Case Title: Mathews v. Becerra

Citation: 

Docket Number: 

State: california

Court: California Supreme Court

Date: 2019-12-26T00:00:00Z

Document:
IN THE SUPREME COURT OF 
CALIFORNIA 
 
DON L. MATHEWS et al., 
Plaintiffs and Appellants, 
v. 
XAVIER BECERRA, as Attorney General, etc., et al., 
Defendants and Respondents. 
 
S240156 
 
Second Appellate District, Division Two 
B265990 
 
Los Angeles County Superior Court 
BC573135 
 
 
December 26, 2019 
 
Justice Liu authored the opinion of the Court, in which 
Justices Cuéllar, Kruger, and Groban concurred. 
 
Chief Justice Cantil-Sakauye filed a dissenting opinion, in 
which Justices Chin and Corrigan concurred. 
 
1 
MATHEWS v. BECERRA 
S240156 
 
Opinion of the Court by Liu, J. 
 
The Child Abuse and Neglect Reporting Act is a 
comprehensive statute designed to protect children from abuse 
and neglect.  (Pen. Code, § 11164 et seq.; all undesignated 
statutory references are to this code.)  The statute designates a 
list of “mandated reporters” who have an affirmative duty to 
make a report to law enforcement or an appropriate child 
protective agency “whenever the mandated reporter, in the 
mandated reporter’s professional capacity or within the scope of 
the mandated reporter’s employment, has knowledge of or 
observes a child whom the mandated reporter knows or 
reasonably suspects has been the victim of child abuse or 
neglect.”  (§ 11166, subd. (a); see § 11165.7.)  Failure to fulfill 
this duty is a misdemeanor and may result in the suspension or 
revocation of a professional license.  (§ 11166, subd. (c); Bus. & 
Prof. Code, § 4982, subd. (w).)  Mandated reporters include 
psychiatrists, psychologists, marriage and family therapists, 
clinical social workers, professional clinical counselors, alcohol 
and drug counselors, and other health professionals.  (§ 11165.7, 
subd. (a)(21), (38).) 
The term “ ‘child abuse or neglect’ ” in the reporting 
statute includes “sexual abuse as defined in Section 11165.1.”  
(§ 11165.6.)  Section 11165.1, in turn, defines sexual abuse to 
include “ ‘sexual exploitation.’ ”  (§ 11165.1, subd. (c).)  In 2014, 
the Legislature expanded the definition of sexual exploitation in 
the reporting statute to cover any person who knowingly 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
2 
“downloads,” “streams,” or electronically “accesses” child 
pornography.  (§ 11165.1, subd. (c)(3), as amended by Stats. 
2014, ch. 264, § 1 (hereafter section 11165.1(c)(3)).) 
The plaintiffs in this case are two licensed marriage and 
family therapists and one certified alcohol and drug counselor 
with significant experience treating patients with sexual 
disorders, addictions, and compulsions.  According to the 
complaint, plaintiffs’ patients include many persons who, during 
the course of voluntary psychotherapy, have admitted to 
downloading or electronically viewing child pornography but 
who, in plaintiffs’ professional judgment, do not present a 
serious risk of sexual contact with children.  Plaintiffs contend 
that the basic norm of confidentiality protected by the 
psychotherapist-patient privilege applies to such admissions 
and that the 2014 amendment to section 11165.1(c)(3), which 
requires plaintiffs to report such patients to law enforcement 
and child welfare authorities, violates their patients’ right to 
privacy under article I, section 1 of the California Constitution 
and the Fourteenth Amendment of the United States 
Constitution.  The Attorney General and the Los Angeles 
County District Attorney (collectively, defendants) filed 
demurrers, contending that plaintiffs had failed to establish a 
valid privacy claim under either the state or the federal 
Constitution.  The trial court dismissed the complaint, and the 
Court of Appeal affirmed. 
As the parties and all members of this court agree, the 
proliferation of child pornography on the Internet is an urgent 
problem of national and international dimension.  By some 
estimates, there were reports of over 45 million online photos 
and videos depicting child pornography in 2018 alone, which 
represents a greater than 45-fold increase over the past decade.  
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
3 
(Keller & Dance, The Internet Is Overrun With Images of Child 
Sexual Abuse.  What Went Wrong?, N.Y. Times (Sept. 28, 2019); 
see Paroline v. United States (2014) 572 U.S. 434, 440 (Paroline) 
[“Because child pornography is now traded with ease on the 
Internet,  ‘the number of still images and videos memorializing 
the sexual assault and other sexual exploitation of children, 
many very young in age, has grown exponentially.’ ”].)  
Technology has amplified the devastating nature and 
magnitude of child pornography, resulting in harms to children 
that are incalculably severe and enduring.  (In re Grant (2014) 
58 Cal.4th 469, 477–478 (Grant).) 
Culpability for this abuse lies not only with the producers 
of child pornography but also with its consumers, who drive 
demand and perpetuate the victimization with every viewing.  
(See Grant, supra, 58 Cal.4th at pp. 477–478; Paroline, supra, 
572 U.S. at pp. 440–441, 457.)  In California, knowing 
possession or control of child pornography is a crime (§ 311.11), 
and such conduct itself implicates no cognizable privacy 
interest.  The narrow question here is whether mandatory 
reporting of patients who admit to possessing or viewing child 
pornography in the course of voluntary psychotherapy to treat 
sexual disorders implicates a cognizable privacy interest. 
The posture in which this question arises is crucial to its 
resolution:  This case is before us on demurrer, which means the 
parties have not yet introduced any evidence bearing on the 
question presented.  “ ‘ “When a demurrer is sustained, we 
determine whether the complaint states facts sufficient to 
constitute a cause of action.” ’ ”  (Centinela Freeman Emergency 
Medical Associates v. Health Net of California, Inc. (2016) 1 
Cal.5th 994, 1010 (Centinela).)  In making this determination, 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
4 
