Woman's Hour - Three-person DNA babies, Emer Kenny, Dangers of sexual strangulation

Episode Date: July 18, 2025

Eight babies have been born in the UK using genetic material from three people to prevent devastating and often fatal conditions. The method, pioneered by UK scientists, combines the egg and sperm from a mum and dad with a second egg from a donor woman. The technique has been legal in the UK for a decade but this is the first proof it is leading to children born free of incurable mitochondrial disease, which is normally passed from mother to child. Anita Rani is joined by Kat Kitto who has two daughters, one of whom has mitochondrial disease, and Louise Hyslop, consultant embryologist at the Newcastle Fertility Centre, to tell us more. Hit ITV crime drama Karen Pirie returns to our screens for a second series this weekend, based on the Val McDermid series of novels about a young Scottish detective. Anita is joined in the studio by showrunner, screenwriter and actor Emer Kenny to talk about bringing a new cold case to life for Karen to solve, juggling series two with a newborn, and how she’s managed to combine acting and writing since landing her first big role as Zsa Zsa Carter in EastEnders at the age of 20.A Government review found that porn involving non-fatal strangulation was "rife" and its prevalence online was contributing to choking, filtering into some people's sex lives - particularly among young people. Last month it was announced that choking will be criminalised in an amendment to the Crime and Policing Bill. To discuss, Anita was joined by Professor Clare McGlynn, Professor of Law at Durham University who contributed to the review, and Dr Jane Meyrick, Associate Professor of Health Psychology at the University of the West of England, who specialises in sexual health and sexual violence. This week, throughout our series on women and gaming, we’ve heard about the influence that games can have in society. We've spoken to women working in the industry, and found out more about the impact gaming can have on women, but we can’t shy away from the fact that there are still barriers stopping women from accessing games. Anita is joined by to Marie-Claire Isaaman, CEO of Women in Games, Nick Toole, CEO of Ukie, and Stephanie Ijoma, gamer and founder of NNESAGA, to discuss what still needs to change and how the industry can improve. Presenter: Anita Rani Producer: Corinna Jones

This BBC podcast is supported by ads outside the UK. deal ratings and price history. So you know a great deal when you see one. That's cargurus.ca. Cuba's Minister of Labour has resigned after claiming that there are no beggars on the Caribbean island. That's just one of the myths surrounding the communist-led country. So what's life really like there? I'm William Lee Adams. On What in the World, we're lifting the veil on a frequently misunderstood country. What in the World? is an award-winning podcast from the BBC World Service. We go in-depth on a different topic every weekday in under 15 minutes. Listen wherever you get your BBC podcasts. BBC Sounds. Music, radio radio podcasts.

Hello, I'm Anita Rani and welcome to Woman's Hour from BBC Radio 4. Good morning and welcome to the programme. Huge congratulations to the Lionesses after their nail biting win 3-2 last night against Sweden after penalties, keeping their dream of defending their European Championship title alive. And now they'll play Italy in the semi-final on Tuesday. So school's out for summer and the weekend is here. What will you be celebrating or cheering on this weekend? Get in touch with the programme in the usual way. The text number is 84844. You can email us via our website. You can follow us on social media. It's at BBC Woman's Hour and our WhatsApp number, which you can save to your phone,

is 03 700 100 444. Also actor, writer, producer, Ima Kenney will be here to tell us about series two of ITV Detective series, Karen Pirie. We've been discussing women in gaming all week and today we zoom out and look at the industry as a whole. If you game, what does it bring to your life? Gaming isn't just shoot-em-ups or driving games. Are you a digital word puzzle solver or Sudoku lover? Lots of us are gaming out there, so your thoughts on that please. And last month, the government announced that the depiction of strangulation in pornography will be banned.

A third of 16 to 34 year olds has experienced choking during sex. We will be talking about that shortly. That text number, once again, if you'd like to get in touch with the programme, about anything you hear, your opinions and thoughts always welcome is 84844. But first, eight babies have been born in the UK using genetic material from three people to prevent devastating and often fatal conditions. The method pioneered by UK scientists combines the egg

and sperm from a mum and dad with a second egg from a donor woman. The technique has been legal in the UK for a decade, but this is the first proof it's leading to children born free of incurable mitochondrial disease. These conditions are normally passed from mother to child. Well, earlier I was joined by Kat Kito, who has two daughters, one of whom has mitochondrial disease, and Louise Hislop, consultant embryologist at the Newcastle Fertility Centre who performed the technique for all the patients as well

as doing the pre-clinical research. I started by asking Louise to explain what mitochondrial disease is. Good question. So inside of our cells are little structures called mitochondria. And inside those, there's also a very, very small piece of DNA called mitochondrial DNA. And our mitochondria are responsible for making the energy that our cells require to function. Now, if that little piece of DNA inside the mitochondria contains a mutation, what can happen

is it means that the mitochondria don't function very well and they don't function very well and they don't produce all the energy that the cells require to function and that specifically really affects tissues that have a really high energy requirement such as our heart, you know, you imagine the heart beating, it needs lots of energy and if these mitochondria aren't producing enough energy it can, you know can affect those sorts of tissues. So can you now explain what this new technique is that you've been developing for 10 years,

but we are now hearing about? Yes, so we actually inherit our mitochondrial DNA from our mums. So this disease is passed from mother to child. And at this present time, there is no cure. So what we've been doing is developing a technique to try and reduce the risk for these women passing on this disease to their children. So basically what we do is we take fertilized eggs from mum, which have been created using her partner's sperm. And we create fertilised eggs from a donor as well. So a donor who we know is healthy, we know that she hasn't

got mitochondrial DNA disease, so that's really important. And what we do is we take the nuclear DNA out of the fertilized egg from the mum and put that nuclear DNA into the donor's fertilized egg that's had its DNA removed. So what you end up with is an embryo that has the nuclear DNA that is responsible for all our characteristics, eye color, hair color, those sorts of things. So the nuclear DNA is from mum and dad and it has lovely healthy mitochondria from the donor. Incredible to sort of get your head around really, especially those of us who don't really, I've seen lots of diagrams to understand it and it really is remarkable science. Kat, I'm going to bring you in here. What does this development mean to you and your family? Why is it so important for you? Thank you. So I I my husband I we have two daughters

