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Erotic asphyxia: Dangerous misinformation and poor-quality content on YouTube
Sebastian Loonen1, Ritisha Ghosh1, Andrea Ramirez1
1Michigan State University College of Human Medicine, Grand Rapids, MI, United States of America.
The American Journal of Emergency Medicine
|July 24, 2026
Summary
Erotic asphyxia videos on YouTube are low quality and unreliable, often containing misinformation. This highlights the need for better safety messaging and harm reduction to prevent serious injury and death.
Area of Science:
- Medical research
- Online content analysis
- Public health
Background:
- Erotic asphyxia, or breath-control play, is a dangerous sexual practice with severe health risks, including brain injury and death.
- Despite its risks, erotic asphyxia is increasingly normalized and depicted in online sexual content, particularly on platforms like YouTube.
Purpose of the Study:
- To analyze the portrayal of erotic asphyxia on YouTube.
- To assess the quality, safety messaging, and prevalence of misinformation in erotic asphyxia videos.
- To inform healthcare providers and platform policies on harm reduction.
Main Methods:
- A retrospective content analysis of 103 YouTube videos identified through relevant search terms.
- Data collection included video characteristics, participant demographics, choking techniques, safety messages, and misinformation.
- Content quality and reliability were assessed using the Global Quality Score (GQS) and a modified DISCERN tool.
Main Results:
- The analyzed videos had high viewership but were of low quality (median GQS=2) and very poor reliability (median DISCERN=1).
- Misinformation was prevalent, with 71.9% of videos containing false or misleading information.
- Only 3.9% of videos included trigger warnings, and depictions ranged from consensual to nonconsensual and autoerotic asphyxia.
Conclusions:
- Widely accessible erotic asphyxia content on YouTube is low quality, unreliable, and frequently misleading.
- There is a critical need for emergency physicians to discuss sexual choking risks in counseling.
- Platform-level harm-reduction strategies are essential to mitigate the risks of serious injury and death associated with erotic asphyxia.
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