Choking, smothering, slapping: More teens are having rough sex. Here’s why.

As a sexuality researcher and college professor, I have a unique window into young people’s sexual lives. One of the most significant changes to teenage sexuality that I’ve seen in recent years has to do with the increase of “rough sex” — a trend influenced by widely accessible pornography, popular erotica such as Fifty Shades of Gray and social media.

Given how widespread rough sex has become among young people and some of the harms I’ve seen, I’m convinced that every parent, caregiver and educator needs to know about this trend — even if (and perhaps especially if) they cannot fathom their teenager would ever try it.

What is rough sex?

As I describe in my new book, Yes, Your Kid: What Parents Need to Know About Today’s Teens and Sex, the term “rough sex” refers to a diverse group of sex acts such as choking, smothering, spanking and slapping. For sexual activities that occur between women and men, the woman is nearly always the person on the receiving end of rough sex, and the man is nearly always the person doing the choking or slapping or smothering. However, rough sex happens between people of all genders and sexual orientations. Some teens begin exploring rough sex early in their development, such as when they start making out. For others, the exploration begins as they become more sexually experienced.

Rough sex as a new norm

In my research, I’ve found that many young people think that sex is supposed to be rough. According to a recent national survey from Common Sense Media, the average age at which young people first see pornography, whether on purpose or by accident, is 12 years old. Given how easy it is to access pornography (the Pew Research Center finds that 95% of teenagers have access to a smartphone), many teens watch pornography for several years before becoming sexually active with a partner. These repeated exposures can create a sense of how sex is “supposed” to play out — especially when what young people see online is not balanced by sexuality education at home or in schools.

Indeed, when we’ve asked college students why they engage in rough sex, they generally say that they engage in it because it feels exciting or adventurous, or that it’s just the way that sex is done these days. Young people sometimes describe worrying they will be “vanilla shamed” — written off as boring — if they’re not into rough sex. Some young men worry they won’t be viewed as masculine if they don’t choke or slap their partner.

Where are they getting the message that rough sex is common, expected and desirable? Young men often describe learning about rough sex from pornography, whereas young women often describe learning about rough sex from social media memes, TikTok and fan fiction. Teens also learn about rough sex from friends, partners, television shows like Euphoria and The Idol, and popular music (Jack Harlow’s “Lovin on Me” is a recent example).

Just how common is rough sex?

Young people who consider rough sex to be the norm these days aren’t entirely wrong. In a 2020 survey of 4,998 undergraduate students representative of college campuses, my colleagues and I found that about 80% of students had engaged in rough sex, and most described liking it. One of the most common forms of rough sex is widely referred to as “choking” even though it is technically a form of strangulation because it involves external pressure to the neck rather than internal blockage of the airways.

People who engage in choking usually use one hand to press against or squeeze their partner’s neck; less often, they use their forearm or a ligature, such as a belt or tie. Although many articles advise readers to press against the sides of the neck as a safer form of choking (it is less risky than pressing on the windpipe), pressing on the sides of the neck still reduces blood flow to the brain. Because blood carries oxygen, glucose and other nutrients to the brain, depriving the brain of blood flow can be harmful.

Although choking — which is a form of erotic asphyxiation — is not a new sexual practice, it used to be quite rare. Even in BDSM and kink communities, sexual asphyxiation was long regarded as too risky, and it was often advised against. Some studies suggest that even as recently as the 2000s, less than 5% of people had ever engaged in erotic asphyxiation.

Times have changed, however. In a 2021 U.S. nationally representative survey, we found that 1 in 3 women age 18 to 24 were choked the last time they had sex. Among college students, about two-thirds of women have been choked during sex, as have nearly one-third of men and about half of transgender and gender nonbinary students. About one-quarter of these students were first choked between the ages of 12 and 17. While most parents would find it difficult to imagine that their teenager or young adult child could be engaging in rough sex, the reality is that it’s happening.

What parents need to know about teens and rough sex

Given what I’ve learned from both my research and my college students, here is what I think parents need to know. First, parents need to understand how mainstream rough sex and choking have become. Their teenager is not a bad person if they are interested in rough sex or have tried it; they are likely just responding to the world around them or even a request from a partner. Second, parents should share with their teens that some forms of rough sex can be harmful and should be avoided. Choking/strangulation can cause injury and death. Contrary to what many articles say, there’s truly no entirely “safe” or zero-risk way to choke. Choking has been linked with short-term and long-term health problems. In one study I conducted, 15% of young people who had ever been choked reported experiencing neck bruising. Also, 3% had lost consciousness, which often means the person has experienced a traumatic brain injury. But it’s not just choking: Being slapped on the face or head can lead to concussion and eye injury.

Because about 40% of people who have been choked have found it difficult to breathe or to speak, parents should also talk with their teens about how choking/strangulation can interfere with a person’s ability to give consent or to ask someone to stop. They should share that even if a person’s partner consents to rough sex, they could be held responsible if they accidentally injure or kill their partner during rough sex. High-risk forms of rough sex — including choking/strangulation — are best avoided altogether.

Finally, it’s important to try to remain calm when talking with teens about sex. Fear-based approaches to sensitive topics — whether that's alcohol, drugs or sex — are often ineffective. Instead, it can help to share fact-based information in a way that shows you care about them and their friends or partner and just want to help them stay safe.

Debby Herbenick is a provost professor at the Indiana University School of Public Health and an AASECT-certified sexuality educator.