Who are now 16 and 14 the youngest of whom has mitochondrial disease? She was diagnosed at about 18 months. So she was seemingly healthy healthy baby hitting all her milestones and at 18 months kind of things started You know looking a little bit, you know, not not typical And actually she is now significantly affected by mitochondrial disease. It's it's a progressive disease As Louise said there's no no cure and there's no treatment So she has lost the ability to speak to to walk. She could never quite walk. She was nearly there, but she's completely in a wheelchair. Now she's tube-fed, has epilepsy, lots of complications.

So it's, you know, she's great, she's brilliant, but her life is, you know, it's a life-limiting condition. We were involved alongside the Lilly Foundation. That's a charity that supports mitochondrial disease and the families affected by it. Ten years ago when this bill was passed through Parliament to introduce the legislation to make this technique possible and I guess at that point it gave a glimmer of hope that my eldest daughter who is not affected may at some point in the future be able to use this technique

to have babies free of the disease, so essentially breaking that chain of mitochondrial disease. Do you know that does she have that is it is it something that your daughter carries is that how this works? She has not been tested right so I didn't know until I had until Poppy was diagnosed I didn't know I carried it I carry it at very very low levels and at those levels, you know, it's completely asymptomatic. There's no noticeable effect on my life. Possibly very similar for my daughter. But as Louise said again, it's the eggs that carry the mutant mitochondrial DNA and if it's an egg with a high load that is passed, then that child may be severely affected as is the case with Poppy. So it may or may not be a technique that our families use but I think the fact that this is there and is available and now eight babies have been born and healthy and you know tracked

over a number of years, this gives you know real real hope that in the future if this technique is needed for our family and many other families then it's you know it's there as it gives options which which weren't there before. Have you had a conversation with your daughter? Very recently. How old is she? She's a teenager? Yeah, she's 16 and bless her sat on the BBC at 10 o'clock news the other night talking

about it. And how was that conversation? How did you discuss it? Yeah, I suppose it's something she's grown up with. Her sister is disabled and has a life-limiting genetic condition. She probably hadn't previously considered it to those depths, but it's a conversation that we would have had at some point. It's come to the fore because this is at the fore.

And when we were involved 10 years ago, helping to give the patient voice, I suppose, to the human element of this technique, to help push it through Parliament with the Lilly Foundation. They were four and six so it wasn't a conversation we were having with them at that point. Obviously ten years later when they're about to publish these amazing results, yeah that suddenly, it shows the time that has passed and how much the science has progressed. So at a point, maybe another ten years if and when she considers a family, who knows where the science will be. And, you know, there'll be a lot more results, hopefully, of families who have had successful treatment.

Louise, who would qualify for this procedure? Yeah, due to the regulation, there's only a small proportion of women that are actually eligible. So to be able to undergo the treatment, we have to apply to the HFEA, which are regulators, the Human Fertilisation Embryology Authority. We have to demonstrate that the women are at high risk of passing on severe disease to their children. And only once they're approved by the HFEA, can we then perform the treatment for them? I suppose it's like for you and your daughter, you'd have to go and get tested first? Yeah, so interestingly, I have sort of lived a previous version of this before this treatment was available. We were considering possibly more children, but knew we then at this point

that we had that risk and that's a really difficult decision at that point to make. We underwent a treatment called PGT that I might let Louise explain where you test the egg before it's re-implanted to know what that mutant load of that particular egg is. Now that was not successful in our case at that time. But you know, it could have been a different story if this treatment was available at that point. So yes, you have to be tested to know what your own mutant load is, but then individual eggs can carry completely different loads as well. I mean, it really is potluck.

Does it always work, Louise? No, it's just like, you know, an IVF cycle. As an embryologist, it's in some respects frustrating because you see these good quality blastocysts, so they're the embryos that can implant and form a pregnancy, but that doesn't guarantee a pregnancy, you know. So it's a saying, you know, at best you could maybe say an IVF treatment works in about 30% of cases. So, you know, it definitely isn't successful in every case. And eight babies have been born using this mitochondrial donation technique. That's right.

And can you tell us about those eight, how many of them have now been children who don't have it? So when the eight children were born, they were obviously tested to look at what their levels were. In five of those eight children, the abnormal mitochondria was undetectable, which is great, which is really what we're aiming for. In three of the children, there was some detectable mitochondria from mum, but at levels that were low, meaning that they were at very low risk of developing the disease in their lifetime. So this really is a risk reduction strategy. We're not at the point yet that we can say it's a prevention, it's a guaranteed prevention, and we talk to the patients about that when they embark on the treatment that, you know,

There's no guarantee. There's no guarantee. It's impossible when you move that nuclear DNA, you're always going to be carrying over some of those abnormal mitochondria from, you can't stop that at the moment anyway. As an embryologist, what does this mean to you? It's amazing. It's another option for these couples. You know, there was this, like I say, a small group of women that pre-implantation genetic testing just wasn't suitable for them because when you look at their eggs, every single egg they produced had such high levels that PGT, as we call it, just wasn't an option. So now this is another treatment that we can add that it opens up more options for women to have genetically related children.

