Harm management response

Address physical injuries

If injuries are present, support access to a routine assessment (or undertake one if in scope). If there are genital injuries, refer to on-site or local sexual health or gynaecological services. If pregnant, refer to the lead maternity carer or emergency department.

Address safety concerns

If there are safety concerns, follow internal safeguarding pathways and/or refer to sexual violence response services for guidance. Discuss police reporting options if appropriate (or refer to a service that can facilitate this).

If sexual strangulation has occurred, refer to ED or urgent care for an assessment. For non-urgent concerns, consider a Non-Fatal Strangulation (NFS) referral. If it occurred in the context of domestic violence, refer to specialist family and sexual violence response services for follow-up. If strangulation is occurring as part of consensual rough sex, offer education on risks.

Assess (if in scope) impacts on mental, spiritual, or social wellbeing, regardless of whether physical injury is present. Consider the need for culturally specific, relevant, and safe services (e.g. Māori or Pasifika-based, disability, rainbow).

Refer to specialised support services as relevant, and with the young person’s consent (e.g. support services such as helplines, GP, mental health and FVSV support services).

If support is declined, provide future options, harm reduction information, and basic safety planning. Encourage connection with existing safe supports (e.g. whānau, counsellors, trusted adults).

Information statement

Rough sex has become more common among young people. Because of the nature of rough sex, there’s an increased risk of physical injuries and other forms of harm. This can happen even when people don’t intend harm.

Question prompt

• Tell me about your experience… Is it something that you felt safe and comfortable with?

• Did anything happen that was unexpected, unwanted, or that you weren't sure about?

• Some people practice sexual choking/strangulation as part of rough sex. Is this something you're familiar with? Do you have any questions about it? Learn more about sexual choking/strangulation on In the Know

Information statement

Sometimes rough sex can affect people emotionally, mentally, or spiritually. Some people describe feeling frightened, degraded, or confused after rough sex. This can happen during or after sex, even if everyone consented, and/or when it occurred with someone who didn’t intend to harm them.

Question prompt

• Would you like to share anything about your experience with me?

• Did anything happen that you didn’t expect, like or want, or that you feel unsure about?

• Did you find yourself responding in a way you didn’t expect? Tell me about that

Information statement

Feeling pressure to have rough sex can be common. This might be because of expectations from a partner, peer pressure, or just because it's considered a “common” type of sex. Any sex that is pressured or unwanted can be harmful – and when specific consent isn't given, it may be considered sexual assault.

Question prompt

• Tell me about your experience. Did you feel pressure to try anything you didn’t want to do, or felt unsure about?

• How did you decide to have rough sex? Was it something you genuinely wanted and agreed on?

Information statement

Consent for rough sex can sometimes feel confusing. Some people blame themselves for unwanted rough sex because they initially consented to general sex, they didn’t say “no” or “stop”, or they think rough sex is just “normal” and “expected”. Consent for rough sex includes informed consent for every single act, and it can be withdrawn at any time.

Any type of unagreed, unwanted, or unexpected sexual experience is harmful.

Question prompt

• Would you like to tell me about your experience?

• Did you know, want, and agree to everything that happened?

• What did consent look like for you?

Information statement

Some people think because rough sex is common or because they consented to sex, rough sex can’t be considered harmful or abuse. But any type of sex that isn’t wanted is harmful. Even if it occurs with a trusted partner or if consent was given, it can still feel degrading, frightening, scary, or unwanted.

Question prompt

• Would you like to tell me about your experience – and how you’re feeling about it?

• What you’re describing sounds like it could be a harmful and unwanted sexual experience. Would you like to talk about how you’re feeling about it?

• Some people only recognise how they felt about rough sex afterwards. Is there anything that has come up for you about your experience that you’d like to talk through?

Information statement

Rough sex can be harmful – even with a caring partner who doesn’t intend to harm you.

Some people feel pressure to try rough sex because their partner likes it, but many people don't like rough sex – and it’s okay not to like it or want it.

Question prompt

• Is rough sex something you and your partner both agree on, want, and enjoy?

• If not, is your partner aware of how you’re feeling?

• Do you feel able to share with them what you didn’t expect, like, want, or feel confused about? Why/why not?

• If not, what support might you need to do this?

Information statement

We encourage anyone who's had a harmful experience to consider ways to prevent harm from occurring again. Everyone deserves safe, enjoyable, and harm-free sex – and because rough sex is riskier sex, it’s important to take steps to keep as safe as possible.

Question prompt

• What do you know about reducing the harms that can occur with rough sex?

• Is it okay to share with you the 4Cs consent, communication, care, and caution tool, which gives tips to help reduce the risks of rough sex?

• Can I share information on safe and confidential services in case you have another harmful experience and want support in the future?

Information statement

What you’re describing sounds like it could be a harmful and unwanted sexual experience. We are here to support you – and as part of that, we can help you access some specialised support.

Some people want to report harmful rough sex experiences to the police, and others don’t. Whatever you decide is your choice, and you don’t have to decide right now. Some specialist services can help you make this decision, if or when you're ready.

Question prompt

• A lot of people find it helpful to get support from specialist services after experiences like this. There are lots of confidential options available – can I share these with you?

• Would you like me to talk through police reporting options? Do you have any concerns about reporting to police? If so, we can talk through them, or I can connect you with a support service that can help.

Information statement

You don't have to take any steps you're not ready for, but knowing what support is available could be helpful in the future.

Question prompt

• I can share information on safe, confidential services if you'd like support in the future?

• Do you have any concerns about accessing support services? If so, we can talk through them

• What could safe "support" look like for you? Have you talked to anyone else about this before? Is there anyone you feel safe talking to?