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. Author manuscript; available in PMC: 2025 Sep 5.
Published before final editing as: Psychol Violence. 2025 Aug 21:10.1037/vio0000638. doi: 10.1037/vio0000638

The Association Between Sexual Victimization History and Consensual and Nonconsensual Rough Sex: Findings from a U.S. Nationally Representative Survey

Zoë D Peterson 1, Debby Herbenick 2, Xiwei Chen 3, Tsung-chieh Fu 4, Jaroslaw Harezlak 5
PMCID: PMC12410599  NIHMSID: NIHMS2097161  PMID: 40918418

Abstract

Objective:

Rough sex is increasingly common among younger cohorts. Preliminary evidence suggests that engagement in rough sex is not always consensual, and it may be associated with a history of sexual victimization. This study sought to examine that relationship in a large U.S. national sample.

Method:

Participants (weighted N = 4,546) were recruited to complete an online survey in which they were asked about their experiences enacting a variety of rough sex behaviors on a partner and their experiences having these behaviors enacted on them by a partner—both consensually and nonconsensually. They were also asked about experiences of sexual coercion (sexual acts through verbal pressure) and sexual assault (nonconsensual sexual acts). A single item assessing nonconsensual rough sex was pilot tested.

Results:

Individuals with a history of sexual victimization (either sexual coercion or sexual assault) were significantly more likely to report enacting rough sex and experiencing both consensual and nonconsensual rough sex. The single item assessing nonconsensual rough sex showed utility (i.e., captured sexual victims that were missed by traditional sexual victimization items) and validity (i.e., was correlated with traditional sexual victimization items and with a multi-item measure of nonconsensual rough sex).

Conclusions:

Engagement in rough sex is associated with sexual victimization history, pointing to the potential for vulnerability and exploitation within rough sex. Additionally, these results speak to the need to assess for experiences of nonconsensual rough sex, and they provide some preliminary evidence for the validity of a single item that could be added to existing victimization measures.

Recently, there has been increased attention to rough sex practices in both empirical research (Burch & Salmon, 2019; Döring et al., 2024; Herbenick, Patterson et al., 2021) and in the popular media (Auer, 2018; Gilmour & Lavinia, 2024; Orenstein, 2024)—and with good reason. Definitions of rough sex vary; however, the term generally refers to sex that incorporates a range of physically or psychologically aggressive elements such as spanking, slapping, hair pulling, biting, or name calling (Döring et al., 2024; McKee et al., 2014; Vogels & O’Sullivan, 2018). Although rough sex occurs among individuals of all ages, research has shown that younger cohorts (those below the age of 40) report engaging in rough sex at higher rates than older cohorts (those above the age of 40; Döring et al., 2024), suggesting that these behaviors are increasingly common. Some research also has suggested that this increase in rough sex includes higher risk sexual practices, such as sexual choking (Herbenick et al., 2023), which is usually done as a form of strangulation and can put individuals at risk for physical injury or even death (Herbenick, Fu, Eastmann-Mueller, et al., 2022; Schori et al., 2022).

Women are more likely than men to be the targets of rough sex behaviors, and LGBTQ+ individuals engage in rough sex at higher rates than their straight and cis gender counterparts (Daminato et al., 2024; Döring et al., 2024; Herbenick, Fu, Kawata, et al., 2022; Herbenick et al., 2023). For example, Doring et al. (2024) reported that men were more likely than women to enact rough sex against a partner (26.9% versus 13.6%, respectively), and women were more likely than men to be the targets of rough sex (25.7% versus 16.2%, respectively). Herbenick et al. (2023) reported that 25.2% of straight women had enacted or experienced choking during sex as compared to 40.8% of lesbians and 37.7% of bisexual women. In that study, trans and nonbinary participants also had enacted or experienced higher rates of choking (40.1%) than cis men (26.5%) or cis women (27.7%). These results provide some evidence the rough sex may be more common among marginalized or vulnerable groups.

Further, recent research has indicated that the rough elements in sex may not always occur consensually (Bhuyan et al., 2025) and that engaging in rough sex may be associated with a history of experiencing sexual victimization (Melnik et al., 2023). Taken together, these findings suggest a high potential for violence and exploitation associated with rough sex. In this study, we sought to examine the associations between experiences of consensual and nonconsensual rough sex and other types of sexual victimization, including both sexual coercion (i.e., sexual contact through verbal pressure or manipulation) and sexual assault (i.e., nonconsensual sexual contact through incapacitation, threat of physical harm, or force).

Is Rough Sex Benign?

The term “rough sex,” has been criticized because it encompasses a large range of behaviors, some of which are likely harmless and some of which might be riskier. When researchers (Burch & Salmon, 2019; Gavey & Brewster, 2025; Herbenick, Fu et al., 2021) have asked participants to identify which behaviors qualify as rough sex, there has been some widespread agreement across studies that certain behaviors (e.g., hair pulling) count as rough sex. Yet, other behaviors have been categorized as rough sex less consistently; for example, only 36% of the participants in Burch and Salmon’s (2019) convenience sample of U.S. college students identified choking as “rough sex,” compared to 77% of Herbenick, Fu et al.’s (2021) representative sample of college students and 77% of Gavey and Brewster’s (2025) sample of New Zealand community adults. Indeed, Gavey and Brewster (2025) warned that the vagueness of the term “rough sex” creates opportunity for misunderstanding as well as strategic misuse, resulting in unwanted or nonconsensual aggressive sexual behaviors.

Although the term “rough sex” includes a continuum of behaviors, ranging from entirely harmless to somewhat riskier, it is, for example, a narrower range than the term “paraphilic interests and behaviors” which is often quite vaguely defined as including sexual interests and behaviors that are considered atypical or abnormal (de Roos et al., 2025). As Longpre et al (2022) pointed out, though, what is socially labeled as atypical or abnormal changes with time, so some interests or behaviors that are thought to be unusual or unacceptable might actually be quite common. Paraphilic interests generally include an interest in rough sex behaviors (or Bondage and Discipline, Dominance and Submission, and Sadism and Masochism [BDSM]) but also an interest in things that would be, not merely risky, but illegal and unmistakably harmful, such as pedophilic behaviors. Much has been written about challenges of where to “draw the line” in terms of which paraphilic interests should truly count as abnormal, atypical, or problematic (e.g., Bártová et al., 2021; de Roos et al., 2025; Joyal & Carpentier, 2022). Similar questions are raised by the term “rough sex.”

Much of the literature on rough sex to date has focused on consensual rough sex and often has emphasized its relative ubiquity and its frequently enjoyable and often harmless nature. For example, rough sex behaviors, such as hair-pulling, spanking, and bondage, have been rated as somewhat desirable and arousing, on average, and are common among adult participants, with approximately 40 to 50% of adults reporting a history of at least one of these types of acts (Vogels & O’Sullivan, 2018). In a nationally representative U.S. sample, Herbenick et al (2017) found that about 32% of adults reported engaging in spanking during sex, and 15% engaged in playful whipping. A total of 28% and 20% of participants rated these behaviors, respectively, as somewhat or very appealing. Similarly, Ryan and Mohr (2005) found that the college students in their sample rated what the researchers called “playful force” during sex as relatively enjoyable, on average. Burch and Salmon (2019) found that consensual rough sex typically resulted in minimal violence and, at most, involved only superficial injuries.

Still, even these studies, which painted a picture of rough sex as mostly benign, highlighted some potential points of concern. Vogels and O’Sullivan (2018) cautioned that some—more physically risky—forms of rough sex (e.g., fisting) were not perceived as desirable or arousing by most participants, and could, in fact, be dangerous. Ryan and Mohr (2005) asked respondents to define “playful force” during sex, and they noted that a few men in their study described explicitly aggressive acts in their definition, suggesting a blurring of the lines between playful and consensual rough sex and physical violence. Burch and Salmon (2019) noted that rough sex behaviors were more common in situations that involved male sexual jealousy, suggesting the potential for rough sex as a form of retribution.