we must accept the facts pleaded as true and give the complaint 
a reasonable interpretation.  (Ibid.) 
Applying this standard of review, we hold that plaintiffs 
have asserted a cognizable privacy interest under the California 
Constitution and that their complaint survives demurrer.  Our 
holding does not mean the reporting requirement is 
unconstitutional; it means only that the burden shifts to the 
state to demonstrate a sufficient justification for the incursion 
on privacy as this case moves forward.  We reverse the Court of 
Appeal’s judgment and remand for further proceedings to 
determine whether the statute’s purpose of protecting children 
is actually advanced by mandatory reporting of psychotherapy 
patients who admit to possessing or viewing child pornography. 
Our dissenting colleagues assert that “plaintiffs are 
unlikely to establish on remand that Assembly Bill 1775 does 
not substantively further its intended purpose.”  (Dis. opn., post, 
at p. 21.)  To be sure, surviving demurrer is no assurance of 
success on the merits once evidence is developed and considered.  
But we see no basis to prejudge what the evidence will show.  In 
the absence of an evidentiary record, we express no view on the 
ultimate validity of the 2014 amendment to section 11165.1(c)(3) 
or plaintiffs’ likelihood of success. 
To be clear, the privacy interest we recognize here 
attaches 
to 
a 
patient’s 
disclosures 
during 
voluntary 
psychotherapy, not to the patient’s underlying conduct.  There 
is no right to privacy that protects knowing possession or 
viewing of child pornography online or through any other 
medium.  Further, we do not hold that patients’ communications 
with their therapists are protected when the therapist believes 
the patient has committed hands-on sexual abuse or poses a 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
5 
threat of doing so.  All statutory exceptions to the 
psychotherapist-patient privilege, including the dangerous 
patient exception (Evid. Code, § 1024), still apply.  Finally, 
because plaintiffs may proceed on their state constitutional 
claim, we have no need to reach plaintiffs’ privacy claim under 
the federal Constitution. 
I. 
The reporting statute was originally enacted in 1980 as 
the Child Abuse Reporting Act.  (Stats. 1980, ch. 1071, §§ 1–5.)  
In 1987, the Legislature renamed it the Child Abuse and Neglect 
Reporting Act (CANRA).  (Stats. 1987, ch. 1459.)  As noted, 
CANRA requires mandated reporters to report incidents of 
suspected “child abuse or neglect” (§ 11166, subd. (a)), a term 
that includes “sexual abuse” (§ 11165.6), which in turn includes 
“ ‘sexual exploitation’ ” (§ 11165.1(c)).  From 1987 to 2014, 
CANRA defined “sexual exploitation” to apply to “[a]ny person 
who depicts a child in, or who knowingly develops, duplicates, 
prints, or exchanges, any film, photograph, video tape, negative, 
or slide in which a child is engaged in an act of obscene sexual 
conduct,” with exceptions for law enforcement and other persons 
not relevant here.  (Former § 11165.1, subd. (c)(3), as enacted by 
Stats. 1987, ch. 1459, § 5, p. 5518.)   
In 2014, the Legislature passed Assembly Bill No. 1775 
(2013–2014 Reg. Sess.) (Assembly Bill 1775), which expanded 
CANRA’s definition of “ ‘sexual exploitation’ ” so that it now 
applies to “[a] person who depicts a child in, or who knowingly 
develops, duplicates, prints, downloads, streams, accesses 
through any electronic or digital media, or exchanges, a film, 
photograph, videotape, video recording, negative, or slide in 
which a child is engaged in an act of obscene sexual conduct,” 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
6 
with the same exceptions as before.  (§ 11165.1(c)(3), italics 
added.)  According to a Senate Bill analysis, “[t]he purpose of 
[Assembly Bill 1775] is to update the definition of ‘sexual 
exploitation’ in the mandated child abuse reporting law with 
respect to visual depictions of children in obscene sexual conduct 
to reflect modern technology . . . .”  (Sen. Com. on Public Safety, 
Child Abuse: Mandatory Reporting, Rep. on Assem. Bill No. 
1775 (2013–2014 Reg. Sess.) as amended May 13, 2014, p. 1 
(Senate Committee Report).) 
One month after Assembly Bill 1775 took effect, plaintiffs 
Don Mathews, Michael Alvarez, and William Owen filed a 
complaint alleging that the amendment violates their patients’ 
right to privacy under the state and federal Constitutions.  
Mathews, a licensed family and marriage therapist, is the 
founder and director of the Impulse Treatment Center in 
Walnut Creek, which, according to the complaint, is the largest 
outpatient treatment center for sexual compulsion or addiction 
in the United States.  Alvarez, also a licensed family and 
marriage therapist, is a private practitioner specializing in 
treatment of addictions, including sex addiction, and was the 
founding director of the sexual disorders program at Del Amo 
Hospital in Torrance.  Owen, a certified alcohol and drug 
counselor, has worked with sex addicts for the past 15 years in 
private practice and at Del Amo Hospital.   
According to the complaint, plaintiffs “have treated 
numerous patients who are seeking treatment for sex addiction, 
sexual compulsivity, and other sexual disorders, many of whom 
have admitted downloading and viewing child pornography on 
the Internet, but whom [plaintiffs], based on their considerable 
training and experience, do not believe present a serious danger 
of engaging in ‘hands-on’ sexual abuse or exploitation of children 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
7 
or the distribution of child pornography to others.  These 
patients typically have no prior criminal history, have never 
expressed a sexual preference for children, and are active and 
voluntary participants in psychotherapy to treat their particular 
sexual disorder, which often involves compulsive viewing of 
pornography of all kinds on the Internet.”  Plaintiffs “have also 
treated patients seeking treatment because of sexual disorders 
involving a sexual attraction to children (including pedophilia), 