I mean the technique has been legal in the UK for a decade now, but as I'm sure you're aware, there's been some controversy around the approach and people are raising concerns about so-called designer babies. And this process is not legal in all countries. What do you say to that? There was a, before it was legalized, there was a lot of debate and obviously there are ethical concerns that by allowing mitochondrial donation, it would be this slippery slope towards designer babies. But in the UK, it's very well regulated. As I explained, it can

only be used for this group of women who are at high risk of passing on severe disease, you know, and we're not picking specific traits to make designer babies. We're replacing those defective mitochondria that would mean that the children would have severe disease. What are the possible implications, Louise, for other genetic conditions? Well, in terms of other conditions, we're only replacing the mitochondria.

So that little piece of DNA only encodes a small number of proteins which are responsible for energy production. So really this technique is only for mitochondrial disease. That if the condition is encoded by the nucleus, nuclear DNA, that's not going to help those conditions at all. And Kat, this is something you have been campaigning for for the last 10 years. What's it like to see the technique finally made legal? I think just, you know, the positive coverage it's picked up

sort of speaks for itself. I remember one of the, all of the Lilly Foundation team at the time sort of, you know, a big cheer in parliament when the decision was passed 10 years ago. That was sort of the first teeny glimmer of hope and in a kind of you know a world mitochondrial disease where there is not much and I think now seeing it come to life and the success there it just sort of expands that hope. Kat Kitto and Louise Hyslop speaking to me earlier today. Later in the program

we're going to be discussing gaming. Lots of you getting in touch about this actually. Kat says, it's great to hear gaming being discussed as it's often considered a more male realm. I've games for over three decades. I prefer simulation games like The Sims or Animal Crossing or Tropico. They're a way to unwind from the stress of the world and get lost in a story in a similar way to reading. We also share our gameplay and creations with online communities. So it's also very social. And someone else has said here, I play Wurdle, Quirdle and Octurdle,

is that how you say it? And Sudoku every day. I find word games very satisfying and look on Sudoku as a real challenge. It's good to challenge yourself. I like the music intro games. Can you guess the intro in one bar, two bars, three bars? Can't name any of them, but they're the ones I prefer. So if you're a gamer, or maybe you didn't even realize you're a gamer and all of a sudden you're like, I do that, get in touch with me and tell me what joy they bring to your life. 84844 is the number to text. Now, did you catch the first series of detective drama, Karen Pirrie? It was one of the ITV's most watched new dramas when it debuted in 2022 and this weekend it returns for a second series with a brand new cold

case for Karen to solve. Based on the bestselling novels by crime writer Val McDermid, Karen has been brought to the screen by my next guest, screenwriter, actor and Karen Pirie showrunner Ima Kenney. Having started out playing Zaza, Carter and EastEnders at the age of 20, Ima's gone on to combine screenwriting and acting and most recently with motherhood in the mix too. Welcome to Woman's Hour. Hello. Congratulations. I'm so happy to be here.

I'm not, I don't, I mean, and also young as well. You're just flying. Oh, thank you. So this pro, I watched the first episode last night, already gripped, loved it for so many reasons. On screen in the show you play forensic archaeologist River Wilde, who also happened, great name. Great name, not my creation, that's Val. Val, but fantastic name. Also happens to be Karen's best friend. I think we'll hear a clip and then we'll talk about it. Here she is discussing evidence with the newly promoted detective inspector played by Lauren Lyle and their boss played by Steve John Shepard. What's going on?

Body found up at Don Lesse Quarry. The weather made the quarry overflow. They were struggling to date the remains because it was in the wetlands, in the peat. Have we got an eye dent on them? Not yet. They found something better. Right, a Voxhole? There's a code on the side.

We ran it through the system and we're trying to find an owner and... They found one. Look, I think it needs more investigation. Who is it? We should prioritize getting an ID on the body. River. It's Katrina Grant. That key is for her car, the one that she and her son were

kidnapped in. What's it like hearing that? I was just watching you intently listen to it and chuckle when she says Vauxhall as well. I just love it whenever anything is funny because it's like my favourite thing to write is trying Trojan Horse little jokes into quite serious drama and so whenever anything actually you know gets in I'm happy. Vauxhall. Vauxhall I find funny for some reason. It's the question because it's set in the modern day but it's a cold case that happened in the in 84. Yes so the case is from 1984 a young woman called Katrina Grant who's an heiress to an oil fortune is kidnapped at gunpoint with her one-year-old son. So it's this really

horrible dramatic opening and then nothing happens. They don't find the kidnapper for 40 years until Karen Pirie comes on the case and reopens it. And lots of delicious 80s flashbacks. Great music, great cars, great hair. Whoever had to do all the research and sourcing of those Range Rovers and the police chase. The problem with those cars is that they look amazing, but then sometimes you get them on set and they don't start or they won't reverse and you have to change all the action. You really are multitasking on this show you're the writer you're acting in it show runner I think we

probably have to explain to our audience what showrunner means it's because it's very hard to tell. How did all of that come about? So a show runner is a TV writer who also executive produces and so they take on more of a role on set and through the edit they have a little bit more creative control over the process and they produce more than a writer would. That came about when I first got involved. I was really keen to be involved in casting because coming from being an actor, I think it's just so integral to the success of a show to have an amazing cast. And so

I really pushed to be an exec because I felt I could really wanted to be a part of that process. And then I found that once I'd stepped into that role, I loved all of that process, being on set every day, being involved in all of the creative decisions with the director and with the other execs and producer. But I found that it was like, I really loved the 360 experience of making a show, not just sitting in a room by myself doing the script. Can we, can we take it back a bit further because you're, you're, can I, you're only 35. How did this gig come about? How does something this humongous land in your lap?

