How to Do It

I Might Like Being Choked in Bed a Little Too Much

Like, until I pass out. Should I stop?

A man with a flashing spiral behind him.
Photo illustration by Slate. Photo by HD91239130/iStock/Getty Images Plus.

How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!

Dear How to Do It,

One of the odder things I’ve discovered about my sexuality is that I’m into getting choked. Like … really into it. Cheryl from the show Archer caliber. The way that other guys get immediately hard if you play with their nipples, I get rock hard as soon as someone puts a bit of pressure on my throat. With a few tops I know—with lots of trust built and conversations before about safety, limits, clear signaling, etc.—it has gone to the point of me blacking out (after which they immediately stop). And like that Smarter Every Day video where they do the experiment with hypoxia, it’s a really weird experience! The disorientation is a bit of a trip. And, for me, also weirdly hot.

I also now totally understand why autoerotic asphyxiation is a thing, and why someone should never do that alone. I mean, you literally cannot form the thoughts to realize you are in danger, so a clear-minded person around is essential.

So. Obviously not the safest of activities. I read what I could on the internet about chokeholds and oxygen deprivation to the brain. But considering internet research of medical issues is sufficient enough to give the world the anti-vax movement, I’m less than trusting of just myself and my Googling abilities. As y’all have experts you turn to: What say them? Are there any risks major risks with getting blacked out for the briefest of moments possible? I wouldn’t want to find out the hard way that I could be putting myself at risk for cardiac arrest or something that would not have necessarily occurred to me safety-wise, apart from the obvious.


Dear Breathless,

Don’t do this. I hate to take the wind out of your sails, but it’s in service of getting oxygen to your brain. If you’re passing out from getting choked, you’re going too far and you’re risking your life. Breath play is a thing, one that many enjoy. I’m not judging, but I’m also not advising it, especially not as far as you’re taking it. Even if we examine the seminal book The Ultimate Guide to Kink, which described “safer” (not “safe,” per se) ways to engage in breath, it drew the line at passing out. “If you see his eyes rolling back in his head, stop,” it read.*

To understand the extent of the risk, I reached out to Madeleine Castellanos, a psychiatrist who specializes in sex therapy with couples and individuals. When you pass out during breath play, it’s because cutting off the blood supply to the head results in a lack of oxygen to the brain, a condition called hypoxia. This can cause brain damage. “The longer the brain tissue is without oxygen, the higher the chance of this happening,” Castellanos wrote in an email. “With each instance, there is the possibility of more brain damage. It is impossible to control how much or how little hypoxia will occur with erotic asphyxiation, even if there is a partner present, and it may only take a minute or two to result in death or permanent brain damage.”

Shook yet? Here are some other potential effects of hypoxia, per Castellanos:

·      Inflammation that may take days to resolve and result in “depression, irritability, issues with attention, aggressiveness, or other mood issues. If the hypoxia results in brain damage, these mood and attention issues can become permanent with noticeable changes in personality.”

·      Elevated blood pressure and stress response that could put you at risk for heart disease and atherosclerosis.

·      Changes in electrolytes, which could lead to heart attack, though Castellanos notes, “For this to happen, the decrease in oxygen usually has to be significant and for more than just several minutes.”

·      Mechanical damage to your neck structure, which, in extreme cases, could be permanent.

So, erotic asphyxiation, especially taken to the extreme that you do, is a no from me. I want you to feel good, but you have to be alive to do so.

Dear How to Do It,

I’m a trans woman in my mid-30s. I transitioned nearly a decade ago and have had bottom surgery. By all accounts, I hit the transition jackpot—not only do I pass for cis in a skimpy bikini, I’m conventionally attractive, live in a progressive city, and have a thriving career and a lot of amazing friends. Life is good, and I’m happier than I’ve ever been.

What I do not have is a lot of dating experience. I’m a solid Kinsey 1, so I’m primarily interested in men. But in my estimation, 99 percent of men on the apps are just not interested in dating a trans woman. I’m not complaining, because it is what it is, and I’m not going to beg anyone to love me, but because I pass so well, I find I have to make a big show of being trans to ensure they actually read my profile, then watch as they unmatch me. It’s exhausting and doesn’t feel like a good use of my time. My problem is that with cosmopolitan dating culture being almost entirely on the apps, I really don’t know where to meet single men. I’m not ignoring bisexual guys here, but there’s also not a great way to find them. There are not a lot of straight or bi men in my social circles either. I also fear the same level of rejection (or even violence) meeting guys in regular social situations. I’m fine to continue “dating myself” for the rest of my life if that’s how it has to be, but I feel like I’m missing something here.

—1 in 100

Dear 1 in 100,

Meeting men as a trans woman in your mid-30s is hard in no small part because “meeting men as a woman in your 30s is hard, period,” a friend of mine who’s a trans woman told me when I asked to discuss your question. That’s not to downplay the elements at hand that speak directly to the trans experience—rejection based on your gender identity and the threat of transphobic violence—but there is a certain universality you’ve touched on.