who have admitted to downloading and viewing child 
pornography, but whom [plaintiffs], based on their training and 
experience, do not believe present a serious danger of engaging 
in ‘hands-on’ sexual abuse or exploitation of children or the 
active distribution of child pornography to others.  These 
patients typically have no prior criminal record . . . , no access 
to children in their home or employment, no history of ‘hands-
on’ sexual abuse or exploitation of children, and often express 
disgust and shame about their sexual attraction to children for 
which they are actively and voluntarily seeking psychotherapy 
treatment.”  Plaintiffs contend that Assembly Bill 1775 requires 
them to report these patients in violation of the patients’ 
constitutional right to privacy. 
The complaint further alleges that statements made to 
psychotherapists during treatment are confidential and 
privileged, and that such confidentiality is an essential 
prerequisite for patients to seek and succeed in treatment:  
“[O]nce current patients who have admitted downloading or 
viewing child pornography during therapy learn that CANRA 
now requires Plaintiffs . . . or other psychotherapists to report 
such activity to law enforcement authorities for investigation, 
they will either cease therapy because Plaintiffs have exposed 
them to criminal prosecution and public disgrace or, if they 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
8 
continue, are unlikely to continue providing the full disclosure 
of intimate details that Plaintiffs need to provide effective 
therapy.  Similarly, persons who are seeking psychotherapy for 
serious sexual disorders may refuse such therapy once Plaintiffs 
inform them during intake screening that they are required to 
report any viewing of child pornography or, if the persons have 
already described such child pornography viewing as a reason 
for seeking treatment, that Plaintiffs are now obligated to report 
them before any therapy even begins.  [Citations.]  Enforcement 
of A.B. 1775 will also deter existing or potential patients who 
have serious sexual disorders — including sexual attraction to 
children — from obtaining needed psychotherapy, despite the 
lack of any evidence that they have engaged in ‘hands-on’ or 
‘contact’ sexual abuse of children.” 
Plaintiffs further contend that CANRA now captures 
conduct that “does not fall within any reasonable definition of 
child sexual abuse,” such as “minors who view sexually explicit 
self-portraits sent to them by other minors over cell phone 
networks,” otherwise known as “sexting.”  In sum, plaintiffs 
allege that requiring therapists to report their patients for 
possessing or viewing child pornography fails to “further 
CANRA’s salutary purpose of identifying and protecting 
children in California who are being abused by others.” 
In response, the Attorney General and the Los Angeles 
County District Attorney filed separate demurrers, contending 
that plaintiffs failed to assert a valid privacy claim under the 
state or federal Constitution.   
Following a hearing, the trial court sustained the 
demurrers without leave to amend and dismissed the action 
with prejudice.  The court held that Assembly Bill 1775 does not 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
9 
violate the right to privacy under the California Constitution 
because there is neither a fundamental privacy right to possess 
or view child pornography nor a reasonable expectation of 
absolute privacy in psychotherapeutic treatment or in 
discussing illegal conduct with a therapist, and the mandated 
reports do not amount to a serious invasion of privacy in any 
event.  The court also held that Assembly Bill 1775 does not 
violate the Fourteenth Amendment because there is no federal 
constitutional right to informational privacy and because, even 
if there were such a right, the applicable test would be rational 
basis review and Assembly Bill 1775 would pass muster.   
The Court of Appeal affirmed.  (Mathews v. Becerra (2017) 
7 Cal.App.5th 334 (Mathews).)  Applying the framework we 
outlined in Hill v. National Collegiate Athletic Assn. (1994) 7 
Cal.4th 1 (Hill), the court concluded that plaintiffs failed to meet 
the threshold requirements for stating a valid privacy claim 
under the California Constitution.  The court determined that 
patients have no legally protected privacy interest in possessing 
child pornography or “in communicating that they have 
downloaded, streamed or accessed child pornography from the 
Internet.”  (Mathews, at p. 358.)  The court further asserted that 
there is no reasonable expectation of privacy in communicating 
illegal conduct to psychotherapists, as such conduct is not 
entitled to constitutional protection.  (Id. at p. 359.)  The same 
was true for minors engaged in consensual sexting, the court 
explained, because “minors do not have a fundamental right to 
produce or possess child pornography, including viewing 
sexually explicit images of other minors.”  (Id. at p. 358.)  The 
court then concluded that even if plaintiffs had satisfied the 
threshold elements to state a valid privacy claim, the invasion 
of privacy resulting from mandated reporting was justified 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
10 
because it substantially furthered the state’s “ ‘legitimate and 
important competing interest[]’ ” in “protecti[ng] . . . children 
from sexual exploitation on the Internet.”  (Id. at p. 366.)  
Finally, the Court of Appeal agreed with the trial court that 
there is no general right to informational privacy under the 
federal Constitution and that even if such a right existed, 
rational basis review would apply and Assembly Bill 1775 would 
easily survive.  (Id. at pp. 367–368.) 
We granted review. 
II. 
At the outset, we clarify the scope of plaintiffs’ challenge 
in three ways. 
First, plaintiffs challenge CANRA only to the extent it 
requires mandatory reporting of patients suspected of simple 
possession or viewing of child pornography online or through 
other electronic or digital media.  The parties agree that such 
