She did not realize how close to death she was.
Four years after England and Wales made strangulation a standalone criminal offense, more than 44,000 reports in a single year mark both a hard-won shift in public awareness and a sobering measure of how much harm was always there, waiting to be named. Survivors like Rachel Williams, who endured eighteen years of abuse before being shot by her ex-husband, have turned their suffering into advocacy, pressing courts and institutions to reckon with a violence that leaves no visible marks yet can cause strokes, brain damage, and death. The law arrived before the systems to enforce it, and the work now is to close that gap — in sentencing, in medical understanding, and in the willingness to believe those who come forward.
- Over 44,000 strangulation reports in a single year — a 13% rise — signal that victims are increasingly naming a crime that was long invisible, yet campaigners warn the true scale remains buried beneath shame and ignorance.
- The medical reality is quietly catastrophic: strangulation can trigger strokes and permanent brain injury without leaving a single bruise, and women under forty face a sharply elevated stroke risk that most victims — and many clinicians — never knew existed.
- Rachel Williams, strangled so violently her children thought an animal was dying, now leads the charge for sentencing that treats the act as the near-fatal assault it is, not a lesser form of domestic violence.
- The Institute for Addressing Strangulation has trained more than 22,000 professionals since 2022 and produced the UK's first medical guidelines on strangulation injury, attempting to retrofit the expertise the law assumed was already in place.
- Government has begun to act on normalization as well as criminalization, moving to ban online pornography depicting strangulation after reports of boys as young as fourteen asking teachers how to choke girls during sex.
- Officials and campaigners now describe a moment of convergence — law, medicine, research, and survivor testimony aligning — but insist the decade-long goal of halving violence against women and girls demands sustained will, not just legislation.
More than 44,000 strangulation reports reached police across England and Wales in the past year — a thirteen percent rise on the year before, and a figure that arrives four years after the act became a standalone criminal offense. For campaigners, the number is both progress and provocation: evidence that victims are beginning to name what was done to them, and a reminder of how many still do not.
Rachel Williams is among those who did not, for a long time, understand. Strangled repeatedly across eighteen years of abuse, she recalls the night six weeks before her ex-husband shot her in her Newport hair salon in 2011 — the violence so severe her children woke upstairs, one believing an animal was dying. She dismissed a sore throat as a minor injury. She did not know she had been brought close to death, or that oxygen deprivation of that kind can cause strokes, lasting brain damage, and permanent cognitive harm. That shared ignorance — among victims, police, and medical professionals alike — became the cause she has pursued ever since.
The Institute for Addressing Strangulation, which released this week's figures, was built precisely to address the gap that opened when the law passed without the infrastructure to support it. Since October 2022, it has trained more than 22,000 frontline professionals and produced the UK's first medical guidelines on strangulation injury — guidelines designed to help clinicians recognize harm that leaves no visible trace. The science is unsparing: the brain starved of oxygen can suffer a stroke or sustain injury that quietly reshapes how a person thinks and remembers. Women under forty who have been strangled face a significantly elevated stroke risk.
Williams is now pressing for sentencing that reflects this reality — for courts to treat strangulation as the life-threatening act it is. The government has already moved to ban online pornography depicting strangulation or suffocation, following a review that found such content widespread on mainstream platforms and linked to normalization among young people; teachers in Wales have reported boys as young as fourteen asking how to choke girls during sex.
Bernie Ryan of the Institute describes the current moment as one of convergence — survivors, clinicians, researchers, and officials working toward a shared goal. The Minister for Safeguarding has echoed the call for stronger cross-sector partnerships, framing the ambition as halving violence against women and girls within a decade. That will require more than a law. It will require the systems, the training, and the collective will to protect people before harm is done — and to believe them when they say it was.
In the past year, police forces across England and Wales recorded more than 44,000 reports of strangulation. The figure arrives as a stark measure of how far awareness has traveled since the act became a standalone criminal offense four years ago—and how far it still has to go.
Rachel Williams, who survived eighteen years of abuse that included repeated strangulation, has become the public face of the push to make the law work harder. She was strangled so violently six weeks before her ex-husband shot her in her Newport hair salon in 2011 that the noise woke her children upstairs; one of them thought an animal was dying. At the time, she did not understand what was happening to her body. A sore throat seemed like a minor injury. She did not know she was being starved of oxygen in ways that could trigger a stroke, cause brain damage, or leave her with permanent cognitive loss. She did not realize how close to death she actually was. That ignorance—shared by victims, by police, by medical professionals—is what she has spent years trying to dismantle.
