Today marks a year since the introduction of the new offence of ‘strangulation and suffocation’. Previously these assaults tended not to be taken seriously and were either not prosecuted or else charged as common assault.
The new law, introduced as part of the Domestic Abuse Act 2021, makes strangulation and suffocation a specific offence, with perpetrators facing a maximum sentence of five years.
The Court of Appeal recently said that, as strangulation creates a real and justified fear of death, an immediate prison term will normally be appropriate. The starting point for sentencing is 18 months, but longer terms can be given if the offence includes factors such as a history of violence, abuse of power, taking alcohol or drugs, using a ligature, or trying to stop the victim getting help. Proven physical or psychological harm is not necessary for a conviction.
The development of the new law
Three years ago, I had no detailed knowledge of these issues. My involvement began with a chance phone call with Advocacy After Fatal Domestic Abuse (AAFDA). I have been a patron of AAFDA since – in my time as an MP – I was able to help its founder, Frank Mullane MBE, whose sister and nephew were killed through domestic abuse.
During that phone call, AAFDA asked me to help their campaign to get this specific offence into law. That led me to co-ordinate the group that succeeded in getting the law changed and went on to establish the Institute for Addressing Strangulation as part of the Faculty of Forensic & Legal Medicine. The faculty held its annual conference in York last month and services for victims of strangulation was one of the main topics of discussion there.
The impact of strangulation and suffocation on victims
I have been shocked to learn that an estimated 20,000 women are subjected to non-fatal strangulation in the UK every year. Add to this trauma the fact that children often witness these attacks – the Crown Prosecution Service recently reported that children were present in one-third of non-fatal strangulation cases.
Being strangled is a terrifying experience for the victim. Very often they are staring the perpetrator in the face. In cases of domestic abuse that is someone they may have once loved and with whom they expected to be safe – instead, they find themselves in fear for their life.
This fear is justified. Women who are strangled are seven times more likely to go on to be victims of murder. And strangulation is itself the cause of death in many homicides. From April 2011 to March 2022, 18% of female homicide victims in England and Wales were killed by strangulation or suffocation, as were 6% of male homicide victims.
Before I got involved in the campaign, I didn’t know that victims of strangulation can lose consciousness in under seven seconds and can experience seizures and incontinence within 30 seconds – all signs of neurological damage. Death can occur within minutes.
Nor did I know that strangulation can lead to memory loss; some victims who lose consciousness are not aware of having done so.
Attacks can also lead to a variety of long-term problems including stroke (strangulation is the second most common cause of stroke in women under 40), miscarriage, facial droop, hearing and sight loss, behavioural changes, post-traumatic stress disorder and other psychiatric conditions. Newly recognised is the significant risk of brain damage.
These attacks often occur in a wider context of coercive control, which is itself an offence. Children can also be victims of these attacks.
It is important for the police, judges and NHS staff to know that ‘no visible injuries’ does not equate to no attack. Some 50% of victims have no visible injuries to their necks and even some fatal strangulations leave no external marks.
Less surprising is that offenders who strangle one partner often go on to do the same in other relationships. So, prosecuting the offence has a vital role in preventing future offending.
Strangulation and sex
As well as strangulation that occurs in domestic abuse and sexual assault, there is an increasing incidence of strangulation during sex – partly because of the widespread circulation of pornography that normalises strangulation as part of sex. In fact, there is little evidence that strangulation improves women’s sexual experience.
Sometimes men who strangle women claim their partners consented to strangulation. But consent needs to be informed. If the risks aren’t understood, there cannot be informed consent. Consent also needs to be capable of being withdrawn at any point. But with the lack of oxygen to the brain, victims can within seconds find themselves unable to move or speak.
The Domestic Abuse Act confirms that a victim cannot consent to strangulation or suffocation that causes actual bodily harm (or worse). So consent is not a valid defence for a perpetrator in such cases.
What next?
There are major gaps in services.
Training is needed to help key personnel in the criminal justice system and the NHS identify the signs of strangulation. Victims may, for example, have long term neck or throat injuries, or weaknesses in limbs, which could be picked up by GPs a long time after the event.
Although there are sexual assault referral centres throughout the country, where trained staff support victims who have suffered strangulation or suffocation as part of a sexual assault, there is a lack of health and forensic support for victims of strangulation in domestic abuse situations. This gap needs to be filled.
More investment is needed in domestic abuse support services to help victims. Earlier interventions can save money by preventing future attacks and the harms they cause.
Perpetrators must be held responsible for their actions, with sentences reflecting the seriousness of the attacks. Some perpetrators will themselves be damaged people and need help to deal with aggression and the wish to control.
During the first year of the specific offence being in force, many in the criminal justice system and the NHS have been keen to learn how best to implement the legislation and to care for its victims. They say it is making a difference. There is still a massive amount to do, but I am optimistic that this change in the law will save lives and protect women and their families from the misery of this previously neglected form of violence.