So I've been writing scripts, spec scripts, what they call in the industry where you write them, no one's paying you, no one's asked you to do them basically, you're just writing them and they got into the hands of World Productions who make such amazing shows like Line of Duty and I started writing for them on other people's shows which I loved, got a bit of experience that way and then I think I was about 29 when they had, they told me they had these books that had a detective who was in her late 20s and they felt that because that was my age I might be able to bring a level of authenticity and relatability to that character. So I read the book and it was interesting

because Karen didn't actually come in until quite late in the book, but I found her fascinating and very fresh and like something I hadn't seen before on TV. So I signed up and we took it to ITV. And then how did you feel stepping into this very important role? Had an incredible country singer from America

on the program the other week who wrote for Beyonce's Carter album. She sang as part of it and I said how did it feel when you got that phone call from Beyonce wondering if the imposter syndrome was a part of it and she's like yeah but then she said but also she sort of knew she was ready. How about you? I think you you know, I started really young in the industry. I started acting when I was 17. So the journey has felt long. So when I got involved, it didn't,

I think it felt like finally, finally I get to do a really big project and take a lot of creative control. So I think I fought to be heard at the beginning because I was still kind of quite young and I think I didn't have the experience that other people involved did. But with the second series, I feel like I've proved myself and so I really got to take it to another level and kind of be really ambitious with it. So I'm really proud of what we've done with this one. Yeah, and you should be, because it's great.

For many reasons, it's brilliant. Just picking up on something you just said, you fought to be heard. How did you do that? Because I know lots of people listening will relate to that. I think there was an element of me feeling like I had to be nice all the time,

and that sometimes with decision-making, I think it's across so many jobs, but in mine the easy option isn't necessarily the best one and sometimes it takes kind of pushing to go a little bit further to make something better and that can feel really uncomfortable. And the first few times I did it saying, you know, we can do better with this, we can push this, it felt really scary. And I think I would sometimes have to call on maybe older male colleagues to say, can you stand behind me on this? And they did. And that was really powerful. It was a shame I had to do that in the beginning. But you know, I'm really happy that now I'm at the point where I feel like I can do it by myself. And also, I would probably stand behind other people who need that voice behind them as well. Yeah that's the important bit isn't it?

You also get to collaborate with Elle McDermott. Yes. What's that like? She's an incredible person, an incredible creative force. She's so impressive, she's so prolific. She's also really, really trusting and I think because she'd been through the TV process before and wire in the blood, she knows that writing a book and selling books is a completely different thing to getting a TV audience. So right at the beginning, she came to set and she said something really amazing. And I'm totally going to paraphrase because I can't remember it word for word, but it was something like, you know, I write novels, I don't write TV, I know that's your thing, so go do your thing, you know, make the best TV show you can make. So I changed

a lot, you know, I stayed true to Karen Pirrie core tenets, but I think, you know, I'm thinking of the TV audience beyond who's read her books, so I think I have to sometimes change things to be hookier or bigger for that audience. That's a skill in itself, isn't it? That says a lot about Val that she has the capacity to say that. And she's confident, you know, she's confident in her own work. Well, she's confident in you. And yet, well, I yeah, yeah. No, thank you. But yeah, no, she's been great.

And I think she's really proud of the show, which is lovely because, you know, it's her it's her baby, her her creation. Such a strong female lead of the show, which is lovely because you know, it's her baby, her creation. Such a strong female lead in this show too, which I really enjoyed. And she's complex as well. Yes, she's eccentric. Yes, I like that. More eccentric women on TV. Yeah.

But you didn't write yourself in as the title role. No. Why not? Well, I think that's where I'm leading to next, another project maybe, but this one wasn't right for me. She's Scottish for one, and I thought it was really important that we had a Scottish actress play that character. And also, Lauren is the perfect casting and there's no way that I would play that role. But eventually that's something I would like to do, bring those two things together.

You've paid tribute to your mum for getting you through the writing and making of this series. First of all, name Check Mom and tell us how she helped you. Tanya Kenny, you're my hero. I'm sure she's listening. She, I mean, I could not have done any of it without her. I went back to work, I sort of had to, 12 weeks after I had my baby, my first child, and she was there holding the baby while I was writing.

And then I went to Glasgow for the shoot and she came with me for the whole time we were filming and she was looking after my toddler. And she's my secret weapon. I couldn't have done any of it without her. Yeah. You say on an Instagram post, raising babies and making TV don't go well together.

No. How has that combination landed for you? I suppose, like you say, you couldn't have done it without mum. It's an impossible conundrum. I don't know how you do it because you have to go away from home and it's nomadic and schedules change and it's all consuming and you work nights and you work weekends. It's not something that you can have boundaries with very easily. I Don't have the answers. I'm just trying to sort of patch it together and keep going with what I want to do because I really don't want to stop making work and You know, I don't want to have to so I'm trying my best

Yeah, and now is your time. Yeah, you're absolutely flying and people might be thinking, well, where's that partner in all of this? Well, your partner is a colleague of mine Rick Edwards is over presenting the breakfast show on five live Yeah, so those hours are quite chaotic. Tell me of like a morning a classic typical morning in your household Well, he goes to work at 345. So he's gone for the morning and he's live on the radio and I I'm with my son and it depends what I have on any day, but I have to get him to nursery often before I then get ready and go and do something. And that's a lot of what a lot of people do,

but if I have to get up really early and go filming, whatever, it's just, there's a lot of gaps to fill where you need community and support and family, because yeah, it's not a's, it's not a routine, you know, that is easy to do. I saw a clip of you talking to Giovanna Fletcher on her podcast telling the her listeners how you revealed your pregnancy. I, um, it was really early on and I, I did a test about six in the morning and I just unthinkingly took a picture of

it and sent it to Rick while he was live on the radio and now I think that's an actual that's an insane thing to do someone I think he took a minute and went out of the studio to have a little moment. Also Rick has his phone on whilst doing live radio. Another thing revealed you mentioned your next project that you were gonna put Center yourself in can you tell us more about it? Can give us I probably can't but It's gonna be I'm really excited about it. It's something we've been working for a long time. It's an original idea It's a comedy drama

We haven't got the green light yet, but I'm hoping that we're really close And it's very quite a noisy project. It's got it's an interesting genre. Well, don't worry. I know you'll come back to tell us about it. And first series of Karen Pirrie became one of the most watched new dramas on ITV in 2022. How are you feeling about the second series? It's going out this weekend. Is the pressure on?