Further, some forms of rough sex are clearly not benign. Herbenick et al. (2023) documented high rates of strangulation (often colloquially called “choking”) during sexual activity among a sample of undergraduate students. Some individuals who have engaged in choking have reported physical injuries, including neck bruising, neck swelling, and loss of consciousness (Herbenick, Fu, Eastmann-Mueller, et al., 2022). In an fMRI study, frequent and recent choking during sex was associated with altered patterns of neural activation during verbal and visual working memory tasks (Huibregtse et al., 2022). Further, this potentially harmful behavior is not always fully consensual. As evidence of this, in qualitative studies, participants often described choking as consensual and pleasurable but occasionally as nonconsensual or obligatory (Herbenick et al., 2022a, 2022b, 2024).

Rough Sex and (Non)Consent

Rough sex is unquestionably common among young adults in the U.S. and internationally, but it is not always clear how often these behaviors are consensual versus nonconsensual. It is important to note that, although consensual rough sex and sexual assault may sometimes involve similar types of aggressive behavior (e.g., choking, hitting), theoretically, in consensual rough sex, the aggression is both consensual and part of the sexual repertoire (i.e., it is a desired act in and of itself), whereas in sexual assault, the aggressive behavior is a tactic used to obtain a nonconsensual sexual act (i.e., it is a means to an end; Bhuyan et al., 2025). Nevertheless, this is a fine distinction, and self-report measures intended to assess consensual rough sex may sometimes inadvertently capture instances of sexual assault and vice versa. Further, many measures of rough sex do not explicitly ask about whether the rough sex was consensual.

In a large random sample of college students, Herbenick, Patterson et al. (2021) found that both enacting and experiencing rough sexual behaviors were prevalent. For example, 60.2% of students reported lightly spanking a partner’s butt, and 34.7% reported spanking hard enough to leave a mark. A total of 79.7% and 50.6%, respectively, reported that a partner did these things to them. Other rough sex behaviors measured in this study and commonly reported in this sample included, face slapping, ejaculating on the face, choking, and calling a partner demeaning or insulting names. Notably, though, the line between consensual and nonconsensual rough sex in the study was ambiguous. The measure did not specify whether the acts described were consensual or not except in the case of choking and face slapping: For choking, approximately half of the participants who had experienced it (47.4%) reported that it was always consensual, and for slapping, approximately a third (34.4%) reported it was always consensual. Thus, over half of those who had experienced those acts had, at least sometimes, experienced them non-consensually. Further, some of the rough sex acts measured in the study (e.g., “aggressively thrust their penis in and out of your mouth [face fucked you]”) might have been part of an initially consensual sexual encounter, but the acts might have been performed more aggressively than the person wanted or expected. Additionally, at least one of the rough sex acts on the measure (i.e., “slipped their penis in your anus without first asking or discussing”) was explicitly nonconsensual and was enacted by 5.7% of the sample and experienced by 9.0% of the sample.

There is also evidence that young adults might conflate the concepts of rough sex and nonconsensual sex. For example, in a study examining which behaviors undergraduate students count as “rough sex,” 17% of students included “making someone have sex” as a behavior that would qualify as rough sex, potentially reflecting a lack of clear distinction in the students’ minds between rough sex and nonconsensual sex (Herbenick, Fu, et al., 2021). Alternatively, it is also possible that some participants interpreted “making someone have sex” as doing so in a consensual way, as with role-playing rape (sometimes called “consensual non-consent”; Herbenick, Fu, Carver, et al., 2025).

Thus, to date, discussions of the relationship between rough sex and nonconsensual sex (or sexual victimization) in the literature are somewhat murky. This is also observable in legal scholarship. On the one hand, criminal charges have been filed against consenting adults, who engage in consensual rough sexual activity as part of BDSM relationships because consent is often not recognized as a valid defense to assault (Greenblatt, 2016). On the other hand, the “rough sex defense” has been evoked in rape—and sometimes murder—trials internationally in recent years (e.g., Connolly, 2021; Gavey, 2024; Sheehy et al., 2023; see also Gallagher et al., 2023, for a review). In these legal cases, men accused of strangulation in relation to rape or murder argue that the women consented to rough sexual activity as a way to undermine the women’s credibility or to argue that deadly strangulation was just rough sex “gone wrong,” representing a new and particularly dark twist on an old rape myth that “she asked for it” (Sheehy et al., 2023).

Beyond these legal defenses, it is clear that those who are attracted to rough sex may act on those attractions ethically and consensually or may intentionally bypass consent depending on their personality traits and other risk factors (de Roos et al., 2025). For example, Robertson (2014; as cited in de Roos et al., 2005) found that, within a sample recruited from a BDSM community, 17% of individuals reported that a partner had failed to respond to their safe word (i.e., had engaged in nonconsensual BDSM behaviors). These legal conundrums and research findings illustrate the applied importance of (1) clearly distinguishing between consensual and nonconsensual rough sexual behavior in both research and applied contexts and (2) better clarifying the relationships between rough sex and sexual victimization.

A few studies have begun to examine these relationships. An unpublished study by Melnik and colleagues (2023) found that college students with a sexual victimization history had higher odds of engaging in choking behavior during sexual activity than those without a sexual victimization history. Those with a victimization history also were more likely than those without to report engaging in choking during sex despite not enjoying it, perhaps suggesting that they felt obligated to engage in the behavior or frightened to refuse it. Bhuyan and colleagues (2025) identified groups of college students who had experienced (1) traditionally defined sexual assault (i.e., non-consensual sexual acts), (2) non-consensual rough sex (i.e., non-consensual rough elements within otherwise consensual sex), (3) both sexual assault and non-consensual rough sex, or (4) neither and compared the four groups on mental health outcomes. Participants who experienced nonconsensual rough sex had a similar likelihood of reporting depression and anxiety as compared to those who had experienced traditional sexual assault and a higher likelihood than those with no victimization. Those who had experienced both non-consensual rough sex and sexual assault had the highest likelihood of experiencing depression and anxiety. This study highlighted that rough sex is not always consensual and that non-consensual rough sex is associated with negative mental health outcomes. Further, as the authors of the study noted, the findings of the study pointed to the value of expanding sexual assault measurement to include items measuring non-consensual rough sex elements within otherwise consensual sex.

The Present Study

The present study had two primary aims: First, we examined the association between sexual victimization history (including both sexual coercion and sexual assault) and consensual and nonconsensual rough sex behaviors in a large, nationally representative sample of adults in the U.S. (Aim 1). We predicted that sexual victimization history would be associated with (1a) enacting rough sex on a partner, (1b) experiencing consensual rough sex from a partner, and (1c) experiencing nonconsensual rough sex from a partner. Second, given recommendations from Bhuyan et al. (2025) that sexual victimization measures be expanded to include the measurement of nonconsensual rough sex, we pilot-tested a new single item measuring non-consensual rough sex that could be added to an existing sexual victimization measure (Aim 2). We examined its utility as a measure of sexual victimization by (2a) evaluating whether it detected instances of sexual victimization that were missed by more traditional sexual victimization items. We also examined its validity as a measure of sexual victimization by (2b) examining whether endorsement of that item correlated with endorsement of more traditional sexual victimization items and (2c) examining whether endorsement on that single item correlated with endorsement on a multi-item measure of nonconsensual rough sex.