conduct is encompassed by the terms “downloads,” “streams,” 
and “accesses through any electronic or digital media” added to 
section 11165.1(c)(3) in 2014.  Legislative history shows that the 
reporting statute did not previously cover simple possession or 
viewing of child pornography, even though knowing possession 
or control of child pornography has been a crime in California 
since 1989. 
As noted, the Legislature enacted section 11165.1(c)(3) in 
1987 and originally defined “ ‘sexual exploitation’ ” to apply to 
any person who “knowingly develops, duplicates, prints, or 
exchanges” any image of child pornography.  (Former § 11165.1, 
subd. (c)(3).)  This definition came from a 1984 statute (Stats. 
1984, ch. 1613, § 2, subd. (b)(2)(C), p. 5719) enacted “to bring 
California’s child abuse reporting law into compliance with 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
11 
recent changes in the federal Child Abuse Prevention and 
Treatment [and Adoption Reform Act of 1978, Pub.L. No. 95-266 
(Apr. 24, 1978) 92 Stat. 204]” (Assem. Conc. Sen. Amends. to 
Assem. Bill No. 2709 (1983–1984 Reg. Sess.) as amended Aug. 
28, 1984, p. 2).  Federal regulations required states, as a 
condition of receiving federal aid for programs addressing child 
abuse and neglect, to have or enact mandatory reporting laws 
that cover “ ‘sexual exploitation,’ ” defined to “include[] . . . 
allowing, permitting, encouraging or engaging in the obscene or 
pornographic photographing, filming, or depicting of a child for 
commercial purposes as those acts are defined by State law.”  (45 
Fed.Reg. 35796 (May 27, 1980) [proposed rule implementing 45 
C.F.R. §§ 1340.2, 1340.13(a)(1)]; see also 48 Fed.Reg. 3698–3699 
(Jan. 26, 1983) [final rule].) 
The 1984 statute, in turn, borrowed the definition of 
“sexual exploitation” from a 1981 statute that made sexual 
exploitation an offense under Penal Code section 311.3.  
(Stats. 1981, ch. 1056, § 1, p. 4080.)  The history of the 1981 
statute indicates that “sexual exploitation” covered the 
production and distribution of child pornography, but not simple 
possession or viewing.  (Deputy Atty. Gen. Raye, Sponsor of Sen. 
Bill. No. 331 (1981–1982 Reg. Sess.), letter to Sen. Stern, Apr. 3, 
1981; Judicial Council of Cal., Rep. on Sen. Bill No. 331 (1981–
1982 Reg. Sess.) Aug. 13, 1981, p. 2.)  In 1989, the Legislature 
enacted a separate statute criminalizing the knowing possession 
or control of child pornography.  (§ 311.11, added by Stats. 1989, 
ch. 1180, § 2, p. 4568.)  But between 1989 and 2014, despite 
making other amendments to section 11165.1(c)(3), the 
Legislature did not alter the reporting statute to include simple 
possession or viewing of child pornography within the ambit of 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
12 
reportable offenses.  (See Stats. 2000, ch. 287, § 21; Stats. 1997, 
ch. 83, § 1.) 
Against this backdrop, the Legislature in 2014 amended 
CANRA’s definition of “ ‘sexual exploitation’ ” so that it now 
applies to any person who “downloads” or “streams” child 
pornography or “accesses [it] through any electronic or digital 
media.”  (§ 11165.1(c)(3).)  These terms encompass a wide range 
of conduct, from viewing a video online to saving a copy of a file 
available on the Internet to transferring a file from a memory 
cloud to a computer hard drive. 
We focus our attention on simple possession or viewing of 
child pornography online or through other electronic or digital 
media — conduct that forms the basis of plaintiffs’ challenge.  
The parties agree that such conduct is covered by the terms 
added by the 2014 amendment, and we find that this conduct 
was not previously covered by section 11165.1(c)(3).  Although 
there is some legislative history asserting that the 2014 
amendment was a mere technical update to CANRA (Senate 
Committee Report, at p. 2), the presumption that “ ‘ “the 
Legislature intends to change the meaning of a law when it 
alters the statutory language” ’ ” (Ennabe v. Manosa (2014) 58 
Cal.4th 697, 715) is borne out by the fact that the Legislature 
did not make possession or viewing of child pornography 
reportable when it enacted CANRA in 1987 and, despite making 
possession of child pornography a crime in 1989, did not amend 
the statute to cover such conduct for 25 years thereafter.  
Moreover, “whatever the Legislature may have believed about 
[CANRA’s] applicability to [possession or viewing of child 
pornography] when it enacted [the 2014 amendment] cannot 
dictate the proper construction of [CANRA] as it stood” before 
that amendment.  (Coker v. JPMorgan Chase Bank, N.A. (2016) 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
13 
62 Cal.4th 667, 689–690; see Western Security Bank v. Superior 
Court (1997) 15 Cal.4th 232, 244 [“[A] legislative declaration of 
an existing statute’s meaning is neither binding nor conclusive 
in construing the statute. Ultimately, the interpretation of a 
statute is an exercise of the judicial power the Constitution 
assigns to the courts.”].) 
Second, the parties do not agree on whether plaintiffs’ suit 
is properly viewed as a facial or an as-applied challenge to the 
reporting requirement added by the 2014 amendment.  
Defendants contend that the suit is a facial challenge, whereas 
plaintiffs argue that the suit presents facial and as-applied 
challenges.  The Court of Appeal concluded that plaintiffs have 
presented “ ‘only a facial challenge’ ” because they “seek ‘only to 
enjoin any enforcement of the [amendment] and did not 
demonstrate a pattern of unconstitutional enforcement.’ ”  
(Mathews, supra, 7 Cal.App.5th at p. 350.) 
We conclude that plaintiffs’ suit “has characteristics of 
both:  The claim is ‘as applied’ in the sense that it does not seek 
to strike [the 2014 amendment] in all its applications, but only 
to the extent it covers” psychotherapists who treat persons who 
have possessed or viewed child pornography but present no 
serious danger of hands-on sexual abuse or exploitation of 
children.  (Doe v. Reed (2010) 561 U.S. 186, 194.)  “The claim is 