Yeah, it's daunting because you know, the only bad thing about something being successful is that you have to match it. So second series is, you know, I just hope we can, we can, people will like it as much as the first one, but I'm, I'm feeling good about it. The initial responses have been really nice. So I'm just hoping everyone out there, please go and watch it. Well, I'm hooked. It's a, it's a brilliant watch. Um, Ima, thank you so much.

Thank you for coming in to speak to me. Ima, Kenny there. And the first episode goes out. Thank you so much for coming in to speak to me, Ima, Kenny there. And the first episode goes out Sunday night, ITV 8pm, 20th of July. Very good. Thank you so much. Now, Listener Week begins on the 4th of August. It's the week when all the stories for the entire week are chosen by you. This is the chance for you to not only suggest ideas,

but also if you so desire, get yourself on the program. If not you, maybe someone who you think would be brilliant to feature, someone with a story worth sharing or an interesting point of view, whatever your idea, whether it's fun, quirky, serious, thought-provoking, maybe you wanna tell us the story

about how your partner found out that you're about to have your first baby. Think relationships, dating, parenting, work, health, anything else you think we should be talking about here on Woman's Hour. The microphone is yours. Get in touch with your ideas in the usual way. The text number 84844, email us via our website or contact us on social media. It's at BBC Woman's Hour.

Cannot wait to hear what you would like us to talk about. Lots of you getting in touch about gaming as well. Ruth says she plays June's Journey, which she says helps her memory enormously, not least around post-menopausal memory loss. And Vanessa says, I play Waffle Wurdle and every day competing against my son and 12 year old grandson. Oh, this is sweet.

I also play PC games in the evening to unwind. My current favourite is Captain of Industry. Cuba's Minister of Labour has resigned after claiming that there are no beggars on the Caribbean island. That's just one of the myths surrounding the communist-led country. So what's life really like there? I'm William Lee Adams. On What in the World, we're lifting the veil

on a frequently misunderstood country. What in the World is an award-winning podcast from the BBC World Service. We go in depth on a different topic every weekday in under 15 minutes. Listen wherever you get your BBC podcasts. Now, as reported earlier this week here on Women's Hour, sex education guidance for schools has been updated in England following concern over an increase in the harmful and

misogynistic content children are exposed to online. For the first time, strangulation will be discussed and it will be made clear that even if it causes no visible injury, it is illegal. It's the government's latest move to crack down on the practice, which is often known as choking. Last month they announced that the depiction of strangulation in pornography will be banned. It's believed that choking is now common practice in some bedrooms and a survey by the Institute for Addressing Strangulation found over a third of 16 to 34 year olds had experienced it. Some believe that the true figure to be much

higher. More is also becoming known of the impact it can have on women's health. To discuss this, I'm joined by Professor Claire McGlin, Professor of Law at Durham University and Dr Jane Merrick, Associate Professor of Health Psychology at the University of the West of England who specialises in sexual health and sexual violence. Welcome to both of you. Dr Jane Merrick, I'll start with you. For those who don't know, what exactly is choking? What are we talking about here? I think the important thing to remember, good morning by the way, Anita,

is that it's a bit of a, have we got, you're looking as though you can't hear me. Hopefully you can hear me, brilliant. So sexual choking or sexual strangulation is cutting off oxygen and blood to the brain, which is the important thing to remember, because there is no safe level of cutting off oxygen to the brain. What we're seeing is depictions of this across pornography online, and this has become more

common. And I think for me, the importance of this issue is that it cuts through a lot of the noise about kink shaming, porn, what is cool, appearing to be square and there is actual real life harm. We've allowed young people to be educated by online porn and now we're seeing the real world harm of this. So this is very little pressure can cause harm. If you think it takes about 20 PSI to open a ring pool on a can to shut down or block the artery of taking blood to your brain is about 11. So very little can cause harm. And the important things to remember is that it's generational. We're seeing evidence of younger people doing this much more than older people. So maybe over 50 year olds, about 3% have experienced it. But in the more

frightening in the 18 to 24 year old, about half. And that kind of mirrors international data that is becoming absolutely normalized. Young people don't understand that this causes harm and that there is no safe level. You can't consent to actual harm. And if you think about consent being something you need to be informed by, you need to be able to withdraw, is if you don't know that it hurts you, you can't give informed consent and also once there is a hand around your throat you can't necessarily tell someone to stop. So we're seeing real-life harm as a result of online pornography. How common is it online? Online I think Claire's the best one to speak to this because she's done

some really excellent research on the content of online porn but a 2010 study found about 88 percent of content was showing some form of violence against women and girls and that's the these are tropes that speak to and I'm going to trigger warning some difficult issues tropes that represent or depict rape incest child sexual abuse strangulation non-consensual sex are in about 88 percent of what's on there. More recently Claire McLean and Fiona Virigray have done landing site content which shows one in eight videos showing something illegal. So the proliferation of violence that you're seeing, the accessibility to young people means we've let them be educated by online porn. Claire, let's bring you in.