Method

Procedures

The Institutional Review Board at Indiana University, Bloomington reviewed and approved study procedures and measures. Data were from the 8th wave of the National Survey of Sexual Health and Behavior (NSSHB) fielded in December 2022 and January 2023 through the Ipsos KnowledgePanel®, which is commonly used for U.S. nationally representative data collection on a wide range of topics, including health and sexual health topics (e.g., Adler et al., 2023; Connor et al., 2020; Mark et al., 2024). The KnowledgePanel® is established through probability-based methods and specifically uses address-based sampling via the U.S. Postal Service Delivery Sequence File to identify individuals and their household members to join the panel. In order to facilitate broad participation in the KnowledgePanel®, Ipsos offers to provide web-enabled device and free internet to households that do not already have internet access so that individuals can complete the online surveys. The Ipsos KnowledgePanel® has about 60,000 members who are non-institutionalized adults and who are invited to complete occasional surveys, for which they can earn points and, over time, accumulate them and exchange for cash or merchandise.

For the present study, Ipsos identified a sampling frame of 14,019 adult KnowledgePanel® members ages 18 and over. These individuals were sent a message from Ipsos to let them know that a new survey was available. People who clicked on the link in the message were directed to the Ipsos site where they could learn more about the study, including that it was about “sexual health and experiences” and was open to everyone, even if they had never engaged in any kind of partnered sexual activities before. Those who wished to participate in the confidential online survey could indicate their consent and then proceed to complete the survey, which was available in English and Spanish languages.

There were 14,019 adults in the sampling frame and, of these, 8,742 (62.4%) consented to participate in the survey and 8,666 completed the survey, for a 61.8% completion rate. Ipsos developed statistical weights to address under-coverage or over-coverage of various demographic groups, using an iterative proportional fitting (raking) procedure to produce the final weights. Ipsos then sent a de-identified data set to our research team.

Participants

The sexual victimization measure was not administered to all participants; a total of 4,566 individuals provided data on at least a portion of the sexual victimization measure and thus were included in these analyses. Consistent with the fact that this was a nationally representative sample, participants were evenly divided among men and women, with a few identifying as another gender. Participants ranged in age from 18 to over 70. Most identified as heterosexual (86.8%), and a slight majority (55.1%) were married. See Table 1 for a full summary of the weighted demographics (weighted N = 4,546).

Table 1.

Weighted demographic variables for the total sample (Weighted N = 4,546)

Variable Category n (%)
Age (years) 18-24 453 (10.0)
25-29 471 (10.4)
30-39 701 (15.4)
40-49 770 (16.9)
50-59 737 (16.2)
60-69 782 (17.2)
70+ 633 (13.9)
Gender Women 2232 (49.1)
Men 2235 (49.2)
TGNB+ 77 (1.7)
Missing 2 (0.0)
Race Black 552 (12.1)
Hispanic 744 (16.4)
White 2845 (62.6)
Another race 405 (8.9)
Sexual Orientation Bisexual 261 (5.7)
Heterosexual 3948 (86.8)
Lesbian or gay 213 (4.7)
Another orientation 93 (2.0)
Missing 32 (0.7)
Region Midwest 933 (20.5)
Northeast 797 (17.5)
South 1738 (38.2)
West 1079 (23.7)
Education Less than high school 405 (8.9)
High school 1344 (29.6)
Some college 1202 (26.4)
College degree or higher 1596 (35.1)
Marital Status Divorced 407 (9.0)
Married 2505 (55.1)
Never married 1385 (30.5)
Separated 66 (1.5)
Widowed 182 (4.0)
Annual Income <$25,000 556 (12.2)
$25,000-$49,999 756 (16.6)
$50,000-$74,999 722 (15.9)
≥$75,000 2513 (55.3)
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Note. Totals may not equal exactly 4,546 due to rounding of weighted values.

Measures

The measures reported here were completed as part of a larger questionnaire study. As part of Ipsos KnowledgePanel® member recruitment and retention efforts, members complete an extensive demographic measure. Participants also answered questions about a variety of other sexual attitudes, behaviors, and experiences, which are not reported here.

Rough sex.

We used three sets of items to measure experiences of enacting rough sex against a partner, experiencing consensual rough sex from a partner, and experiencing nonconsensual rough sex from a partner. These measures were adapted from prior research (Herbenick et al., 2020) and underwent cognitive testing with a diverse set of participants prior to implementation. To measure enacting rough sex, participants were first asked, “How recently have you done the following to a partner while you were kissing or having sex together?” The behaviors listed were: pulled their hair; slapped their face; slapped their genital area (clitoris, vaginal area, penis, or scrotum); spanked them lightly; spanked them hard enough to leave a mark; choked them (e.g., you used your hands, arm, or object to press against or squeeze a partner’s neck); called your partner names like bitch, slut, whore, fag, etc.; smothered them during sexual activities (e.g., you put a pillow or your hand over their mouth/nose). Response options were: in the past month, in the past year, more than a year ago, or never done this. For the analyses reported here, responses were collapsed so that participants were dichotomized as having ever enacted any form of rough sex (1) in the past year and (2) in their lifetime. Participants were next asked how recently “has a partner done the following to you with permission or consent” and “has a partner done the following to you without your permission or consent.” All the same rough sex behaviors were repeated for these questions. These responses were similarly dichotomized.

Sexual victimization.

Given time and budget limitations, the sexual victimization measure was given to a randomly selected half of the overall sample. Sexual victimization was measured with a modified version of the Sexual Experiences Survey-Short Form Victimization (SES-SFV; Koss et al., 2007). As published, the SES-SFV includes item stems describing seven completed or attempted sexual acts (fondling/kissing, oral sex, vaginal penetration, anal penetration, attempted oral sex, attempted vaginal penetration, and attempted anal penetration); each stem is followed by five coercive/aggressive tactics for obtaining that sexual act—two tactics representing sexual coercion (lies and manipulation; anger and criticism) and three tactics representing sexual assault (incapacitation from drugs/alcohol; threat of physical harm; use of force). Participants are asked to rate how often they have experienced each sexual act and coercive tactic combination since age 14 on a scale from 0 to 3 or more times. The SES-SFV is the most widely used measure of sexual victimization and has been shown to have adequate convergent validity and test-retest reliability (Anderson et al., 2018). For this study, we made two modifications to the SES-SFV as it is published: (1) We added two additional sexual acts assessing being made to penetrate the perpetrator’s vagina and being made to penetrate the perpetrator’s anus (i.e., “Someone made me put my fingers, penis, or another object into their vagina [anus/butt] without my consent by:”). Prior research has suggested that including items measuring experiences of being made to penetrate another person when measuring sexual victimization ensures that sexual victimization measures are more appropriate for men and for LGBTQ+ individuals (see Peterson, Littleton et al., 2024, for a review). (2) Because the survey was very long, we simplified the response options from 0 to 3 or more to simply Yes or No, so participants could indicate whether they had ever experienced each form of sexual victimization. Participants were dichotomized as having experienced any sexual coercion (i.e., any attempted or completed sexual act through lies/manipulation or anger/criticism) or sexual assault (i.e., any attempted or completed sexual act through incapacitation, threat, or force) since age 14.

To address Aim 2, we also created a new item assessing nonconsensual rough sex since age 14 in a similar format as the other SES-SFV items. This item was written in consultation with experts in both sexual victimization and rough sex and was designed to assess a broad range of explicitly nonconsensual rough sex experiences and to correspond to the format of the other SES-SFV items. Cognitive interviewing with a diverse sample of participants ensured the item was clear and interpretable before administration. The item read: “Someone did rough things to me during sexual activities (e.g., choking, hitting, slapping, etc.) that were harder or more aggressive than I had consented to.”

