Sexual boundaries: standards, allegations and the 2026 reforms

Sexual misconduct is much broader than sexual assault. Ahpra describes it as including sexual abuse, sexual harassment, sexual exploitation and breaches of professional boundaries. It can happen inside or outside the patient relationship, and it can be a single act or a pattern of behaviour. Much of it begins with conduct that may look trivial on its own, which is why regulators pay close attention to early boundary erosion.

Two principles run through every case. First, intent is not the test. A remark about a patient's body meant 'as a compliment', or an examination more extensive than needed 'to be thorough', can still be sexual misconduct; the question is whether the conduct was clinically justified and properly consented to. Second, consent is not a defence to a sexual relationship with a patient. The power imbalance belongs to the clinical role, and it does not disappear because the patient agreed, initiated the relationship or is a health professional themselves.

Sexual boundaries are set by the National Law, by each National Board's code of conduct and by specific guidance. Boards, panels and tribunals measure conduct against these documents, so it is worth knowing which apply to you.

• The shared Code of conduct, in effect from 29 June 2022 and adopted by twelve National Boards, requires practitioners to maintain professional boundaries and never use a professional position to establish or pursue a sexual, exploitative or improper relationship.
• The Medical Board of Australia's code, Good medical practice, is read with its guidelines Sexual boundaries in the doctor-patient relationship (December 2018), the most detailed Australian statement on the subject. Other professions can use it as a benchmark, although their own code is the standard that applies to them.
• The Nursing and Midwifery Board's codes of conduct for nurses and for midwives, supported by its guidance on professional boundaries.
• The Psychology Board's Code of conduct, in effect from 1 December 2025, which contains specific obligations on sexual relationships with clients and former clients.
• The National Law's mandatory notification provisions, under which sexual misconduct in connection with practice is a category of notifiable conduct.

Other laws sit alongside these. Sexual assault, indecent assault and image-based abuse are criminal offences. The Sex Discrimination Act 1984 (Cth) prohibits sexual harassment at work and imposes a positive duty on employers to take reasonable and proportionate measures to eliminate it. Child protection, working with children and reportable conduct laws add further obligations where children are involved.

Current patients

A sexual or romantic relationship with a current patient is never acceptable, in any profession. This includes people you treat informally, such as a friend you give a script to or manual therapy at a party. Ending the professional relationship in order to begin a personal one does not cure the problem if the relationship developed during care.

Former patients

Relationships with former patients are not automatically prohibited in every profession, but they carry real risk. The Medical Board's guidelines list factors regulators consider: the duration and nature of the professional relationship, the person's vulnerability and dependence, the time since care ended, how and by whom it ended, whether knowledge or influence from the professional relationship was used, and whether you are likely to treat the person again. Where care involved psychotherapy, counselling or significant emotional dependence, the relationship should be treated as permanently off-limits, and psychologists must follow the specific rules in their Board's code.

People close to a patient

Boundaries extend to partners, parents of child patients, carers and other people closely connected with a patient. A relationship with such a person may be unethical where the practitioner used knowledge or influence gained through the professional relationship, particularly where the patient depends on that person or the treatment is important. For non-sexual boundary issues such as gifts and dual relationships, see our page on professional boundaries.

Allegations of sexual misconduct are treated as high-risk matters. A Board may take immediate action to restrict or suspend registration while a matter is investigated, where it reasonably believes this is necessary to protect the public or is otherwise in the public interest. Investigations can involve interviews and review of records. Less serious matters may go to a performance and professional standards panel; the most serious go to a tribunal, which can find professional misconduct.

Conditions in boundary cases commonly include education, mentoring, supervision, practice audits and restrictions on seeing certain groups of patients. Chaperone conditions were reviewed in 2017 and are no longer favoured as an interim protection where there is a serious allegation of sexual misconduct. Tribunals regularly cancel registration where a practitioner has had a sexual relationship with a patient, and disqualification periods can be lengthy.

A registered practitioner who, in the course of practising, forms a reasonable belief that another practitioner has engaged in sexual misconduct in connection with practice must notify Ahpra. Employers and education providers have similar duties. The threshold is a reasonable belief based on direct knowledge or reliable information, not certainty or proof.

For treating practitioners, sexual misconduct is handled differently from the health-related categories. Outside Western Australia, a treating practitioner must notify if they reasonably believe their practitioner-patient has engaged, is engaging or is at risk of engaging in sexual misconduct in connection with practice. That includes risk of future misconduct, so a disclosure of grooming behaviour or a plan to offend can trigger the duty. Western Australia and Queensland have different or additional provisions, which practitioners there should check.

Where boundary concerns are substantiated, Boards often look for evidence that the practitioner understands why the conduct was wrong from the patient's perspective, recognises the warning signs they missed and has made concrete changes. Education on sexual and professional boundaries, intimate examinations and consent can support that understanding, and reflective writing helps show it. Our course Sexual Boundaries and Preventing Sexual Misconduct in Australian Healthcare covers the full spectrum, including grooming and the 2026 reforms.

Education cannot by itself demonstrate insight, and no course can guarantee any regulatory outcome. Boundary-related conditions often specify education that must meet requirements set by the Board; if conditions or an undertaking apply to you, confirm with Ahpra or your Board, and your adviser, whether a particular course is acceptable before you rely on it.

For practitioners with no concern raised, the same learning is preventive. Knowing your Board's exact wording on boundaries, explaining and documenting consent for every intimate examination, offering privacy and a support person, and keeping communication professional and on clinical channels are simple habits that protect patients and practitioners alike.