Understanding the Rules of Confidentiality

One reason that people with a sexual interest in children may not seek treatment is because they're afraid they'll be arrested for their sexual thoughts. Some people have this fear even if they’ve never sexually abused a child and are not in a position to harm a child.

It’s important to remember that thoughts are not illegal, but acts can be!

When you talk to a doctor or participate in research, the information you provide stays confidential. But there are some exceptions to this rule. The information below will explain what these exceptions are and why they exist. We hope that understanding the rules about when confidentiality can and cannot be broken will help people feel more comfortable about seeking treatment in the Sexual Behaviours Clinic (SBC).

When can confidentiality not be broken?

Canada doesn’t have “thought police”. If someone tells a healthcare professional that they have sexual thoughts about children, but have never acted on these thoughts and do not have access to children, this information must be kept confidential.

The SBC has an increasing number of clients that have never offended and are not considered to be a risk to children. These clients are not reported to authorities and all of their information remains entirely confidential. Confidentiality can only be broken if the victim of a sexual offence is still a child. This means that sex offences committed against someone who is now an adult cannot be reported.

Unlike most sexual offences against children, accessing, possessing, and distributing child pornography do not meet Ontario's mandatory reporting requirements. This means that if someone tells a healthcare professional that they've been watching child pornography, this information cannot be reported to the police. However, if the professional has reasonable grounds to suspect that this person may harm a child, they must report this information to the Children's Aid Society

When can confidentiality be broken?

The Ontario Child and Family Services Act sets out regulations to ensure the protection, well-being, and best interests of children. This requires professionals, including those working in the healthcare industry (e.g. psychiatrists), to break confidentiality by reporting behaviours that cause, or have the potential to cause, harm to children.

The duty to report legally overrides the rules of confidentiality that normally exist between patients and healthcare professionals. This means that confidentiality is no longer protected in specific situations. Healthcare professionals must immediately report to the Children’s Aid Society if they have reasonable grounds to suspect that harm has or will come to a child, who is still a child (aged 16 or younger), and who can be identified.  

The definition of harm includes:

  • Child molestation, exploitation, and/or sexual abuse
  • Involvement in making child pornography
  • Physical harm
  • Emotional harm
  • Neglect
  • Abandonment
  • Withholding medical treatment

Healthcare professionals' duty to report is both mandatory and ongoing. This means that they are legally required to make additional reports to the Children’s Aid Society if they suspect that a child continues to be in need of protection from abuse or neglect.

To learn more about the rules and limits of confidentiality, click here.

Still have questions? Send us an anonymous email. 

If you're interested in getting treatment for sexual interest in children, check out The Prevention Study, a research project in the SBC that helps men get treatment before acting on this sexual interest. 

You can also get treatment for sexual interest in children or other problematic sexual interests/behaviours without participating in research. Visit our Referrals page to learn more.


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