“I Didn't Know I Could Turn Colors”: Health Problems and Health Care Experiences of Women Strangled by an Intimate Partner

Abstract

Strangulation is a unique and particularly pernicious form of intimate partner violence. To increase the relatively little that is known about strangulation survivors, focus groups and interviews were conducted as part of a practice-research engagement with a domestic violence shelter. All of the participants had been strangled and, among them, almost all were strangled multiple times. The loss of consciousness was common. Participants associated "choking" with use of body parts and "strangling" with use of objects. Although some minimized the assault, most considered strangulation to be serious and reported a variety of medical conditions following the assault. Few sought medical care. Of those who did, few disclosed the assault, or were asked about strangulation, which commonly resulted in misdirected treatment. Implications for improving detection and treatment are discussed.

A Systematic Review of the Epidemiology of Nonfatal Strangulation, a Human Rights and Health Concern

“…In other research, we found that abused women use "choked" when referring to an incident in which the partner used his hands to strangle her and "strangled" when he used a ligature. 5 Thus, questions that ask about having been "choked or strangled" might yield a more complete and accurate assessment of the phenomenon. Behaviorally specific questions (e.g., "Tried to choke you or placed his arms around your neck in an attempt to harm you?"…”

“…Multiple strangulations are reported among one third to as many as three fourths of women in domestic violence emergency shelters. 4,5 Strangulation is a relatively common cause of homicide death, particularly for women. We compiled data available through the World Health Organization 6 to document the risk of homicide by asphyxiation among women around the globe and to illustrate gender differences in the risk of homicide by asphyxiation.…”

Addressing domestic violence: the surgeon's role

“…Non‐lethal strangulation using either hands or objects is commonly used by perpetrators as a symbol of their power and control over the victim. Around 30% of female victims have experienced domestic violence assaults involving strangulation . Stable appearing victims often present no obvious external marks on the skin, though a history of strangulation is considered high risk marker of future fatality.…”

“…Stable appearing victims often present no obvious external marks on the skin, though a history of strangulation is considered high risk marker of future fatality. As a consequence of strangulation, victims can develop serious brain injuries in the weeks after the assault due to deprivation of oxygen to the brain . Victims who report a loss of bowel or bladder function when being strangled may have high risk of severe co‐existing brain injury .…”

“But What About Feminist Porn?”

“…Laughon, Renker, Glass, and Parker (2008), reviewing a range of studies, found that between 34% and 68% of women experiencing intimate partner violence reported strangulation (p. 504). Joshi, Thomas, and Sorenson (2012), who conducted a series of focus groups and interviews at a domestic violence shelter, found that ''all of the participants had been strangled and, among them, almost all were strangled multiple times. The loss of consciousness was common'' (p. 798).…”