‘facial’ in that it is not limited to plaintiffs’ particular case, but 
challenges application of the law more broadly to all” 
psychotherapists who treat such patients.  (Ibid.)  “The label is 
not what matters.”  (Ibid.)  Plaintiffs’ claims and requested relief 
“reach beyond the particular circumstances of these plaintiffs” 
and “must therefore satisfy [the] standards for a facial challenge 
to the extent of that reach.”  (Ibid.) 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
14 
Third, we decline to address plaintiffs’ claim that the 2014 
amendment violates the privacy rights of minors who engage in 
consensual sexting (e.g., sending sexually explicit images or 
videos by smartphone).  The complaint does not allege that any 
of the plaintiffs treat minors who engage in consensual sexting 
or that any of the plaintiffs, in their roles as therapists and 
counselors, anticipate having to report such minors.  We 
therefore express no view on the constitutionality of the 2014 
amendment as applied to consensual sexting by minors. 
III. 
 “In reviewing an order sustaining a demurrer, we 
examine the operative complaint de novo to determine whether 
it alleges facts sufficient to state a cause of action under any 
legal theory.”  (T.H. v. Novartis Pharmaceuticals Corp. (2017) 4 
Cal.5th 145, 162 (Novartis).)  “ ‘ “ ‘We treat the demurrer as 
admitting all material facts properly pleaded, but not 
contentions, deductions or conclusions of fact or law. . . .  We also 
consider matters which may be judicially noticed.’ . . .  Further, 
we give the complaint a reasonable interpretation, reading it as 
a whole and its parts in their context.” ’ ”  (Centinela, supra, 1 
Cal.5th at p. 1010, citations omitted.) 
We begin with plaintiffs’ state constitutional claim.  
Unlike the federal Constitution, the California Constitution 
expressly recognizes a right to privacy:  “All people are by nature 
free and independent and have inalienable rights.  Among these 
are enjoying and defending life and liberty, acquiring, 
possessing, and protecting property, and pursuing and 
obtaining safety, happiness, and privacy.”  (Cal. Const., art. I, 
§ 1; see American Academy of Pediatrics v. Lungren (1997) 16 
Cal.4th 307, 326 (American Academy of Pediatrics) (plur. opn. of 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
15 
George, C.J.) [“[I]n many contexts, the scope and application of 
the state constitutional right of privacy is broader and more 
protective of privacy than the federal constitutional right of 
privacy as interpreted by the federal courts.”].)  The word 
“privacy” was added to the state Constitution by a 1972 ballot 
initiative.  (Lewis v. Superior Court (2017) 3 Cal.5th 561, 569 
(Lewis).)  The ballot materials urging adoption of the initiative 
stated:  “ ‘The right of privacy is the right to be left alone.  It is 
a fundamental and compelling interest.  It protects our homes, 
our families, our thoughts, our emotions, our expressions, our 
personalities, our freedom of communion and our freedom to 
associate with the people we choose. . . .  [¶]  Fundamental to 
our privacy is the ability to control circulation of personal 
information.’ ”  (White v. Davis (1975) 13 Cal.3d 757, 774 
[quoting proponents’ statement in 1972 election brochure].)  The 
inclusion of privacy among the inalienable rights recognized by 
our state Constitution “ ‘creates a legal and enforceable right of 
privacy for every Californian.’ ”  (Ibid.) 
In Hill, supra, 7 Cal.4th 1, we set forth a framework for 
analyzing constitutional privacy claims.  “[A] plaintiff alleging 
an invasion of privacy in violation of the state constitutional 
right to privacy must establish each of the following:  (1) a 
legally protected privacy interest; (2) a reasonable expectation 
of privacy in the circumstances; and (3) conduct by defendant 
constituting a serious invasion of privacy. . . .  [¶] . . . .  [¶] A 
defendant may prevail in a state constitutional privacy case by 
negating any of the three elements just discussed or by pleading 
and proving, as an affirmative defense, that the invasion of 
privacy is justified because it substantively furthers one or more 
countervailing interests.  The plaintiff, in turn, may rebut a 
defendant’s assertion of countervailing interests by showing 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
16 
there are feasible and effective alternatives to defendant’s 
conduct which have a lesser impact on privacy interests.”  (Id. 
at pp. 39–40.)  The standard for evaluating the justification for 
a privacy invasion depends on “the specific kind of privacy 
interest involved and the nature and seriousness of the invasion 
and any countervailing interests.”  (Id. at p. 34.)  “Where the 
case involves an obvious invasion of an interest fundamental to 
personal autonomy, . . . a ‘compelling interest’ must be present 
to overcome the vital privacy interest.  If, in contrast, the privacy 
interest is less central, or in bona fide dispute, general balancing 
tests are employed.”  (Ibid.) 
A. 
We first examine whether plaintiffs have established a 
legally protected privacy interest.  In distinguishing this inquiry 
from the second threshold element (whether there is a 
reasonable expectation of privacy in the circumstances), we find 
Hill instructive.  There, university student athletes challenged 
the National Collegiate Athletic Association’s (NCAA) drug 
testing program, which required disclosure of medical 
information and observation of athletes while they gave urine 
samples.  (Hill, supra, 7 Cal.4th at pp. 11–13.)  In concluding 
that “the NCAA’s drug testing program impacts legally 
protected privacy interests” (id. at p. 40), Hill said that the 
“program intrudes on a human bodily function that by law and 
social custom is generally performed in private and without 
observers” (id. at pp. 40–41), and that “information about the 
internal medical state of an athlete’s body . . . is regarded as 
personal and confidential” (id. at p. 41).  Then, proceeding to the 
second threshold element, we examined whether student 
