Client Confidentiality

Posted On: January 7, 2011

This article first appeared on The Online Citizen.

As the Lion City’s only clinical sexologist with a doctorate in human sexuality, I have often been asked by journalists, friends, and complete strangers to share my thoughts about what I felt was my most bizarre/ interesting/ fulfilling case.

I could become the next media darling or belle of the party but I have always refused to give them what they wanted. Instead, I may reply: “I treat all my client information as strictly confidential, so I couldn’t discuss any of that. But, I can share the most common kinds of issues related to sex….”

Some publications, however, won’t take no for an answer: “I completely understand your need for client confidentiality. However, what I’m asking ….”

It doesn’t matter what follows the rest of the request because obviously they are still trying to get what they want and do not respect what client confidentiality means.

Client confidentiality is the principle that an institution or individual should not reveal information about their clients to a third party without the prior consent of the client or a clear legal reason. This concept is commonly provided for, or codified, in law by most countries. In my own case, client confidentiality is honouring and respecting that everything, and I mean everything, that is shared in session as sacred (i.e. not to be repeated), outside of the confines of my office. This includes not letting anybody see my case notes, or indeed even taking my notes out of my office.

It also means that it is not all right to make reference to my client by changing their actual names or making it anonymous. Mentioning their case might still lead them to be potentially identified and/or embarrassed by people who know them.

At this point, a layperson might suggest: Why don’t you ask them for their permission to cite their case without their names?

Now we are going into the ethics of casework. My clients have approached me at a time of distress. The terms of employment state clearly from the start that this is fee for service: They pay; I help them. I cannot turn around and say, “I helped you so I like you to do this, that, and the other for me.” In all likelihood, a client, out of utter gratitude and obligation, would say yes. Having said yes, are they truly able to comprehend the consequences including potential fallout such as negative public reactions in the media causing them to experience emotional distress, and hindering their ability to move on?

It is quite another matter for my client who, having overcome their sexual concern(s) to return and offer to help me in my publicity efforts. Yet, just how many clients would be truly comfortable to share their stories or even think of doing so? They are probably, and rightly should be, focused on their healing, growth and onward journey.

Hence, I am not going to change my mind when the media cites me the example of Dr So-and-so who has a weekly column in XYZ publication sharing patient stories, with the intention of helping readers have a better understanding. I am not obliged to do what everyone else is doing. As a practitioner, my primary responsibility is my client’s well-being and welfare, as well as sense of safety. It is not my job to entertain strangers, humour my friends or help struggling journalists with pressing deadlines to please their demanding editors.

The testimonials you see on my website are from clients whose work has been completed and were generous enough to write me a short note. All had expressly asked to remain anonymous.

Dr. Martha Lee is Founder and Clinical Sexologist of Underneath The Moon. She is a certified sexologist with a Doctorate in Human Sexuality. She provides sexuality and intimacy coaching for individuals and couples, conducts sexual education workshops and speaks at public events. For more, visit or email

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