Strangulation Often Signals Escalating Domestic Violence: Fairfax County

FAIRFAX COUNTY, VA — Strangulation often leaves little or no visible evidence, but Fairfax County officials say it is one of the strongest warning signs that someone experiencing domestic violence may later become the victim of homicide.

That message is behind a July 29 training for medical providers, law enforcement, victim advocates, attorneys and other professionals who work with survivors of domestic and sexual violence.

While the training is not open to the general public, county officials say raising public awareness about strangulation could save lives.

"Strangulation actually increases the risk of lethality for someone experiencing domestic violence by over 700 percent," Abby Picard, prevention and education coordinator with Fairfax County's Domestic and Sexual Violence Services, told Patch in an interview.

Hidden Injuries Can Become Deadly

Picard said strangulation is both a legal and medical term describing any act that intentionally impedes another person's ability to breathe.

While many people think only of someone placing their hands around another person's neck, strangulation can also include suffocation with an object, such as a pillow, or any action that blocks a person's airway.

One of the greatest dangers, she said, is that victims frequently do not realize they have suffered serious injuries.

"It actually takes very little pressure to occlude a person's breathing," Picard said, adding that many victims have no obvious bruising or other external injuries immediately afterward.

Instead, symptoms can develop over the next 24 to 48 hours as internal injuries worsen.

People should seek immediate medical attention if they lost consciousness, develop changes in their voice, have difficulty swallowing, notice bruising or marks on their neck, or experience other symptoms after being strangled, Picard said.

Survivors can receive specialized care through Inova's Forensic Assessment and Consultation Team (FACT), whose nurses have extensive training in treating victims of domestic and sexual violence. FACT services are available 24 hours a day, according to Picard.

Virginia Made Strangulation A Felony

Virginia lawmakers first created the standalone crime of strangulation in 2012, making it a Class 6 felony when someone intentionally impedes another person's breathing by applying pressure to the neck and causes bodily injury.

In 2023, the General Assembly expanded the law to specifically include suffocation by intentionally blocking or obstructing another person's airway, also making that offense a Class 6 felony.

Picard said that legal distinction is important because many domestic assault cases are prosecuted as misdemeanors, while strangulation carries felony penalties.

Officials Seeing More Cases

Although the July 29 course is designed for professionals, Picard said Fairfax County has increasingly focused on educating health care workers, courts, schools, nonprofit organizations and other agencies because strangulation is encountered across many settings.

She also noted a growing body of research linking strangulation to domestic violence homicides and said reports involving strangulation have increased among both domestic violence and sexual assault survivors.

Picard said researchers have also documented an increase in college students — and some high school students — reporting that someone placed hands around their neck during sexual encounters.

What Friends And Family Should Do

One of the most important messages, Picard said, is that friends and relatives often play a greater role in helping victims than they realize.

Rather than telling someone what they should do, she recommends expressing concern, asking what the person needs to feel safe and continuing to offer support.

"You already have the skills to be a supportive friend, a supportive family member," Picard said. "The best advocate in the world with all the best training in the world is not going to have the same kind of impact as you can as a friend or family member."

She also emphasized that victims frequently remain in abusive relationships for complex reasons and that continued support can have a lasting impact on their safety.

Help Is Available Without Calling Police

Picard said many survivors hesitate to seek medical treatment or support because they fear it will automatically trigger a police investigation.

She stressed that Fairfax County's Domestic and Sexual Violence Services offers confidential assistance that does not require victims to report abuse to law enforcement.

The county's 24-hour Domestic and Sexual Violence Hotline — 703-360-7273 — is available for victims, concerned family members and friends seeking guidance. Calls are free and confidential. Hotline advocates provide crisis support, safety planning, referrals and information, and services are available regardless of gender, sexual orientation or immigration status.

"If people want to reach out for resources, whether or not they decide that law enforcement is the best case for them, they can always reach out to us," Picard said.

The only situations requiring mandatory reporting involve suspected child abuse, abuse of vulnerable adults, or threats of imminent harm to oneself or others, she said.

Services Extend Beyond Adult Victims

Fairfax County's Domestic and Sexual Violence Services also provides support for children who witness domestic violence, teens experiencing dating violence and survivors of sexual assault.

In addition to crisis intervention, the county offers advocacy, counseling, hospital accompaniment, housing and economic support, court assistance and educational outreach. The Domestic Violence Action Center (DVAC) also connects survivors with legal assistance, safety planning, emergency shelter and other community resources.

Residents interested in learning more can request presentations for community groups through Fairfax County's Domestic and Sexual Violence Services outreach program. The county also periodically offers public "Tier One" domestic violence and sexual violence training sessions, along with its "Unscripted Conversations About Sexual Domestic Violence" podcast, which will soon feature episodes focused on strangulation.

If you or someone you know is in immediate danger, call or text 911.

For confidential support in Fairfax County:

• Domestic and Sexual Violence 24-Hour Hotline: 703-360-7273
• Inova Forensic Assessment and Consultation Team: 855-694-6682
• Virginia Family Violence and Sexual Assault Hotline: 800-838-8238

• To request a training or speaker with our division: Outreach and Education Services | Family Services
• Fairfax County's Domestic and Sexual Violence Services podcast: Unscripted: Conversations about Sexual and Domestic Violence Podcast