athletes had a reasonable expectation of privacy in urination 
and in information about their bodily condition “within the 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
17 
context of intercollegiate athletic activity and the normal 
conditions under which it is undertaken” (ibid.), and we 
concluded that their expectation of privacy is “diminished” in 
that setting but “not thereby rendered de minimis” (id. at p. 43).  
The first threshold element thus examines the basic nature of 
the privacy interest at a general level, while the second element 
asks whether an expectation of privacy is reasonable in the 
particular setting or context at issue. 
Applying this approach, we conclude that section 
11165.1(c)(3) impinges on a legally protected privacy interest.  
“In California, as in all other states, statements made by a 
patient to a psychotherapist during therapy are generally 
treated as confidential and enjoy the protection of a 
psychotherapist-patient privilege.”  (People v. Gonzales (2013) 
56 Cal.4th 353, 371 (Gonzales); see Jaffee v. Redmond (1996) 518 
U.S. 1, 12 (Jaffee) [“all 50 States and the District of Columbia 
have enacted into law some form of psychotherapist privilege”].)  
For more than 50 years, this privilege has been protected by 
statute in California.  (Evid. Code, § 1014 [recognizing a 
patient’s “privilege to refuse to disclose, and to prevent another 
from disclosing, a confidential communication between patient 
and psychotherapist”]; see id., § 1014, subd. (c) [the patient’s 
privilege may be claimed by “[t]he person who was the 
psychotherapist at the time of the confidential communication”]; 
Gonzales, at pp. 371–372 [discussing history of the privilege].)  
In addition, “[t]he psychotherapist-patient privilege has been 
recognized as an aspect of the patient’s constitutional right to 
privacy.  (Cal. Const. art. I, § 1; [citations].)”  (People v. 
Stritzinger (1983) 34 Cal.3d 505, 511 (Stritzinger); see People v. 
Hammon (1997) 15 Cal.4th 1117, 1127.) 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
18 
The Law Revision Commission’s comment on Evidence 
Code section 1014 explains the scope and purpose of the 
privilege:  “Psychoanalysis and psychotherapy are dependent 
upon the fullest revelation of the most intimate and 
embarrassing details of the patient’s life. . . .  Unless a patient 
or research subject is assured that such information can and will 
be held in utmost confidence, he will be reluctant to make the 
full disclosure upon which diagnosis and treatment or complete 
and accurate research depends.”  (Cal. Law Revision Com. com., 
reprinted at Deering’s Ann. Evid. Code (2004 ed.) foll. § 1014, 
p. 217.)  Similarly, this court “ha[s] recognized the contemporary 
value of the psychiatric profession, and its potential for the relief 
of emotional disturbances and of the inevitable tensions 
produced in our modern, complex society.  [Citations.]  That 
value is bottomed on a confidential relationship; but the doctor 
can be of assistance only if the patient may freely relate his 
thoughts and actions, his fears and fantasies, his strengths and 
weaknesses, in a completely uninhibited manner.”  (Stritzinger, 
supra, 34 Cal.3d at p. 514.)  We recently observed that where “a 
private 
individual 
voluntarily 
and 
confidentially 
seeks 
treatment from a psychotherapist[,] . . . the fact that treatment 
has been sought may itself be considered confidential 
information.”  (Gonzales, supra, 56 Cal.4th at p. 375, fn. 7.) 
The Evidence Code contains various exceptions that limit 
the applicability of the psychotherapist-patient privilege.  (Evid. 
Code, §§ 1016–1027.)  “[F]or reasons of policy,” such exceptions 
must be “construe[d] narrowly,” and the privilege must be 
“broadly construed in favor of the patient.”  (Stritzinger, supra, 
34 Cal.3d at pp. 511, 513.)  In Stritzinger, the defendant was 
convicted of molesting his stepdaughter, Sarah, based on 
testimony provided by a clinical psychologist, Dr. Walker.  In a 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
19 
counseling session with Dr. Walker, Sarah had revealed sexual 
activity with her stepfather.  (Id. at p. 509.)  The next day, Dr. 
Walker met with the defendant, who made statements 
confirming the incidents that Sarah had revealed to Dr. Walker.  
(Ibid.)  We held that Sarah’s statements to Dr. Walker “were not 
privileged because Evidence Code 1027 provides an exception 
when, as here, the patient is under 16 years of age and the 
psychotherapist has ‘reason to believe that the patient has been 
the victim of a crime and that disclosure of the communication 
is in the best interest of the child.’ ”  (Id. at p. 513.)  But we 
further held that the defendant’s communications with Dr. 
Walker were “redundant” and, for that reason, did not fall 
within 
the 
child 
abuse 
reporting 
exception 
to 
the 
psychotherapist-patient privilege.  (Id. at p. 514; see ibid. [“In 
this case, Dr. Walker reported his suspicion of child abuse 
following his consultation with Sarah . . . .  He was not then 
required to make a second report of the same incidents, based 
on defendant’s subsequent redundant communications.”].)  In 
adopting this narrow construction of the child abuse reporting 
exception, we said, “[I]t is impossible to conceive of any 
meaningful therapy” if the patient is aware “at the outset that 
[the psychotherapist] will violate his confidence and will inform 
law enforcement of their discussions.”  (Ibid.) 
The District Attorney suggests that the privacy interest 
here is undercut by the exceptions for circumstances where the 
services of a psychotherapist are sought to aid commission of a 
crime or to escape detection (Evid. Code, § 1018) and for 
situations where “[t]he psychotherapist has reasonable cause to 
believe that [a] patient [under age 16] has been the victim of a 
crime and that disclosure . . . is in the best interest of the child” 
(id., § 1027, subd. (b)).  But plaintiffs do not allege their patients 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
20 
