Despite the fact that prohibitions on sexual relationships between psychotherapists and their patients have been introduced in ethical codes and criminal legislation, research has indicated that between 2 to 10 percent of therapists have engaged in sexual relations with patients. The current study investigated the clients' perspectives of these sexual relationships and identified psychological variables associated with the diverse client perspectives on therapist-client sex (TCS). Participants were 24 psychotherapy clients who reported sexual engagements with their therapists; participants were recruited via newspaper article in Israel following reports of a TCS scandal there. Face-to-face or telephone interviews were conducted with each participant and focused on their accounts of what occurred, as well as their emotional experiences of the TCS and their perceptions of the clinical treatment they received. Participants also completed several research instruments, including the Self-Image Questionnaire, the Therapist-Client Sex-Feelings Inventory, and the Therapist Perception Questionnaire. Results indicated that clients perceived of the sexual relationship as either romantic or abusive. Those who perceived the relationship as romantic also reported more favorable perceptions of the therapy they received and reported better emotional states. However, when the same variables were assessed for two post-TCS periods, even the romantic group reported deteriorating psychological well-being, suggesting that the perception of the TCS as romantic in nature provided only a temporary shielding effect for the client. As such, the authors contend that the perceptions of clients regarding their sexual relationships with therapists should not be a guiding factor when determining whether the relationship should be considered unethical. Tables, figures, references