Three axioms are presented which frame the discussion that follows: since only the therapist has a professional code to violate, only the therapist can be held responsible or criminal; since both therapist and patient are adults, both can be held accountable for their actions; and dynamically informed exploration of sexual misconduct can only be beneficial, in the long run, to patients, the mental health professions, and society. The resistances that have interfered in this discussion include the lure of reductionism, gender bias, a desire for a politically correct explanation of sexual misconduct, and confusion over the nature of the trauma in sexual misconduct. The authors conclude that understanding therapist-patient sexual misconduct will be achieved through empirical study of both politically incorrect and correct models and careful consideration of the complexities of transference-countertransference interactions. 12 references