How common is it? Well, as Jane says, what we know is it's far more common than it was, say, even 20 years ago when it just didn't feature in mainstream pornography. It's actually very difficult now to know exactly how much strangulation there is because it is so normalized and ubiquitous. It's not labeled as such. So you would go on material labeled force or labeled rape or rough and

it will include strangulation. But what we know is basically if you go online on these freely easily accessible mainstream sites, vast majority and very high numbers of these videos are depicting strangulation and depicting it as normal and as safe. What does the law say about both choking in pornography and in real life? So in terms of pornography there are some restrictions on the most graphic and life-threatening depictions so asphyxiation and such like but the average standard depictions of strangulation are not currently unlawful in pornography online. It's really important to note that actually for a long time it's been unlawful offline to show this sort of

material it's just that our online regulations have just not caught up. From the 25th of July the Online Safety Act will require internet companies to conduct stricter age verification methods to check whether a user is under 18. Will this have an impact on how many young people see choking? How's it going to work? How's it going to be enforced? You're right. From the end of this month, all the largest porn platforms and social media like X and Twitter, let's not forget, must introduce highly effective age assurance. And Twitter here is really significant because that's actually where most young people access their pornography and also where it's completely more graphic than in some of the mainstream sites. Even the minimal content regulations you get on sites like Pornhub are not on ex-Twitter. So they also have to introduce this highly effective

age assurance. We'll require the regulator Ofcom to enforce this. They have started to take some enforcement action against some porn platforms, but for me, what's gonna be critical is that they do tackle the likes of ex-Twitter and the larger platforms, not just the smaller, more niche ones who frankly welcome the PR publicity that comes from enforcement action against them.

Jane, can we talk about, you mentioned it briefly when we started talking, but the actual impact of sexual strangulation on women's health. What do we know about what it can do? I think one of the most sinister things is that a lot of the harm comes down the line. So in the immediate impact there'll be some physical, psychological impacts but so dizziness, a feeling of euphoria potentially, losing consciousness, maybe wetting yourself, maybe losing control of your bowels. That signifies that your brain has lost oxygen and that the cumulative effect of that can be really serious.

So there's a recent study 2020 by Helen Bitchard over at University of Bangor that shows that in under 40 year old women, strangulation might be the second most cause. So that's strokes in youngish women. So it's the, if you think about the structures in the neck, you have veins and arteries in the windpipe. If it's 11 PSI to cut off or block the artery, that also damages the structure. So that can dissect, that can rupture. So

there's rupture. If you do it repeatedly, then that weakness accumulates. But for me the real harm is about normalizing violence against women as sex, that we've depicted, we've allowed sexual violence to be depicted as normal sex and that we haven't balanced that with access to really good comprehensive sex education about what healthy sex looks like. So I think young people are going into this expecting to do it. Yeah. How have we got to that stage? We haven't controlled online pornography. So 11, 12-year-olds will get a smartphone.

Most analogue parents will be trying to parent digital children, have no concept about how to control that, don't know what's going on. And those young people will face, as Claire said, across... Social media platforms are often the most extreme and least regulated. So they'll be on social media platforms and they'll see this regularly. They might be producing it themselves

or they might think that they should be. So for me, it's very clearly the idea that somehow it's too hard, it's too difficult. We can regulate this offline, we can regulate other harms online. It's really about the business model and then maybe a little bit about vested interest, about the commonality of use of pornography across our society. How do you, Claire, gain control on the internet which is essentially uncontrollable? I think it is controllable though. We control all sorts of businesses. You know, the car you drive to work,

the cakes you buy from the bakery. We tell these companies what they can and they cannot do. And we need to do the same with the internet platforms, including the porn platforms. So we could take that action. And in fact, the online safety bill, the online safety act does have these regulations in them. So this is what could make a huge difference here.

If we make any depiction of strangulation unlawful in pornography, the Online Safety Act says that those platforms, including X, must prevent us accessing it and must remove it when they're notified of it. And if we enforce that legislation, it will make a transformative difference to the type of material that's online. We just have to have the political will to do it. Jane, this might be for you, Clare, it might be for either of you. Have you spoken to young people who are engaging in this?

What are they telling you? What have they said about why they are doing it, Jane? So I am the Research in Residence at the Bridge Sark in Bristol, that's Sexual Assault Referral Centre. I work a lot with survivors and survivors voice. I speak to young people. So for me, it's the transfer of these tropes to real world abuse, survivors experience real world abuse that where perpetrators are performing what they've seen online. And that is incredibly worrying. I have teenage boys myself. So unfortunately, they've got a real burden in having a mom who does this work. And any kids come near me, I'll start talking to them about this kind of stuff. And so I've had

young people who are in tears, both a boy and a girl, for example, who didn't want to strangle and didn't want to be strangled. And they were crying because they thought they had to. How have we got to this point? How have we allowed this to happen? I find it incredible. I started working in sex education maybe 30 years ago, and I didn't mention any of this stuff. I know that teachers aren't resourced or trained to be able to handle this. You know it's all very well saying you've got to talk about porn. Who is talking about porn? Are they qualified? There's some great agencies like Beyond Equality, Tender who do this but you need to pay for them to come into schools. A lot of schools can't afford that. And what do you say to people, and I'm sure people have said this to you because you will be having these conversations at every different level, that adults who say that they enjoy choking and want to be left alone to

enjoy their sex life in private? That's fine if it's informed choice. So do they know that there is no safe level? Do they know how to withdraw it? That's the key to that. I don't want to be judgy, that's the problem. I don't want to be judgy either. Claire. The key point here is that consent does not protect you against brain damage. Sure.

That's why we need to have more than a discussion than just about consent. And it needs to be not just in schools. There needs to be a bigger national awareness raising campaign about the harms of sexual strangulation because it is impacting on young women's brain health predominantly and you know it's a ticking time bomb in that sense so it's not just about consent everyone needs to

know about this. You contributed Claire to Baroness Gabby Burton's review on regulating pornography in fact she joined us recently on the program to talk about it do you think enough is being done to implement her findings? We're at very early stages. Not enough is being done yet. This is the first of our of the government announcements. What I really hope is that we're going to see some swifter progress now to take some of the steps that she's recommended.