Analyses

All statistical analyses were adjusted for survey weight and performed using software R (version 4.2.2) and RStudio (version 2023.03.0). Chi-square tests were used to evaluate the association between sexual victimization and rough sexual experience; the prevalences and the corresponding Wald-type 95% confidence intervals were calculated for rough sex by type of victimization. p-values were two-tailed and significant at values < 0.05. Participants were excluded on a pairwise basis from any analysis on which they were missing data. Our large sample provided us with greater than 99% power to detect even small (ϕ = 0.10) effect sizes.

Results

Weighted demographics are presented in Table 1. In total, 14.0% of our sample reported experiencing sexual coercion, and 16.5% reported experiencing sexual assault since age 14. In their lifetime, 55.9% of participants had enacted one or more types of rough sex on a partner, 49.9% had experienced consensual rough sex from a partner, and 19.4% had experienced nonconsensual rough sex from a partner. In the past year, these rates were 34.9%, 30.7%, and 8.7%, respectively. Rates of rough sex and sexual victimization as a function of gender and other demographic variables are presented elsewhere (Herbenick, Fu, Chen, et al., 2025; Peterson et al., 2025).

Aim 1: Association Between Sexual Victimization and Rough Sex

As shown in Table 2, there was support for all three of our Aim 1 hypotheses. We examined the relationships between sexual victimization history (both sexual coercion and sexual assault) and rough sex. Consistent with our predictions, a history of experiencing sexual coercion or sexual assault since age 14 as measured by the modified SES-SFV was significantly associated with enacting rough sex on a partner (1a), experiencing consensual rough sex from a partner (1b), and experiencing nonconsensual rough sex from a partner (1c). Additionally, looking at the rough sex behaviors individually, enacting and experiencing (consensually or nonconsensually) each type of rough sex in the last year and in the lifetime was significantly associated with both sexual coercion and sexual assault history (all ps < .001 except for spanking the other person hard enough to leave a mark in the last year, which was correlated p = .01 with coercion and p = .03 with assault), suggesting that results were not driven exclusively by either the more or less severe types of rough sex; rather the relationship existed for the entire range of rough sex behaviors.

Table 2.

Relationship between sexual victimization history and consensual and non-consensual rough sex (N = 4,546)

Rough sex
experiences		 Overall
% [CI]		 Sexual coercion
victimization
since age 14		 Sexual assault victimization
since age 14
Yes
% [CI]		 No
% [CI]		 X 2 p Yes
% [CI]		 No
% [CI]		 X 2 p
Enacted rough sex (past year) 34.9%
[33.3%, 36.6%]		 47.8%
[43.4%, 52.3%]		 32.8%
[31.1%, 34.6%]		 55.06 <0.001 45.7%
[41.8%, 49.7%]		 32.7%
[31.0%, 34.5%]		 47.20 <0.001
Enacted rough sex (lifetime) 55.9%
[54.3%, 57.6%]		 74.1%
[70.3%, 77.7%]		 53.0%
[51.1%, 54.8%]		 100.87 <0.001 74.8%
[71.3%, 77.9%]		 52.1%
[50.3%, 54%]		 132.31 <0.001
Experienced consensual rough sex (past year) 30.7%
[29.1%, 32.3%]		 47.3%
[42.9%, 51.8%]		 28.0%
[26.3%, 29.7%]		 97.45 <0.001 45.7%
[41.8%, 49.7%]		 27.7%
[26.0%, 29.5%]		 97.1 <0.001
Experienced consensual rough sex (lifetime) 49.9%
[48.2%, 51.6%]		 75.1%
[71.2%, 78.7%]		 45.8%
[44.0%, 47.6%]		 190.77 <0.001 75.0%
[71.5%, 78.2%]		 44.9%
[43.0%, 46.7%]		 230.95 <0.001
Experienced non-consensual rough sex(past year) 8.7%
[7.7%, 9.8%]		 19.7%
[16.2%, 23.7%]		 6.9%
[5.9%, 7.9%]		 114.35 <0.001 17.2%
[14.3%, 20.5%]		 7.0%
[6.0%, 8.1%]		 82.76 <0.001
Experienced non-consensual rough sex (lifetime) 19.4%
[18.1%, 20.8%]		 47.7%
[43.3%, 52.1%]		 14.8%
[13.5%, 16.2%]		 382.83 <0.001 43.4%
[39.5%, 47.4%]		 14.6%
[13.3%, 16.0%]		 337.7 <0.001
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On an exploratory basis, we also examined correlations between sexual victimization (coercion or assault) history and enacting rough sex on a partner, experiencing consensual rough sex from a partner, and experiencing nonconsensual rough sex from a partner in their lifetime and in the last year (twelve total correlations) separately for cis women, cis men, and transgender/nonbinary/other gender (TGNB+) individuals and compared the strengths of these correlations using z scores (see Supplemental Table 1). All of the correlations were significant for all genders, and in general, the strengths of the correlations were similar for men and women, although women had a significantly stronger association between experiencing coercion and lifetime enactment of rough sex compared to men (p = .03) and a significantly stronger association between experiencing assault and lifetime enactment of rough sex compared to men (p = .005). In contrast, men demonstrated significantly stronger associations between experiencing coercion and assault in the past year and nonconsensual rough sex compared to women (p = .01 and p = .02, respectively). TGNB+ individuals consistently had stronger correlations between sexual victimization and rough sex than cis women or cis men, and many of these comparisons (six out of 12 compared to cis women, and seven out of 12 compared to cis men) were significantly different (see Supplemental Table 1).

Although it was not one of our a priori research questions, on an exploratory basis, we also examined whether consensual and non-consensual rough sex were associated. Indeed, individuals who reported a lifetime experience of enacting rough sex on a partner were significantly more likely (86.9% [84.2%, 89.2%]) than those who did not (48.5% [46.7%, 50.4%]) to also report a lifetime history of experiencing nonconsensual rough sex, X2 (df = 1, N = 4,546) = 425.05, p <.001, ϕ = .31. Similarly, individuals who reported a lifetime experience of consensual rough sex that was enacted on them by a partner were significantly more likely (88.5% [85.9%, 90.7%]) than those without 40.6% [38.8%, 42.5%]) to report a lifetime experience of nonconsensual rough sex, X2 (df = 1, N =4,546) = 654.41, p < .001, ϕ =.38. In other words, engaging in rough sex with consent appears to make one vulnerable to experiencing rough sex without consent.

Aim 2: Pilot-Testing a New Item Measuring Nonconsensual Rough Sex

To address Aim 2, we created a new item measuring nonconsensual rough sex that was similar in format to the other items on the SES-SFV and pilot-tested its utility and validity as an add-on to the existing measure of sexual victimization. We found that the item demonstrated evidence of utility (2a)—that is, it identified sexual victims that would otherwise have been missed by the SES-SFV. In other words, the nonconsensual rough sex item captured a few individuals who had experienced nonconsensual rough sex but had not experienced any other form of sexual victimization described on the SES-SFV and thus would otherwise have been labeled as non-victims on the SES-SFV (see Table 3). We also found that the new item demonstrated evidence of validity in that endorsement of the item was moderately related to endorsement of other items on the SES-SFV (ϕ = .39 for sexual coercion and ϕ = .39 for sexual assault; see Table 3), suggesting that the item measured something that was consistent in content with the other items included on the measure. (2b). Additional evidence of validity came from the fact that endorsement of nonconsensual rough sex on the single item was moderately correlated with endorsement on the multi-item measure of lifetime nonconsensual rough sex, X2 (df = 1, N = 4,546) = 518.41, p < .001, ϕ =.34, such that those that reported nonconsensual rough sex on the multi-item measure were more likely to endorse the single item (23.7% [20.5%, 27.1%]) than those that did not (2.5% [2.0%, 3.1%]), p < .001 (2c); however, the single item missed a large number of individuals who reported nonconsensual rough sex on the multi-item measure.