are children under age 16 who are victims of crimes.  And there 
is no basis to infer that plaintiffs’ patients have sought 
psychotherapy in order to aid criminal conduct or to escape 
detection.  According to the complaint, the patients “are active 
and voluntary participants in psychotherapy to treat their 
particular sexual disorder.” 
In addition, the Attorney General and the District 
Attorney contend that the dangerous patient exception means 
plaintiffs’ patients have no cognizable privacy interest.  (See 
Evid. Code, § 1024 [“There is no [psychotherapist-patient] 
privilege . . . if the psychotherapist has reasonable cause to 
believe that the patient is in such mental or emotional condition 
as to be dangerous to himself or to the person or property of 
another and that disclosure of the communication is necessary 
to prevent the threatened danger.”].)  Our case law has 
recognized that downloading, streaming, or accessing child 
pornography is harmful conduct.  (See Grant, supra, 58 Cal.4th 
at pp. 477–478, 480.)  But no court has held that patients who 
have admitted to downloading or viewing child pornography 
categorically fall within the ambit of Evidence Code section 
1024. 
Indeed, the statute does not authorize courts to determine 
what kinds of patients are dangerous.  By the statute’s plain 
terms, it is up to “the psychotherapist” to make that 
determination for each patient.  (Evid. Code, § 1024.)  In 
Gonzales, we rejected the contention that a trial court could 
review 
a 
defendant’s 
psychological 
evaluations 
and 
independently find probable cause to believe the defendant is 
dangerous to himself or others within the meaning of Evidence 
Code section 1024.  (See Gonzales, supra, 56 Cal.4th at pp. 379–
382.)  We explained that the exception “come[s] into play only 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
21 
when the therapist has reasonable cause to believe and actually 
believes that the patient is dangerous.”  (Id. at p. 380, fn. 12, 
italics added; see Tarasoff v. Regents of University of California 
(1976) 17 Cal.3d 425, 431 (Tarasoff) [“When a therapist 
determines, or pursuant to the standards of his profession 
should determine, that his patient presents a serious danger of 
violence to another, he incurs an obligation to use reasonable 
care to protect the intended victim against such danger.”].)  In 
this case, plaintiffs’ complaint makes clear that they do not 
believe the patients whose privacy is at issue pose “a serious 
danger” (Tarasoff, at p. 431) to themselves or to others. 
The dissent says our approach would extend privacy 
protection to a patient who “discloses to his psychotherapist that 
he recently logged into a live-streaming platform to watch a man 
sexually assault a six-year-old boy.”  (Dis. opn., post, at p. 21.)  
This example is drawn from a newspaper report of a group of 
men who live-streamed the sexual assault of a six-year-old boy, 
encouraged and gave directions to the perpetrator during the 
assault, cheered and masturbated for each other to see, and 
broadcast other prerecorded child pornography over the live-
streaming platform.  (Ibid., citing Keller & Dance, Child 
Abusers Run Rampant as Tech Companies Look the Other Way, 
N.Y. Times (Nov. 9, 2019).)  Unlike the patients described in 
plaintiffs’ complaint, the men in this horrific example appear to 
have been actively involved in the sexual assault of a child.  As 
a general rule, someone who describes being actively involved in 
hands-on abuse is a person who is a danger to others (Evid. 
Code, § 1024), and such a communication is therefore 
reportable.  (See Tarasoff, supra, 17 Cal.3d at p. 431.)  Here, the 
question presented concerns the mandatory reporting of 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
22 
patients not believed to pose a serious danger of either hands-
on abuse or active distribution of child pornography. 
In sum, the narrow exceptions to the psychotherapist-
patient privilege do not apply here.  Because they do not apply, 
the general rule of confidentiality governs.  Plaintiffs’ patients 
have 
a 
legally 
protected 
privacy 
interest 
in 
their 
communications during voluntary psychotherapy. 
B. 
We next ask whether plaintiffs’ patients have a reasonable 
expectation of privacy in the circumstances.  Based on the 
allegations in the complaint, we conclude that the patients have 
such an expectation.   
Here the psychotherapist-patient communications involve 
revelations of criminal conduct.  (§ 311.11.)  The Court of Appeal 
emphasized, and we agree, that “possession of Internet child 
pornography does not involve any ‘vital privacy interest.’ ”  
(Mathews, supra, 7 Cal.App.5th at p. 354, quoting People v. 
Luera (2001) 86 Cal.App.4th 513, 522.)  But plaintiffs do not 
contend that possessing or viewing child pornography itself 
implicates a privacy interest.  They contend that privacy 
interests arise when their patients admit to possessing or 
viewing child pornography in the context of voluntary 
psychotherapy to treat sexual disorders. 
The Court of Appeal held that there can be no reasonable 
expectation of privacy in information subject to mandatory 
reporting under CANRA (§ 11171.2, subd. (b)) because the 
Legislature has made an exception to the psychotherapist-
patient privilege for such information.  (Mathews, supra, 7 
Cal.App.5th at p. 357.)  The Attorney General echoes this 
assertion, arguing that although “the precise statutory 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
23 
definition of reportable abuse and neglect has varied over time,” 
“the fact remains that information suggesting conduct that 
harms children—including certain acts of obtaining child 
pornography—has been reportable and expressly exempted 
from the psychotherapist-patient privilege for thirty years.”  
“Against that legal and cultural backdrop,” he contends, 
patients have no reasonable expectation of privacy when they 
reveal in psychotherapy that they have downloaded or viewed 
child pornography. 
This court considered and rejected a similar argument in 
