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Choking during sex: many young people mistakenly believe it can be done safely, our study shows.
(theconversation.com)
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And that’s basically it!
That's the joke.
People serious like to tease the reaper and cum as they are literally about to die with a rope or belt around their neck because cuming and going is supposedly the best. It is basically suicidal to do that solo and just stupid with a partner to provide some sort of rescue.