We need a regulator really as well to oversee this industry, to get a lot of this material taken down because the current regulator, Ofcom, doesn't really have the resources and the time to be able to do this. So we're getting there, but we definitely need to move faster and quicker. Thank you both for joining me for that really interesting discussion. Professor Claire McGlin, Professor of Law at Durham University and Professor, and Dr. Jane Myrick, Associate Professor of Health Psychology at the University of the West of England. And if you've been affected by anything raised, you can find support on the BBC Action Line website. We have a statement

from the Department for Education who say the new RSHE guidance responds to the realities facing children today, making sure that all young people understand healthy relationships, sexual ethics beyond consent and harmful online content such as pornography and deep fakes. As part of our Plan for Change mission to halve violence against women and girls, we're also providing schools with new funding resources from Oak National Academy, which will help teachers explain the law and harms relating to strangulation and suffocation as part of their age-appropriate lessons on relationships and sex education more widely. The text number 84844.

Now, all this week we've been talking about the world of women and gaming. We've heard why games are so influential, found out more about the impact they can have on women and spoken to those working in the industry. We've focused a lot on the good and the positive impacts of gaming and the benefits it can bring but we can't show our way from the fact that there's still barriers stopping women from accessing games whether behind the scenes or as gamers. Well today I'm joined by a panel of guests to look at what can be done to break down some of those barriers.

We've got Marie Claire Isserman, the CEO of Women in Games, a not-for-profit organisation aiming to build a fairer playing field. Nick Poole, CEO of Yu-Ki, the trade body representing the UK's video games and interactive entertainment industry. And Stephanie Ijeoma, a gamer and founder of Ney Saga, an agency dedicated to celebrating and pushing for diversity in the industry. Welcome to all three of you. And we've got loads of messages coming in from our listeners who are gamers. And I'll be reading some of those out in the moment. But Marie Claire, let's start with you. What are the biggest challenges as you see it in the

games industry at the moment for women? OK, yes. hello, everyone. The three biggest challenges I see are women in leadership, entrepreneurship, and lack of funding, toxicity and harassment and discrimination in the workplace and online, and girls in games, the pipeline, education and talent development.

And for women in games, these are the core areas that we're focused on at the moment. And Stephanie, barriers for you that girls, women might face. Yeah, I mean just echoing off what Marie said, everything like that. But then, you know, for me and how I, you know, entered the space 10 years ago, it was not only being a woman, but it was also being a black woman. And in an industry like gaming, which is historically racist, it is difficult to navigate a space where it's supposed to be for everyone.

So I try to use my barriers as superpower and to show that whether you are a woman, whether you are a black woman, whether you are somebody from a different background, you can still belong in this space. And that's what we created for Nezaga, a space where people can feel like they belong. How was it when you first entered the industry then for you? What did you come

up against? Loads of things, you know, for me when I wanted to get into the games industry, I actually just wanted to work for a games company, you know, from an entry level. I have a background in health so I wanted to transition into that and I've been gaming since I was four so it was something I wanted to pursue as a career but it was difficult to find like minded people. So when it came to applying and trying to find my way into the space, it is a white boys club. So if you don't look like them, it's difficult to even try and be in a space like that. So I had to create my own platform, my own company to ensure that I can still be in the industry, but there isn to ensure that, you know, I can still be in

the industry but there isn't a one size fits all type of route to be into it. Nick, I'm delighted we've got you here. You represent the industry as a whole. What is Yuki doing to create change for women? You've just heard Marie and you've heard Stephanie. I absolutely agree with, you know, what Mary-Claire and Stephanie have said. You know, all this week in this amazing series we've heard brilliant women bringing their talent to the video game industry and we've also heard about

the challenges that they've faced and so we really really need to target those structural and systemic issues that we've heard about. Access to investment is critical whether girls are seeing themselves reflected in the industry and seeing role models and understanding you know the career pathways and options that they need to be taking through education but also you know there's not enough representation in games and we need to make sure that the the more stories we can tell the richer the kind of narrative and storytelling you know ultimately the stronger our industry is going to be.

Access to investment. I mean, we talk about this on Women's Day when we talk about female entrepreneurship and business startups, generally just how the lack of funding that goes into women run businesses. Mary Claire, what can be done to change that? Yeah, well, a lot can be done. I think that the industry, the government, I think, bodies like Yu-Ki who are already looking at this and thinking about it, need to get behind it. There needs to be,

because what happens is it gets a sort of sidelined as an issue, but the stats are terrible. With women-led gaming companies getting less than 2% of VC funding, and just 6.6 UK game studios have all-women leadership. Women in games are currently working on a variety of programs. There is progress, but it's very slow. It's not happening fast enough.

And I think also VC firms, for instance, if they have more women partners, they're significantly more likely to invest in women founders. So you know, widening the gender gap among decision makers, you know, that that helps close it for entrepreneurs. So it's, it's a sort of bigger picture as well. And I think the more we talk about it, and the more that we we put together programs, and we put together actions that will solve it, I think we'll get some headway there

because there's definitely, lots and lots of talented women out there. So how do you get them to where they need to be? Because there are barriers. 100%. And going back into the investment, when I started, I wasn't given any sort of investment. I had to find my way myself.

