Chokes Are Inherently Unsafe

The context we're talking about is consensual, explicitly negotiated, intimate contexts. We are not discussing family violence situations or anything remotely resembling a grey area.

Having grappling as a special interest is really helpful here, even when you don't engage in this particular activity. I used to teach this, but I don't anymore. Here's why:

Cultural Context

Choking is extremely normalised among young people to an extent that it is perhaps not even considered a kink. This is often attribute to pornography or social media, as well as the lateness and extreme risk aversion of formal sex education resulting in the only message from it being "don't do this".

Medical Risks

This topic is overwhelmingly discussed in terms of chokes (air) and strangles (blood), and almost always framed as though those are two completely separate concepts. They're not.

There is a very large amount of extremely important stuff in your neck, and most of it is quite exposed. As a result of its anatomy, it is very difficult to put pressure on the carotid arteries without putting any pressure on the windpipe (and vice versa). The question is simply which one you're putting more pressure on.

The risks of blood chokes are not really spoken about in BJJ, and it is often simply assumed that because their teammates always wake up, they must be fairly safe. Nothing could be further from the truth.

Even a cleanly executed blood-dominant choke which does not produce unconsciousness or lightheadedness is still high risk in the general population, and this risk may be delayed for weeks or months after the event. BJJ players are broadly younger, fitter, and better supervised than this, and even then there is emerging concern of long-lasting cerebral injury which goes unnoticed among athletes.

Simple pressure on the neck can absolutely be sufficient to cause fainting, transient ischemic attacks, full strokes, and artery delamination or dissection. While the risk profile scales with pressure and repetition, you do not need to be "choked out" for any of this to happen.

Pressure to the trachea often also causes a panic reaction, which is extremely unsexy and often traumatic. This is a common risk even among scenes where no permanent physical damage occurred: panic attacks are no joke, and can have even more serious long-term consequences.

Differential Mechanics

All forms of choking or strangling hit multiple mechanisms at once, but the proportions of each mechanism differ. Something which might be illustrative on this topic is the distinction between the palm-on-palm choke and the classic MMA-style rear-naked choke.

Judo and the like have a bit of confusion about the exact nomenclature of the two techniques, because technically they're both in the "hadaka-jime" family (unclothed strangle).

A correctly applied palm-on-palm choke places a large amount of pressure directly on the windpipe. This is a miserable experience, even for people who otherwise enjoy this style of play. It is extremely painful and by its mechanism often directly causes panic attacks. This is mostly an "air" choke, and is a straightforward demonstration of the "wrong" way to choke someone.

The famous rear-naked choke, as seen in a large proportion of MMA fights, is not obviously a completely different type of thing while having a completely different effect. When applied correctly, it is mostly a "blood" choke. The hand and arm positioning are not miles away from the palm-on-palm, and my central point here is that you don't need to get it all that wrong to switch category.

In a dynamic context where either or both party is fatigued or distracted by other goings-on of the scene, it is completely reasonable to expect shifts in positioning to the tune of centimeters — more than enough to make things critically dangerous.

Legal Risks

In Victoria, when handled as a family violence matter, choking or strangulation of a partner is specifically criminalised: even if there is no injury at all, if a healthcare practitioner (or several other mandatory reporters) believes strangulation occurred as part of family violence — the practitioner must assess and document the incident, they can (depending on assessed risk) hand over to the police without the recipient's consent, the police can investigate and charge without the recipient's cooperation, and consent is not a defence. These are serious indictable offenses with serious jail time.

The eagle-eyed among you will realise that this creates a profound incentive not to seek medical treatment for (potentially serious) injuries incurred through consensual play. This type of law was written with an utter ignorance of kink contexts, and has serious unintended consequences. This is another example of a system creating or worsening the risk it was supposed to be fixing — even actual DV survivors may avoid treatment for this type of injury now.

"I explicitly asked them to do it, and now it's unsafe for either of us to go to the emergency department" is a worst-case scenario that this legislation unnecessarily creates. The system is the source of risk here.

Not to put too fine a point on it: most DV advocacy doesn't actually understand that kink is a categorically different type of thing. At most they often argue that abuse hides inside kink, therefore they don't need to distinguish.

Most Common Mechanics

The most common variation used by laypeople is a strangle with a delightful name I won't repeat here, where the top simply places their hands on the bottom's neck and squeezes. This is a particularly unsafe way to strangle someone, as a centimeter or two of hand positioning can drastically change the risk profile — the density of important infrastructure in this space means that this is life and death.

As soon as the squeezing begins, all involved are potentially in life-changing trouble, even if there is no injury. Trained grapplers using dedicated strangling techniques carry enough risk already, let alone laypeople with no training.

Intimate Context

Just about every aspect of engaging in this activity in an intimate context increases the risk, not decreases it.

First up: it is overwhelmingly unlikely that there is a first-aid trained third party watching over the situation, like there is in a jujitsu school.

By definition, participants in erotic strangulation are overwhelmingly likely to have more than one thing on their mind as they engage in it, which means that the only person who is in a position to keep the bottom safe is pretty darn distracted. Pressure on the windpipe can inadvertently make safewording difficult¹, and bodyweight can easily inadvertently put pressure on the diaphragm.

When you combine these factors with a lack of technical training and physical fitness, you potentially have a powderkeg. Adding in things like alcohol and substances brings a match to it.

Central Point

In an intimate context, choking and strangling are unsafe — legally, medically and ethically — and there is no way to make them safe. They are an inherently unsafe thing to be doing. Whether or not they're common or normalised is completely irrelevant.

Given the seriousness of the consequences, the complexities of non-obvious injury mechanisms, and the knife-edge between fine and dead, splitting hairs about how it can maybe be done probably without disaster is not productive.

That's not to say that I'm advocating for nobody to ever do this. Just pointing out the actual risk profile: no matter how you mitigate it, there is a substantial risk of catastrophic failures in multiple domains. You can do this in a risk-aware way, but not a safe/sane/consensual one.

This is by far closer to bringing a loaded gun into the bedroom than something you saw in porn once and decided to give a crack: a deeply nuanced extreme risk which must be very carefully considered with detailed information.

🔗 Checkin

Written: 2026-02-10 to 2026-02-11

Written on: 7.5mg olanzapine since 2025-11-11

Cognitive capacity: very poor - estimate 15% brain

¹Always, always, always have secondary physical safewords: tapping, stamping your foot, "uh-uh", clicking your fingers, one hand clapping.