Erotic Asphyxia in the Social Media Era: Online Misinformation and Health Risks

Social media platforms allow teens and young adults to discuss taboo subjects, including high-risk sexual behaviors. This study examines the prevalence, characteristics, and health risks of erotic asphyxia content on YouTube, with a focus on misinformation and lack of safety messaging.

This retrospective content analysis used YouTube’s search engine to identify videos relating to erotic asphyxia during November 2025. Quantitative and qualitative variables included the number of views, participants, and methods used to induce hypoxia or anoxia. Viewers’ comments were examined as an index of audience response. Content quality and reliability were evaluated with the global quality score (GQS) and the DISCERN tool. Safety suggestions and misinformation were characterized using three board-certified emergency physicians and policy statements from the American Academy of Pediatrics. Descriptive statistics, frequency tables, and Kappa scores for interrater reliability were calculated.

Ninety-four videos met inclusion criteria: consensual (67.0%), nonconsensual (11.7%), and auto-erotic asphyxia (21.3%). Mean video length was 3.9 ± 2.6 minutes (range 1.5–25.1). Collectively, videos had 3.3 million views (mean 35,533 per video). Mean GQS and reliability scores were 2.3 ± 1.2 and 1.0 ± 1.2. Most video participants were female (63.8%), Caucasian (59.6%), and 20–25 years old (51.0%). Eleven choking techniques were depicted, including manual choking, ligature strangulation, breath holding, smothering, and chest compression. Only four videos (4.3%) included trigger warnings. Although most (77.7%) had some educational content, all lacked key safety information and 70.2% contained misinformation. Interrater reliability was substantial (Kappa = 0.79).

Erotic asphyxia content on YouTube is prevalent, highly viewed, and frequently low quality, with minimal warnings and substantial misinformation. These patterns raise important safety concerns for young viewers and highlight the need for stronger platform policies, accurate harm reduction messaging, and collaboration with medical and public health experts.