The new figures, released this week by the Institute for Addressing Strangulation, show a thirteen percent increase in reports from the previous year and document 24,446 prosecutions since the offense entered law. Williams welcomed the numbers as evidence that victims are beginning to see the crime as serious enough to report. But she is clear that the real toll is hidden. Many people still do not come forward. Many do not understand what has been done to them.
Dr. Helen Bichard, a clinical psychologist who helped secure the original government funding that created the Institute, points to a gap that opened the moment the law passed: the systems to enforce it were not yet in place. Medical professionals had no guidelines for recognizing or treating strangulation injuries. Frontline workers did not know what to look for. So the Institute was built to fill that void. Since its creation in October 2022, more than 22,000 professionals have been trained through its specialist program. New medical guidelines—the first of their kind in the UK—have been developed to help health workers understand that strangulation can be catastrophic even when the skin shows no marks.
The science is unforgiving. When the brain is starved of oxygen, it can suffer a stroke. It can sustain injury that alters how a person thinks, remembers, and functions. Women under forty who have experienced strangulation face a significantly elevated risk of stroke. These injuries can happen silently, leaving no visible trace. This is why strangulation is used as a weapon: it is efficient and it is effective.
Williams is now pushing for sentencing that reflects the severity of the harm. She wants courts to treat strangulation not as a minor assault but as the life-threatening act it is. The government has already moved on one front: online pornography depicting strangulation or suffocation is to be made illegal, following a review that found such content was widespread on mainstream sites and had helped normalize the act among young people. Teachers in Wales have reported boys as young as fourteen asking how to choke girls during sex.
Bernie Ryan, chief executive of the Institute, frames the moment as one of convergence: government, clinicians, researchers, specialist organizations, and survivors working toward a single goal. The report demonstrates what that collaboration can achieve. It also makes clear what remains undone. Natalie Fleet, the government's Minister for Safeguarding and Violence Against Women and Girls, echoes the call for stronger partnerships across healthcare, policing, and academia. The mission, she says, is to halve violence against women and girls within a decade. That will require more than law. It will require the systems, the training, the understanding, and the will to protect people before they are strangled, and to believe them when they report it.
Citações Notáveis
It woke my kids up from the bedroom upstairs and one of them said they thought they could hear a pig squealing because of the noise I was making.— Rachel Williams, describing a strangulation attack during her 18-year abusive relationship
Strangulation is a dangerous form of abuse that can leave victims with devastating and long-lasting physical and psychological harm.— Natalie Fleet, Minister for Safeguarding and Violence Against Women and Girls
A Conversa do Hearth Outra perspectiva sobre a história
Why did it take until 2022 for strangulation to become its own crime? Wasn't it already illegal under assault laws?
It was, technically. But assault charges didn't capture what strangulation actually does—the specific danger of oxygen deprivation, the invisible injuries. Making it standalone meant courts and police had to treat it as the distinct threat it is.
Rachel Williams says the real numbers are much higher than 44,000. How much higher are we talking?
She doesn't give a figure, but the point is clear: many victims still don't report it because they don't understand it's serious, or they're afraid, or they've internalized the idea that a sore throat isn't worth involving police. The 44,000 is what we can count. The rest is silence.
The medical guidelines seem like they came late. Why weren't they in place before the law?
That's the gap Dr. Bichard identified. The law passed, but the infrastructure didn't follow. Doctors had no training, no protocols. So people walked into emergency rooms with stroke symptoms or cognitive problems and no one connected it to strangulation. The guidelines are meant to fix that—to make the invisible visible.
What does it mean that boys are asking teachers how to choke girls?
It means the normalization is real and it's young. If pornography is showing strangulation as routine, and no one is teaching young people that it's dangerous, then it becomes just another thing. That's why the government is moving to ban that content—to interrupt the pipeline before it reaches behavior.
Is 24,446 prosecutions in four years a lot or a little?
It's hard to say without context, but consider this: if 44,000 reports came in just last year, and only 24,446 have been prosecuted total across four years, there's a significant gap between reporting and conviction. That's where sentencing comes in—if sentences are light, it signals the crime isn't serious, which affects both prosecution decisions and victim willingness to report.