My friend tells me she’s had no luck making meaningful connections on apps—some dates, some casual sex, and that’s about it. There are apps specifically made for dating while trans, but she has no experience with them nor does she know anyone who has. She surmised that they probably “turn into the same thing that Grindr usually does, which is connecting you with 45-year-old cis dudes who will maybe talk to you weirdly even if it’s complimentary.” (Still, search “trans” or “transgender” in an app store if you’re curious to try.)

Your best bet, in her experience, is to ask friends to set you up, which will have the added bonus of being a litmus test for that friendship (“It might reveal something about the people she keeps in her life if any of them have a problem with it,” she explained). Also: queer spaces. In a city like New York, scenes only welcome to cisgender gay men are rarer than they used to be; you can easily find clubs and bars that attract a pan-queer crowd featuring men with an array of queer tastes.

And finally, a call to action that may or may not be relevant to your specific search but that my friend asked me to include nonetheless: “Trans men, ask out trans women. We don’t know where to find you,” she said, adding: “They tend to treat us like humans, in my experience.”

Dear How to Do It,

I’ve found myself in a somewhat unusual situation. I’m a 30-something virgin (I’m a woman). I wasn’t a late bloomer—more of a morning glory. I dated all through high school, with the usual teenage clumsiness about sex. Around senior year, I got as close as I’ve gotten to date to “cashing in my V chip.” In retrospect, the event was traumatizing. There wasn’t a breach of consent or anything like that, it was just beyond cringy and awkward. I realized in that moment it was not how I wanted my first time to happen, and that was that. Even before then, I’d been completely terrified of sex partially because of a very religious upbringing and because I thought I was supposed to look and perform like a Venus goddess right out of the gate.

Over the next decade, I went through phases of “I’m never having sex” to “I could … but … could I?” to “If it’s so awful, why is Cosmo always saying how wonderful it is?” to “Nope, I’m going to live like a nun.” Now I’m in a new phrase: I decided I was ready (yay!), and sex was something I wanted to do. After a long list of frogs, I found a good not-frog. He’s the first person I’ve felt comfortable enough to talk to this about—in fact, he’s the only one who knows about the sex-that-wasn’t incident. We’ve talked through the having of the sex and my anxiety over it multiple upon multiple times, and every time he’s been patient and caring and non-judgy. We’ve both made the joke that he’s like my sex therapist. Suffice it to say, he is the one I want to be my first, because I feel that I can trust him.

Here’s the other problem: I’m still terrified. I’ve been through all the articles and had talks with myself about it. I know I’m ready. But I’m also over 30 and pretty much feel like I’m going to mess up or humiliate myself in front of him and then have to shrivel up and die of embarrassment. All this despite his assurances to the contrary. Part of me says it’s normal anxiety, because it’s a major thing. But then the other part of me thinks I’m some kind of freak that needs to see a licensed sex therapist. I know there are other “late bloomers” out there, but since we don’t have the support group started yet, here I am.

—Short of the Finish Line

Dear Short of the Finish Line,

I feel for you, and I also feel that you really needed to get that off your chest because you didn’t ask me a question. I mean, literally not a single one in three paragraphs. So allow me to affirm you: It’s nice to have a magical first time, but many of us don’t experience that and actually have to learn the magic. It was quite emotionally mature of you at a young age to realize you’d pushed yourself past the threshold of comfort and then modify accordingly. There’s nothing to be embarrassed about for understanding your limitations and waiting until you’re ready, and even if there were, your not-frog knows all this and accepts it. He knows you don’t have practice and are likely to be unskilled in certain ways, and he’s OK with it. Trust his kindness, go as slow as you want, let him teach you things, and know that barring any recurrence of trauma, sex gets easier and more fun the more you do it.

The anxiety could melt away once you prove to yourself that you’re capable of feeling good and making him feel good. You’re not a freak, but seeing a therapist is never a bad idea, so I’d look into that, too.

Dear How to Do It,

How can I tactfully ask a new partner or casual hook-up to wash up if they taste a bit funky while I’m in the middle of performing oral? I usually like the taste of penises and vulvas. But some recent partners just tasted outright unpleasant—think crotch sweat and urine.

—Smell Test

Dear Smell Test,

It is nice that you want to be tactful about letting someone know that they stink, but it’s simply impossible to tell them without possibly offending them, no matter how nicely you do it. (I want to be clear that pheromone-fortified crotch is not necessarily bad smelling to all, and I’m responding on the terms you outlined.) That said, you can avoid the subject entirely by suggesting you both jump in the shower while playing; enough people find shower sex erotic that your intentions will be ambiguous at worst. And even if they do suspect olfactory motivations, they won’t have enough evidence that you’re calling them out to call you out. And so they probably won’t. Tact rules!


Correction, Feb. 19, 2020: This piece originally misstated that Tristan Taormino wrote a chapter on choking in The Ultimate Guide to Kink. She edited the book; Felice Shays wrote the chapter Juzwiak quoted.

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