Table 3.

Endorsement on a new exploratory sexual victimization item measuring non-consensual rough sex as a function of other sexual victimization history and as a function of gender (N = 4,546)

Sexual coercion victimization
since age 14 on modified SES-SFV		 Sexual assault victimization
since age 14 on modified SES-SFV		 Gender a
Nonconsensual
rough sex item		 Overall
% [CI]		 Yes
% [CI]		 No
% [CI]		 X 2 ϕ Yes
% [CI]		 No
% [CI]		 X 2 ϕ Women
% [CI]		 Men
% [CI]		 TGNB+
% [CI]		 X 2 ϕ
Someone did rough things to me during sexual activities (e.g., choking, hitting, slapping, etc.) that were harder or more aggressive than I had consented to. 6.5%
[5.8%, 7.4%]		 30.6%
[26.7%, 34.8%]		 2.6%
[2.1%, 3.3%]		 700.17* 0.39 28.4%
[24.9%, 32.1%]		 2.2%
[1.7%, 2.8%]		 708.9* .39 9.5%
[8.2%, 11.0%]		 3.3%
[2.5%, 4.2%]		 16.6%
[9.6%, 27.2%]		 85.14* 0.10
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Note. TGNB+ = Transgender, non-binary, and other gender expansive identities

a

N = 4,544 because two individuals were missing data on gender.

*

p <.001

Discussion

Rough sex is common among individuals of all ages and is particularly prevalent among younger cohorts, and thus, this phenomenon is of substantial interest to researchers, clinicians, and the lay public. Yet, in much of the research to date, the relationship between rough sex and sexual victimization is poorly elucidated. When asking participants about rough sex, researchers often do not clearly assess whether the rough aspects of sex were consensual, and participants themselves seem to conflate rough sex and nonconsensual sex in some cases (Herbenick, Fu, et al., 2021). Further, some preliminary findings suggest that individuals with a sexual victimization history may be more likely to engage in rough sex, including unwanted rough sex (Melnik et al, 2023). This study sought to better assess the relationship between history of sexual victimization (having experienced sexual coercion or assault) and enacting and experiencing rough sex—both consensually and non-consensually.

Using a large, nationally representative sample, we found a robust relationship between sexual victimization history and rough sex. Sexual victimization was associated with enacting rough sex, experiencing consensual rough sex, and experiencing nonconsensual rough sex, and these relationships were retained if we examined sexual coercion or sexual assault and if we asked about rough sex in their lifetime or in the past year. The relationships also held for cis men and cis women, and although our sample of trans and nonbinary individuals was fairly small, the relationship often seemed to be stronger for gender minorities than cisgender individuals.

This consistent relationship between rough sex and sexual victimization illuminates a couple of important points: First, some rough sex is consensual, and some is nonconsensual, and participants seem able to distinguish among these experiences when explicitly asked. Thus, when assessing rough sex, it is important to clarify this distinction with participants. Second, given that a history of sexual victimization is strongly associated with both consensual and non-consensual rough sex, even consensual rough sex may be associated with vulnerability for some individuals who engage it. This is important given that clear and nuanced consent communication may be especially necessary for safe engagement in rough sex (Eastman-Mueller et al., 2023), and a victimization history could make such communication feel more challenging or threatening. Melnik et al.’s (2023) finding that college students with a sexual victimization history were more likely than those without to report engaging in choking during sex despite not enjoying it is consistent with this idea. Although replication is needed with a larger trans and nonbinary sample, gender minorities may be a group for whom there is particular vulnerability surrounding rough sex.

Limitations

Although our measure of rough sex improved on several prior measures by assessing a variety of different types of rough sex and by separately assessing enacting rough sex, experiencing rough sex consensually, and experiencing rough sex nonconsensually, there are still potential weaknesses with the measure. The breadth of the behaviors included on the measure could be considered both a strength and a weakness. Gavey and Brewster (2025) warned of the vagueness of the term “rough sex,” and pointed out that there is substantial disagreement about which behaviors do and don’t qualify under the umbrella of rough sex. As such, it is likely that not everyone would agree that all of the behaviors in our measure should count as rough sex. It is notable, though, that all of the behaviors that we labeled as “rough sex” in this study showed the same patterns of correlations with sexual victimization, providing some evidence that our results were not specific to only one or two of the behaviors on our measure.

Another potential weakness with our measures is that, although we distinguished between experiencing (i.e., being a target of) rough sex with and without consent, we did not ask about being forced to enact rough sex with and without consent. Although it seems less likely than experiencing nonconsensual rough sex, it is theoretically possible that someone also could force or intimidate a partner into enacting rough sex without their consent. Future research could examine this possibility. Additionally, we did not ask explicitly about perpetration of nonconsensual rough sex; thus, it is possible that, in some cases in which respondents reported enacting rough sex on a partner, that behavior might have represented nonconsensual rough sex perpetration.

Despite our large, nationally representative sample, our sample of trans and nonbinary individuals was still fairly small, forcing us to combine trans women, trans men, nonbinary individuals, and other gender expansive individuals into one group. Prior research has demonstrated particularly high rates of rough sex (Herbenick et al., 2023) as well as high rates of sexual victimization (Grocott et al., 2022) among gender minorities. In this study, we also found that trans and nonbinary individuals, in many cases, showed a stronger relationship between rough sex and sexual victimization than cisgender individuals. Taken together, more research—and more nuanced research that can attend to differences between subgroups of trans and nonbinary individuals—is needed to better understand these vulnerabilities.

Research Implications

Importantly, the association between sexual victimization and rough sex leaves many unanswered questions that need to be addressed in future research. We will discuss these unanswered questions in relation to consensual and non-consensual rough sex separately, starting with consensual rough sex. First, this is a cross-sectional study, and thus, it cannot provide information about order effects or causality. Thus, the order of the relationship could be such that sexual victimization could proceed the engagement in consensual rough sex, and the fact that we found a significant relationship between sexual victimization since age 14 and rough sex in the last year does seem to suggest that this was true for at least some of our participants. In cases in which sexual victimization came first, there may be a couple of possible mechanisms to explain this relationship, and these could be tested in future research: One possible mechanism is that, as described above, a history of sexual victimization could impair consent communication, making some individuals fearful or reluctant to speak up and refuse unwanted rough sexual activity, leading them to passively comply with unwanted but consensual rough sex. In this case, assertiveness training may be a useful intervention. Notably, though, we found that a sexual victimization history was also associated with enacting consensual rough sex, and it seems somewhat less likely that someone would consensually enact unwanted rough sex on a partner; that is, it seems slightly less likely that, if someone was uncomfortable with rough sex, then they would be the one to enact the aggression, although it is still possible that that could occur if they thought that their partner wanted it and they felt unable to say no (see Peterson, 2024, for a discussion of initiating unwanted consensual sex). A second possible mechanism worthy of future study is that consensual rough sex could be used in the aftermath of sexual victimization as a way to cope with or heal from sexual victimization. This link has frequently been theorized, but the empirical studies that have examined the association between practices such as BDSM and sexual victimization history have found mixed results, with many finding no association (see Gerwirtz-Meydan et al, 2024, for a review). A few qualitative studies, though, have found that some victims describe an increased interest in kinky or rough sexual behaviors following sexual abuse or assault as a way to regain a sense of control over their sexuality (Cascalheira et al., 2023; Hammers, 2014).

