality and sexual relationships” includes “the possibility of having pleasurable and safe sexual experiences” (WHO, 2006; reaffirmed 2022).
True’s Natasha Milner emphasised that organisations themselves often need values clarification: supposedly risk-averse policies like “no funny business in the bedroom” can contradict the legal right to private life, relationships and sexual expression—and may actually increase organisational risk. Tenille from
Safer Me Safer You argued that people can’t critically reflect on biases they don’t know they have—reflection needs to be intentional, not a bureaucratic tick-box exercise. What is emerging, overwhelmingly, is the need for a cultural shift away from procedural defensiveness and towards relational, rights-aligned practice.
Sexologists like
Niamh Mannion,
Alicia Melita,
Jodi Rogers and
Lud Allen reinforced the importance of reflective practice through SAR (Sexual Attitude Reassessment) training, where professionals are encouraged not to be “judgement free” but judgement aware.
Rubix Support similarly attends Relate Sexology training that surfaces implicit biases through structured exercises. Jodi’s training with caregivers asks support workers to explain, without euphemism, topics like oral sex or abortion to each other—because if you can’t talk about them clearly, you won’t teach them clearly. Niamh’s values-continuum exercises surface discomforts; people physically move in a room in response to statements like “PWID should make their own reproductive decisions,” revealing not just belief, but intensity of belief.
And this is where it all connects: debates about choking in porn, moral panics about kink, and the challenges of sex education for PWID are all ultimately conversations about whose values count, and whose experiences get erased by the data we choose to prioritise. If we do not interrogate our biases—whether as researchers, practitioners, policymakers or bus drivers who panic at overhearing a conversation about fetish ethics—we will continue reproducing the same narrow, stigmatised understandings of sex.
I suspect the driver wouldn’t have asked me to move if I’d been loudly debating post-Keynesian critiques of capital accumulation or the viability of universal asset trusts. But sex, unlike macroeconomics, hits closer to home. Everyone has values about it, and those values shape the entire ecosystem—from legislation to policy to practice to what support a disabled adult receives on Tuesday at 3pm.
Which is exactly why we have to examine them.
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Bibliography
Durham University Research Brief. (2024). Strangulation in sexual contexts: Current evidence and gaps. Durham University.
Herbenick, D., Fu, T., Patterson, C., et al. (2022). “Sexual experimentation, BDSM practices, and communication strategies in partnered sex.” Journal of Sex Research.
Huibregtse, E., et al. (2022). “Associations between non-fatal strangulation during sex and brain activation patterns.” Neuropsychologia.
Institute for Addressing Strangulation (IFAS). (2024). Pilot survey on UK experiences of strangulation and choking during sex. IFAS.
Patch, M. (2017). Non-fatal strangulation: Forensic and clinical insights. Forensic Medicine Review.
Sharman, L., et al. (2023). “Health outcomes and evidential challenges of non-fatal strangulation.” Journal of Forensic and Legal Medicine.
Sharman, L., McGlynn, C., & Durkin, C. (2024). Public perceptions and prevalence of sexual strangulation in the UK.Durham University.
WHO. (2006; reaffirmed 2022). Defining sexual health: Report of a technical consultation on sexual health. World Health Organization.
YouGov. (2021–2023). Poll data on sexual behaviours among young adults in the UK
Easy English Version
Strangulation during sex has been discussed a lot recently in the news. Some people say it is always dangerous and harmful. Some say it should even be made illegal in pornography. I want to explain why this debate is more complicated than it first seems, and why it connects to the importance of understanding our own values when teaching sex education.
What we know from research
Many studies say strangulation is linked to serious harm and even death. But a lot of this research comes from:
This means researchers are already looking at people who were hurt, often in abusive relationships. So the findings describe non-consensual violence, not consensual kink. This can make the results look more one-sided than they really are.
There is also very little research with people in BDSM or kink communities, even though these groups often use safety plans, safe words, non-verbal cues, and careful consent processes. They could help researchers understand how people do this safely. But they are rarely included. This is a kind of researcher bias – when researchers accidentally focus on some groups and ignore others.
One study mentioned in a recent broadcast looked at people who enjoy consensual strangulation and found that there may be harm that isn’t visible from the outside. This study is important, even though it is only one piece of evidence. It shows that the risks are real — and it reminds us that all of us, including me, are drawn to the evidence that supports our own beliefs. This is why these debates are so difficult.
Should this kind of porn be banned?
Some people argue that strangulation porn should be illegal. But banning it will not stop people from wanting to explore power, intensity, or fantasy. It may simply push them into unsafe spaces or shame them more.
Another option is ethical porn, where actors explain the act, show clear consent, and talk about safety. This already exists on some platforms. Showing ethical practice could help people understand what safer kink looks like.
What this debate tells us about sex education
This whole discussion links to a bigger problem in sex education: many educators teach as if their own values are “neutral”. But no one is neutral. Our beliefs about safety, shame, pleasure, and risk all influence what we think is “good sex” or “bad sex”.
Research shows that sex educators often say values-based teaching should be open-minded, respectful, and non-judgemental. But in reality, many feel unsure about their own biases, especially around topics like kink, power play, or sexual diversity. Clare Maxwell writes that pleasure is often forgotten in sex education, even though the World Health Organization says sexual pleasure is an important part of sexual health and human rights.
When sex educators avoid talking about pleasure, or hide their own discomfort, learners pick up on it. And people with intellectual disabilities — who already face barriers to sexual autonomy — are often given even more limited, risk-focused information. This means they miss out on learning how consent, safety, boundaries, and pleasure work together in real life.
Why acknowledging our biases matters
If we want to teach sex education well, we have to know:
what our own values are
when our personal feelings are guiding our teaching
where our information comes from
and whether we are ignoring groups that challenge our assumptions
Kink is already heavily judged in society. If researchers and educators only focus on the dangerous cases and ignore the consensual ones, kink becomes even more misunderstood. People who want to explore these desires may feel ashamed, unsafe, or turn to harmful spaces.
Acknowledging our biases doesn’t make us less professional — it makes us better, clearer, and more honest educators.
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