There wasn't access to mentors or I couldn't have that access to mentors because again, when there's people that don't look like me, it's very difficult to try and find a way through. And over the years, it's been a journey, but it's been a successful journey for us. We've been able to work with the biggest brands in the world, consult, provide workshops,

be able to provide paid opportunities for talented people, get them through into the rooms, but still more needs to be done. And when it comes to the investment, it's also putting the same amount that you're putting, you know, male-led companies as well, because, you know, it's no point, there's no point of talking about if, you know, the investment isn't there, it's more so putting your money where your mouth is, you know? Ultimately, this is, it comes down to the games industry, seeing what their problems are and wanting to make a change. And it comes to the kind of gatekeepers,

the people who are running the ship to make those changes. How much power do you actually have, Nick, to speak to people and enforce change? I think we have a lot of opportunity here to drive real change. This industry's been through a real disruption in the last few years. A lot of the old rules are being rewritten. and what we want to make sure is that we take

forward the energy and the creativity of video games but maybe we unlearn some of the lessons that got us to where we are. We've got an amazing opportunity. The government's published a games growth package. They've announced the launch of a UK video games council which is a 50-50 representation of men and women on the council and I think we can send a very clear message now that we're an industry that really can demonstrate leadership and progress but you know amazing work of people like Stephanie we are definitely seeing progress but it is too slow and we need

to try and accelerate that. Well let's talk about something else Mary-Claire mentioned which is toxicity in fact earlier this week we spoke to three women from black girl gamers who shared their experience of toxicity online. Stephanie, where do we even begin? How do we change that? So for me I try to change the narrative. I don't want to always be boxed or put in the conversations around toxicity because it's a living experience. What I do want to do is talk about how are we powering through that and navigating that. We have consulted with a lot of companies to ensure that there are measures in place

and programs and initiatives and ways where people can report things online or work with companies to combat that. And unfortunately, that's the reality of games and the gaming industry, but it's more so how do we flip the script to ensure that we are in power. So yes, toxicity is something that I don't want us to not forget about or put to the side, but that shouldn't define us as women or us as women who come from a marginalized background. It's more so about how do we tackle that, but tackle it so we're in the power of different things.

Yeah, and also it shouldn't be the person who's suffering it shouldn't be their responsibility to solve the problem. Exactly. It should be everybody else. Yeah, because you know the studios and the companies, they create the games, they see that things are happening and you know they have things in place to prevent that from happening, but again it's a two-way street. Yesterday I spoke to an incredible young woman who designed her own game. She's only 25, she designed it when she was 17, she's incredible. But the thing that stuck with me is that she was the only girl studying IT in her GCSE. She's not even that, she's not old, we're not talking about the

you know the the 90s. So one other thing that you're exploring exploring at UK is a proposed digital creativity GCSE and you're in talks with the government how do you see that having an impact on on getting women and girls into the industry yeah we think it could be a real game changer this one and it's if you look ahead to the next 10 20 years the skills that we're going to need to have are absolutely about finding creative solutions to kind of big challenges, big problems. And so by introducing a digital creativity GCSE into the curriculum, we think we can equip more people and particularly girls with the skills not just to build and code great games, but to tell amazing stories and to solve real kind of,

you know, huge challenges in the world. So we're having great traction with teachers, we've got good support from heads, we've had some initial engagement with the Department for Education and we really think now is an opportunity through curriculum reform to really transform how people find their way into technology driven industries. Marie Claire, what needs to happen? I mean you named the big three things, leadership, toxicity online, girls in the industry, I mean, how do we encourage more women to come through and actually get to the top to make the change? Well, I think education, this whole piece on education,

which Yuki has put together, I think is really, really important. And it reflects successful Nordic education models, which are all about actually building things in teams, working out things in teams, and that fosters equity. So I think the idea that we might have this GCSE, I think thinking about higher education as well, prior to my role as CEO of Women in Games, I ran a BA and an MA in games art and design. When I first took up the role I was the only woman on the staff and there were no female students

and you know I think it's improved. I left education in 2016 but you know I had to work very hard to change that dynamic and when I left it was 60-40 and 50-50 in the staff. But you have to make a decision to do that. You know, I went out a lot, I went to schools, I talked a lot to girls, I showed role models, I took my, you know, one of my students, Sophia George, was the first game designer in residence at the V&A. So she became this role model and I started getting more and more girls coming onto the programme. So I think there's a lot that can still be done and Women in Games run a lot of activities and events where we're encouraging

women in education to come forward so that they also can learn about how to deliver, how to deliver a curriculum that really encourages girls. Well, I'm very impressed because doing all of that work takes energy as well. And to be persistent and not give up because I'm sure it's been exhausting, only you know your journey. I want to read out a couple of messages actually

whilst I've got you all here because lots of our listeners are gamers. Anna says, I love unwinding after dinner with a cup of tea playing strategy games like Clash of Clans or Plants vs Zombies. There is something about those three minute battles that I really enjoy. It's fast, it's cathartic and you get to smash and destroy things and win medals. I know this is not the most feminine style of gaming, whatever that means, but I don't care. I've also really enjoyed playing Minecraft in the past, which my kids got me into. Another one says, regarding toxicity in gaming gaming as a girl I often get chattered up by male players which is normalized but

the most disturbing thing for me is the outfits are very sexual and with unrealistic body types and inappropriate outfit designs for female characters hence why we need more women in the design process as well. There is so much to talk about in this field. We've barely covered an overview, but we have discussed it at length all week. If you've missed any of them, go back to BBC Sounds where you can hear them again. But for now, thank you so much for taking the time

to come and join me, Mary Claire Isamon, Stephanie Ijeoma and Nick Paul. And as I said, it's all available on BBC Sounds. That's it from me. Enjoy your weekend. That's all for today's Woman's Hour. Join us again next time. Hello, my name is Alex von Tunselman and I want to introduce you to History's Heroes,

the BBC's breathtaking, high stakes, story-led podcast shining a light on extraordinary people and ordinary people who become extraordinary, including a pioneering surgeon who rebuilt the shattered faces of soldiers. You know, he would look at these men and he would say, don't worry, Sonny, you'll have as good a face as any of us when I'm done with you. And the woman who created the international charity Save the Children. Subscribe to History's Heroes on BBC Sounds. Cuba's minister of labor has resigned after claiming that there are no beggars on the Caribbean island.

That's just one of the myths surrounding the communist-led country. So what's life really like there? I'm William Lee Adams. On What in the World, we're lifting the veil on a frequently misunderstood country. What in the World is an award-winning podcast from the BBC World Service. We go in-depth on a different topic every weekday in under 15 minutes. Listen wherever you get your BBC podcasts.