Alternatively, the order of the relationship could be such that engagement in rough sex could proceed sexual victimization; in this case, engagement in consensual rough sex may increase the vulnerability to sexual victimization. For example, some sexual partners who enjoy rough sex might be more likely to perpetrate sexual coercion or assault, and thus, might be high-risk partners. Potentially consistent with this idea, we also found an association between consensual and nonconsensual rough sex, suggesting that engaging in consensual rough sex leaves one vulnerable to nonconsensual rough sex. It is also possible that some experiences of consensual and nonconsensual rough sex occurred with the same partner and potentially even within the same sexual event, as when someone consents to being choked but does not consent to being slapped. Our assessment of these sexual behaviors treats them in isolation, but it is possible, and even likely, that some of these behaviors co-occur or occur sequentially in dynamic ways within partnered encounters. Future research is needed to explore these dynamics.

Importantly, the significant association between consensual rough sex and sexual victimization/nonconsensual rough sex does not mean that all consensual rough sex is inherently bad or dangerous. As a parallel, having more consensual sexual partners is a vulnerability factor for sexual assault (Bramsen et al., 2012), but clearly, this does not mean that engaging in consensual sex is inherently bad. Rather, the relationship between more partners and sexual assault is likely explained by the fact that more sexual partners can increase the likelihood that one is exposed to a potential perpetrator. Similarly, rather than concluding that consensual rough sex is inherently problematic, more research is needed to understand the variables that may help to account for the relationship between consensual rough sex and sexual victimization/nonconsensual rough sex.

The relationship between experiencing sexual victimization and experiencing nonconsensual rough sex is perhaps less surprising than the relationship between sexual victimization and consensual rough sex, given that a single experience of sexual victimization leaves one vulnerable to future experiences of victimization. For example, in a recent study, 81.3% of those that had experienced sexual assault reported more than one incident of sexual assault (Peterson, Koss et al., 2024). Thus, it makes sense that individuals who experience one form of sexual victimization (nonconsensual sexual acts) would be vulnerable to another form (nonconsensual rough sexual elements). Nevertheless, some questions remain about the relationship between sexual victimization and nonconsensual rough sex. For example, for those who have experienced both traditional sexual coercion or assault and nonconsensual rough sex, did those experiences occur during the same incident or do they represent different victimization incidents? Did they occur at the hands of the same perpetrator (e.g., an intimate partner) or different perpetrators? Future research should examine these questions. Additional qualitative research specifically examining the contexts of nonconsensual rough sex also would be beneficial to address questions such as: How, if at all, is nonconsent typically communicated in instances of nonconsensual rough sex? Or are victims not afforded an opportunity to object? How, if at all, is consent for the sexual acts negotiated in cases of nonconsensual rough sex, and how is the communication around the rough sexual elements different than the communication around the more traditional sexual acts? For example, how do individuals ask for consent to spank or choke a partner and how is that similar to or different from how they ask for consent to engage in oral or anal sex?

A notable proportion of our total sample (19%) reported experiencing some form of nonconsensual rough sex in their lifetime. This is important because most measures of nonconsensual sexual experiences ask about nonconsensual sexual acts (e.g., Koss et al., 2024), but do not ask about instances in which the sexual act itself was consensual but nonconsensual rough elements occurred during the sex. Given this, measures of nonconsensual sex may be missing some instances of sexual victimization. We pilot tested a single new item that we added to the modified SES-SFV to assess for the experiences of nonconsensual rough sex since age 14. The item asked about rough sex behaviors “that were harder or more aggressive than I had consented to.” The item showed evidence of utility in that it captured a few individuals who had experienced nonconsensual rough sex but not other forms of sexual victimization measured by the SES-SFV, and it showed evidence of validity in that endorsement of the item was correlated with endorsement of the existing items on the SES-SFV. Additionally, endorsement of the single new item on the SES-SFV was correlated with endorsement of one or more types of nonconsensual rough sex on the multi-item measure of rough sex that we utilized in this study. However, although 19% of our participants endorsed one or more nonconsensual rough sex items on the multi-item measure, less than 7% endorsed the single item nonconsensual rough sex item added to the SES-SFV (very few individuals endorsed the single item, but did not endorse an item on the multi-item measure). Notably, the multi-item measure did ask about lifetime experiences, and the SES-SFV item asked about experiences since age 14; nevertheless, rough sex prior to age 14 is uncommon (Herbenick, Stanojevic, et al. 2025), so the age difference is unlikely to account for this discrepancy. In some ways, this discrepancy is unsurprising, though. Prior research has found higher rates of reporting for sensitive behaviors when surveys include a larger number of behaviorally specific questions (Abbey et al., 2021; Matthews et al., 2020). Given that, for researchers who are specifically interested in experiences of nonconsensual rough sex, a multi-item measure that includes separate items describing different types of rough sex is likely the best way to assess nonconsensual rough sex. However, for researchers who are interested in sexual victimization broadly, adding even a single item measuring nonconsensual rough sex to an existing sexual victimization measure may help to capture some instances of nonconsensual rough sex that are missed by traditional sexual victimization measures. Future research should also consider expanding perpetration measures to include one or more items assessing enacting nonconsensual rough sex.

Prevention and Clinical Implications

To better address problematic rough sex behaviors—especially for individuals who may already be vulnerable due to a sexual victimization history—sex education and sexual assault prevention efforts should be expanded to include discussions of nonconsensual and coercive rough sex, and sexual consent education should explicitly address sexual consent communication in the context of rough sex. Additionally, clinicians who are assessing and treating clients with sexual victimization histories should be aware of the possibilities of nonconsensual rough sex and cognizant of the association between rough sex and sexual victimization history. Clinicians who treat sexual trauma would benefit in being trained and comfortable in asking about experiences with rough sex and in having conversations about clients’ comfort, consent, pleasure, and feelings of safety during rough sex encounters.

Supplementary Material

3

Public Significance Statement.

Rough sex (e.g., sex involving hitting, biting, and choking) is relatively common, and can occur with or without consent. This study examined the association between sexual victimization history (i.e., a history of sexual contact through coercion, incapacitation, threat, or force) and rough sex. Enacting rough sex on a partner and experiencing rough sex (both consensually and nonconsensually) was associated with having a history of sexual victimization. Clinicians who treat sexual trauma and educators who teach about sexual consent should be aware of the association between sexual victimization history and rough sex behaviors and the potential for exploitation within rough sex interactions.

Acknowledgments

Data collection for this project was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD102535; PIs: Herbenick and Fu). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Contributor Information

Zoë D. Peterson, Kinsey Institute & Department of Applied Psychology in Education and Research Methodology, Indiana University

Debby Herbenick, Department of Applied Health Science, Indiana University.

Xiwei Chen, Department of Epidemiology and Biostatistics, Indiana University.

Tsung-chieh Fu, Department of Applied Health Science, Indiana University.

Jaroslaw Harezlak, Department of Epidemiology and Biostatistics, Indiana University.

