An Australian teenage girl’s death, suspected to be preceded by consensual “choking” during sex, has renewed calls to ban showing the act in porn.

This latest tragedy, reportedly believed to involve sexual strangulation, comes just months after the UK banned porn showing the practice. But despite all the noise, most people still aren’t aware of just how dangerous the trend is.

Sexual strangulation or “choking” during sex, as it’s referred to colloquially, has become wildly popular—especially among adults aged 18 to 35, despite the risk of severe injury, brain damage, and even death. Some researchers argue that porn is to blame for that normalization, but members of the adult industry say that banning depictions of choking won’t stop this kind of content from flourishing or serve as the kind of sex education and media literacy the public sorely needs.

“With the misinformation that’s out there, especially online, many people do think that maybe at lighter pressures they might be ‘safe,’ and that’s not the case,” says Debby Herbenick, a professor at the Indiana University School of Public Health and one of the leading researchers on sexual strangulation. Herbenick cautions that applying sustained pressure to the front and sides of the throat—via your hands, an object, or otherwise—can lead to blood clots and stroke, tears in the carotid arteries, vision impairment, and cumulative brain injuries.

“It’s these things that we wouldn’t even notice,” she says. “Those tiny, incremental changes in your vision, or your brain, or so on.”

Or, in the most extreme cases, death. Pressing on the front of the throat can lead to airway collapse, Herbenick says. Two weeks ago, a 16-year-old girl in Sydney passed out after authorities believe she was strangled by her equally young partner during sex. She died after being taken to a local hospital in critical condition, and the investigation is ongoing. It’s unknown what her exact injuries were.

The Australian Social Services Minister has since said the government is “very seriously” looking at efforts to ban pornographic depictions of choking in sex, in line with the country’s recently passed age-verification laws that ban social media for children under the age of 16. But critics of these social media bans say they don’t actually work and make it harder for teens to access news and information they need, including sex education around the dangers of choking and strangulation.

The data regarding rates of young people choking and being choked during sex can appear staggering. In Herbenick’s 2021 survey of nearly 5,000 college students in the US, 58 percent of women had been choked during sex and a quarter had been first choked by age 17. Researchers in Australia similarly found rates of around half of people aged 18 to 35 engaging in the practice. Herbenick found that women are usually the ones being choked by men during heterosexual sex and that sexual and gender minorities are also more likely to be choked during sex.

“There are other people who say ‘I asked them to choke me or I said it was OK, but then they really pushed past my limits or it was a lot harder than I expected, or I asked them to stop and they didn’t,’” Herbenick says. She also says that while some young men enjoy the act, others “tell us that they don’t want to be choking their partners, but they think they’re supposed to, or they get asked all the time.”

Most of the self-reported occurrences of sexual strangulation among US college students Herbenick surveyed were described as consensual, but when choking is nonconsensual, it can be even more dangerous. In fact, strangulation is one of the strongest predictors for murder in an abusive relationship.