References

  1. Abbey A, Helmers BR, Jilani Z, McDaniel MC, & Benbouriche M (2021). Assessment of men’s sexual aggression against women: An experimental comparison of three versions of the sexual experiences survey. Psychology of Violence, 11(3), 253–263. 10.1037/vio0000378 [DOI] [Google Scholar]
  2. Adler A, Biggs MA, Kaller S, & Schroeder R, & Ralph L (2023). Changes in the frequency and type of barriers to reproductive health care between 2017 and 2021. JAMA Network Open, 6(4), e237461. 10.1001/jamanetworkopen.2023.7461 [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Anderson RE, Cahill SP, & Delahanty DL (2018). The psychometric properties of the Sexual Experiences Survey–Short Form Victimization (SES-SFV) and characteristics of sexual victimization experiences in college men. Psychology of Men & Masculinity, 19(1), 25–34. 10.1037/men0000073 [DOI] [Google Scholar]
  4. Auer S. (2018, May 12). BDSM and consent: How to stop rough sex crossing the line into abuse. BBC. Retrieved from https://www.bbc.com/news/world-44041947 [Google Scholar]
  5. Bhuyan L, Peterson ZD, Zhou Y, Akers B, Eastman-Mueller H, Guerra-Reyes L, Fu T-c., & Herbenick D (2025). Nonconsensual rough sex and sexual assault: Their associations with mental health symptoms in a college sample. Manuscript submitted for publication. [Google Scholar]
  6. Bramsen RH, Lasgaard M, Koss MP, Elklit A, & Banner J (2012). Adolescent sexual victimization: A prospective study on risk factors for first-time sexual assault. European Child & Adolescent Psychiatry, 21(9) 521–526. 10.1007/s00787-012-0290-9 [DOI] [PubMed] [Google Scholar]
  7. Burch RL, & Salmon C (2019). The rough stuff: Understanding aggressive consensual sex. Evolutionary Psychological Science, 5, 383–393. 10.1007/s40806-019-00196-y [DOI] [Google Scholar]
  8. Cascalheira CJ, Ijebor EE, Salkowtiz Y, Hitter TL, & Boyce A (2023). Curative kink: Survivors of early abuse transform trauma through BDSM. Sexual and Relationship Therapy, 28(3), 353–383. 10.1080/14681994.2021.1937599 [DOI] [Google Scholar]
  9. Conner A, Azrael D, Miller M (2020). Firearm safety discussions between clinicians and U.S. adults living in households with firearms: Results from a 2019 national survey. Annals of Internal Medicine, 175(5). 10.7326/M20-6314 [DOI] [PubMed] [Google Scholar]
  10. Connolly C. (2021). Should defendants be allowed to rely on the “rough sex defence” in New Zealand trials? 5 NZWLJ 123 https://heinonline.org/HOL/LandingPage?handle=hein.journals/nzwomlj5&div=12&id=&page= [Google Scholar]
  11. Daminato L, Riboli G, Nese M, Brighetti G, Giunti D, & Borlimi R (2024). How Italians transgress: A survey on rough sexual behaviors in a sample of Italians. Sexes, 5(2), 58–70. 10.3390/sexes5020005 [DOI] [Google Scholar]
  12. Döring N, Mohseni MR, Pietras L, Dekker A, Briken P (2024). Research in brief: How prevalent is rough sex? Results from a national online sample of adults in Germany. Perspectives on Sexual and Reproductive Health, 56(2), 90–97. 10.1111/psrh.12267 [DOI] [PubMed] [Google Scholar]
  13. Eastman-Mueller H, Oswalt SB, & Nevers JM (2023). Sexual diversity on college campuses: Using a BDSM framework to discuss consent. Journal of American College Health, 71(3), 660–664. 10.1080/07448481.2021.1905649 [DOI] [PubMed] [Google Scholar]
  14. Gallagher B, Wager N, Gall V Gilroy B, Hudspith L, Singh M, Sykes J, & Whitaker V (2023). Consensual aggression and violence during sex in the general population (“rough sex”): A scoping (literature) review. In Bows H & Herring J (Eds), “Rough sex” and the criminal law: Global perspectives. doi: 10.1108/978-1-80117-928-720221002 [DOI] [Google Scholar]
  15. Gavey N. (2024). Deconstructing ‘rough sex’ in a New Zealand murder trial: Beyond the modern mythology of everyday kink. Social & Legal Studies. Online ahead of print. [Google Scholar]
  16. Gewirtz-Meydan A, Godbout N, Canivet C, Peleg-Sagy T, & Lafortune D (2024). The complex interplay between BDSM and childhood sexual abuse: A form of repetition and dissociation or a path toward processing and healing? Journal of Sex & Marital Therapy, 50(5), 583–594. 10.1080/0092623X.2024.2332775 [DOI] [PubMed] [Google Scholar]
  17. Gilmour P, & Lavinia E (2024, April 17). Rough sex ideas and tips for pleasurable but safe experiences. Cosmopolitan. Retrieved from https://www.cosmopolitan.com/uk/love-sex/sex/a14414784/rough-sex-tips/ [Google Scholar]
  18. Greenblatt J. (2016). “Cruelty is uncivilized”: Consent, BDSM, and legal regulation of the civil(ized) subject. In Dhawan N, Fink E, Leinius J, & Mageza-Barthel R (Eds), Negotiating normativity. Springer. 10.1007/978-3-319-30984-2_11 [DOI] [Google Scholar]
  19. Grocott LR, Leach NR, Brick LA, Meza-Lopez R, & Orchowski LM (2022). Institutional response and impact of reporting sexual violence: an examination of sexual and gender minority college students. Journal of Interpersonal Violence, 37(21-22), NP20653–NP20676. https://doi.org/08862605211055078 [DOI] [PubMed] [Google Scholar]
  20. Hammers C. (2014). Corporeality, sadomasochism and sexual trauma. Body & Society, 20(2), 68–90. 10.1177/1357034X13477159 [DOI] [Google Scholar]
  21. Herbenick D, Bowling J, Fu T-C, Dodge B, Guerra-Reyes L, & Sanders S (2017). Sexual diversity in the United States: Results from a nationally representative probability sample of adult women and men. PLoS ONE, 12(7), e0181198. 10.1371/journal.pone.0181198 [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Herbenick D, Fu TC, Carver DN, Brandenburg D, Balle M, & Eastman-Mueller H (2025). Prevalence and correlates of sexual choking and consensual non-consent (CNC) among college students: Findings from a campus-representative survey. Journal of Sex & Marital Therapy, 51(2), 224–242. 10.1080/0092623X.2025.2458173 [DOI] [PubMed] [Google Scholar]
  23. Herbenick D, Fu T-c., Chen X, Ali S, Stanojevic IS, Hensel D, Wright P, Peterson ZD, Harezlak J, & Fortenberry JD (2025). Prevalence and demographic correlates of “rough sex” behaviors: Findings from a U.S. nationally representative survey of adults ages 18 to 94. Manuscript under review. [Google Scholar]
  24. Herbenick D, Fu TC, Eastman-Mueller H, Thomas S, Svetina Valdivia D, Rosenberg M, Guerra-Reyes L, Wright PJ, Kawata K, & Feiner JR (2022). Frequency, method, intensity, and health sequelae of sexual choking among U.S. undergraduate and graduate students. Archives of Sexual Behavior, 51(6), 3121–3139. 10.1007/s10508-022-02347-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Herbenick D, Fu TC, Kawata K, Eastman-Mueller H, Guerra-Reyes L, Rosenberg M, & Svetina Valdivia D (2022). Non-fatal strangulation/choking during sex and its associations with mental health: Findings from an undergraduate probability survey. Journal of Sex & Marital Therapy, 48(3), 238–250. 10.1080/0092623X.2021.1985025 [DOI] [PubMed] [Google Scholar]
  26. Herbenick D, Fu T-c., Patterson C, Rosenstock Gonzalez YR, Luetke M, Svetina Valdivia D, Eastmann-Mueller H, Guerra-Reyes L, & Rosenberg M (2023). Prevalence and characteristics of choking/strangulation during sex: Findings from a probability survey of undergraduate students. Journal of American College Health, 71(4), 1059–1073. 10.1080/07448481.2021.1920599 [DOI] [PubMed] [Google Scholar]
  27. Herbenick D, Fu TC, Patterson C, Rosenstock Gonzalez YR, Luetke M, Svetina Valdivia D, Eastman-Mueller H, & Guerra-Reyes L, & Rosenberg M (2021). Prevalence and characteristics of choking/strangulation during sex: Findings from a probability survey of undergraduate students. Journal of American College Health, 71(4), 1059–1073. 10.1080/07448481.2021.1920599. [DOI] [PubMed] [Google Scholar]
  28. Herbenick D, Fu TC, Svetina Valdivia D, Patterson C, Rosenstock Gonzalez Y, Guerra-Reyes L, Eastman-Mueller H, Beckmeyer J, & Rosenberg M (2021). What is rough sex, who does it, and who likes it? Findings from a probability sample of U.S. undergraduate students. Archives of Sexual Behavior, 50(3), 1183–1195. 10.1007/s10508-021-01917-w [DOI] [PubMed] [Google Scholar]
  29. Herbenick D, Fu TC, Wright P, Paul B, Gradus R, Bauer J, & Jones R (2020). Diverse sexual behaviors and pornography use: Findings from a nationally representative probability survey of Americans aged 18 to 60 years. The Journal of Sexual Medicine, 17(4), 623–633. 10.1016/j.jsxm.2020.01.013 [DOI] [PubMed] [Google Scholar]
  30. Herbenick D, Guerra-Reyes L, Patterson C, Rosenstock Gonzalez YR, Wagner C, & Zounlome NOO (2022a). “If their face starts turning purple, you are probably doing something wrong”: Young men’s experiences with choking during sex. Journal of Sex & Marital Therapy, 48(5), 502–519. 10.1080/0092623X.2021.2009607 [DOI] [PubMed] [Google Scholar]
  31. Herbenick D, Guerra-Reyes L, Patterson C, Rosenstock Gonzalez YR, Wagner C, & Zounlome NOO (2022b). “It was scary, but then it was kind of exciting”: Young women’s experiences with choking during sex. Archives of Sexual Behavior, 51, 1103–1123. 10.1007/s10508-021-02049-x [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Herbenick D, Patterson C, Beckmeyer J, Rosenstock Gonzalez YR, Luetke M, Guerra-Reyes L, Eastman-Mueller H, Svetina Valdivia D, & Rosenberg M (2021). Diverse sexual behaviors in undergraduate students: Findings from a campus probability survey, Journal of Sexual Medicine, 18(6), 1024–1041. 10.1016/j.jsxm.2021.03.006 [DOI] [PubMed] [Google Scholar]
  33. Herbenick D, Patterson Perry C, Lumsdaine B, Fu T-c., Williams A, Ovide T, Miller O, Thomas S, & Eastman-Mueller H (2024). “I just really didn’t know what I was walking into”: Scary sexual experiences in a campus-representative survey of undergraduate students. Journal of Sex & Marital Therapy, 51(1), 58–73. 10.1080/0092623X.2024.2433102 [DOI] [PubMed] [Google Scholar]
  34. Herbenick D, Stanojevic IS, Fu T-c., Chen X, Ali S, Wright P, Hensel D, Pseterson ZD, Harezlak J, & Fortenberry JD (2025). Prevalence and demographic correlates of rough sex behaviors: Findings from a U.S. nationally representative survey of adolescents ages 14 to 17. Manuscript under review. [Google Scholar]
  35. Huibregtse ME, Alexander IL, Klemsz LM, Fu TC, Fortenberry JD, Herbenick D, & Kawata K (2022). Frequent and recent non-fatal strangulation/choking during sex and its association with fMRI activation during working memory tasks. Frontiers Behavioral Neuroscience, 16. 10.3389/fnbeh.2022.881678 [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Koss MP, Abbey A, Campbell R, Cook S, Norris J, Testa M, Ullman S, West C, & White J (2007). Revising the SES: A collaborative process to improve assessment of sexual aggression and victimization. Psychology of Women Quarterly, 31(4), 357–370. 10.1111/j.1471-6402.2007.00385.x [DOI] [Google Scholar]
  37. Koss MP, Anderson RE, Peterson ZD, Littleton H, Abbey A, Kowalski R, Thompson M, Canan S, White J, McCauley H, Orchowski LM, Fedina L, Lopez E, & Allen C (2024). The revised Sexual Experiences Survey Victimization Version (SES-V): Conceptualization, modifications, items, and scoring. Journal of Sex Research, 61(6), 839–867. 10.1080/00224499.2024.2358407 [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Mark KP, Arenella K, Girard A, Herbenick D, Fu J, & Coleman E (2024). Erectile dysfunction prevalence in the United States: Report from the 2021 National Survey of Sexual Wellbeing. Journal of Sexual Medicine, 21(4), 296–303. 10.1093/jsxmed/qdae008 [DOI] [PubMed] [Google Scholar]
  39. Matthews B, Pacella R, Dunne MP, Simunovic M, & Marston C (2020). Improving measurement of child abuse and neglect: A systematic review and analysis of national prevalence studies. PLOS ONE, 15(1), e0227884. 10.1371/journal.pone.0227884 [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Melnik J, Nardella S, Ward SB, & Walsh K (2023, November 16-19). Associations between lifetime sexual violence and engaging in choking during sex: Findings from an undergraduate sample [Poster Presentation]. “The Society for the Scientific Study of Sexuality Annual Conference” New Orleans, Louisiana, United States of America. [Google Scholar]
  41. McKee A, McNair B, & Watson AF (2014). Sex and the virtual suburbs: The pornosphere and community standards. In Maginn PJ & Steinmetz C (Eds.), (Sub)urban sexscapes: Geographies and regulation of the sex industry (pp. 159–174). London: Routledge. 10.4324/9780203737569-9. [DOI] [Google Scholar]
  42. Orenstein P. (2024, April 12). The troubling trend in teenage sex. The New York Times. Retrieved from https://www.nytimes.com/2024/04/12/opinion/choking-teen-sex-brain-damage.html [Google Scholar]
  43. Peterson ZD (2024). Beyond sexual victimization and perpetration: Men, masculinities, and unwanted consensual sex. Psychology of Men & Masculinities, 25(4), 402–417. 10.1037/men0000475 [DOI] [Google Scholar]
  44. Peterson ZD, Herbenick D, Chen X, Fu T-c., & Harezlak J (2025). Prevalence and demographic correlates of sexual victimization in a nationally representative sample of U.S. adults. Manuscript in preparation. [Google Scholar]
  45. Peterson ZD, Koss MP, & Anderson RE (2024). Preliminary prevalence estimates of sexual exploitation as measured by the Sexual Experiences Survey-Victimization (SES-V) in a National US sample. Journal of Sex Research, 61(6), 904–921. 10.1080/00224499.2024.2359639 [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Peterson ZD, Littleton HL, Anderson RE, & Koss MP (2024). Quantifying criminal sexual exploitation: The Illegal Sexual Exploitation module of the Revised Sexual Experiences Survey-Victimization (SES-V) measure. Journal of Sex Research, 61(6), 868–881. 10.1080/00224499.2024.2359049 [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Ryan KM, & Mohr S (2005). Gender differences in playful aggression during courtship in college students. Sex Roles, 53(7-8), 591–601. 10.1007/s11199-005-7144-6 [DOI] [Google Scholar]
  48. Schori A, Jackowski C, & Schön CA (2022). How safe is BDSM? A literature review on fatal outcome in BDSM play. International Journal of Legal Medicine, 136(1), 287–295. 10.1007/s00414-021-02674-0 [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Sheehy E, Grant I, & Gotell L (2022-2023). Resurrecting “she asked for it”: The rough sex defence in Canada. 20 Alta L. Rev, 651–684. Retrieved from https://heinonline.org/HOL/LandingPage?handle=hein.journals/alblr60&div=30&id=&page= [Google Scholar]
  50. Vogels EA, & O’Sullivan LF (2019). The relationship among online sexually explicit material and exposure to, desire for, and participation in rough sex. Archives of Sexual Behavior, 48(2), 653–665. 10.1007/s10508-018-1290-8 [DOI] [PubMed] [Google Scholar]

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