American Academy of Pediatrics, supra, 16 Cal.4th 307, which 
held that a state law requiring minors to secure parental 
consent or judicial authorization before obtaining an abortion 
violated the minors’ state constitutional right to privacy.  In 
concluding that pregnant minors have a reasonable expectation 
of privacy in the circumstances, the plurality opinion said:  
“Although it has been suggested that, in light of the general 
statutory rule requiring a minor to obtain parental consent for 
medical care, and the existence of numerous abortion/parental 
consent statutes in other states, a minor has no reasonable 
expectation of privacy in this context, it plainly would defeat the 
voters’ fundamental purpose in establishing a constitutional 
right of privacy if a defendant could defeat a constitutional claim 
simply by maintaining that statutory provisions or past 
practices that are inconsistent with the constitutionally 
protected right eliminate any ‘reasonable expectation of privacy’ 
with regard to the constitutionally protected right.”  (Id. at 
pp. 338–339 (plur. opn. of George, C.J.).)  Justice Kennard, who 
concurred in the holding, observed that “California law long 
required parental consent for many medical procedures” but 
that “the Legislature has generally not required parental 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
24 
consent for medical procedures relating to sexuality and 
procreation.”  (Id. at pp. 374, 375 (conc. opn. of Kennard, J.).)  
Here, it is true that former section 11165.1, subdivision (c)(3) 
made a broad range of child pornography offenses subject to 
mandatory reporting.  But plaintiffs challenge CANRA only to 
the extent that it reaches simple possession or viewing of child 
pornography.  Such conduct became subject to mandatory 
reporting as a result of the 2014 amendment whose 
constitutionality is at issue here. 
The Attorney General also argues that CANRA’s existence 
for almost three decades prior to the 2014 amendment has 
eroded any expectation of privacy in admissions during 
psychotherapy suggesting conduct that harms children.  In 
evaluating this contention, we begin by observing that there is 
no general exception to the psychotherapist-patient privilege for 
a patient’s admission that he or she has engaged in criminal 
conduct.  The exceptions that appear in Evidence Code sections 
1016 to 1027 are specific and must be “construe[d] narrowly.”  
(Stritzinger, supra, 34 Cal.3d at p. 513.)  Although there is an 
exception for situations where a patient has sought the services 
of a psychotherapist to aid the commission of a crime or to 
escape detection (Evid. Code, § 1018), there is no general 
exception for admission of a crime.  Indeed, when the 
psychotherapist-patient privilege was codified, the Law 
Revision Commission said the privilege would “appl[y] in all 
proceedings,” unlike the “physician-patient privilege[, which] 
does not apply in criminal proceedings.”  (Cal. Law Revision 
Com. com., reprinted at Deering’s Ann. Evid. Code, supra, foll. 
§ 1014, p. 216; see ibid. [“This difference in the scope of the two 
privileges is based on the fact that the Law Revision 
Commission has been advised that proper psychotherapy often 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
25 
is denied a patient solely because he will not talk freely to a 
psychotherapist for fear that the latter may be compelled in a 
criminal proceeding to reveal what he has been told.”].)  In 
Gonzales, we held in the context of a commitment proceeding 
under the Sexually Violent Predator Act (Welf. & Inst. Code, 
§ 6600 et seq.) that the privilege barred the admission of 
statements by a parolee who, in the course of psychotherapy 
undertaken as a condition of parole, admitted he had molested 
up to 16 children.  (Gonzales, supra, 56 Cal.4th at pp. 364–365, 
372–383.) 
It is true that all jurisdictions, including California, have 
enacted laws requiring psychotherapists and other professionals 
to report child abuse and neglect in compliance with 
requirements for receiving federal aid to support child abuse 
and neglect prevention and treatment programs.  (See ante, at 
pp. 10–11.)  But even if psychotherapy patients have no 
reasonable expectation of privacy in disclosures covered by those 
long-standing reporting laws, the question here concerns 
disclosure of conduct — possessing or viewing child pornography 
— that such reporting laws generally do not cover.  There appear 
to be only six states besides California with statutes that require 
mandatory reporting of psychotherapy patients who knowingly 
possess or view child pornography.  (See Colo. Rev. Stat. §§ 18-
6-403, 19-3-304; Del. Code Ann. tit. 11, § 1111; id. tit. 16, § 903; 
Miss. Code Ann. §§ 97-5-33, 97-5-51; Tenn. Code Ann. §§ 37-1-
605, 39-17-1003; Utah Code Ann. §§ 62A-4a-403, 76-5b-201; Vt. 
Stat. Ann. tit. 33, §§ 4912, 4913.)  Arizona law includes knowing 
possession of child pornography within its definition of “sexual 
exploitation of a minor” (Ariz. Rev. Stat. Ann. § 13-3553) but 
allows a psychotherapist to “withhold the reporting of [a] 
statement” by a patient voluntarily seeking sex offender 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
26 
treatment if the psychotherapist “determines it is reasonable 
and necessary to accomplish the purposes of the treatment” (id., 
§ 13-3620).  And federal law requires mental health 
professionals engaged in certain activities on federal land or in 
federal facilities to report the fact that a patient has viewed 
child pornography.  (34 U.S.C. § 20341; see Off. of Legal 
Counsel, U.S. Dept. of Justice, Duty to Report Suspected Child 
Abuse Under 42 U.S.C. § 13031 (May 29, 2012) pp. 10–13.)  
Among all other jurisdictions, it appears that none has 
interpreted its CANRA equivalent to cover simple possession or 
viewing of child pornography. 
Apart from mandatory reporting laws, 10 states have a 
statutory exception to the psychotherapist-patient privilege for 
matters concerning child abuse or neglect.  (See Kan. Stat. Ann. 
§ 65-5810; La. Code Evid. Ann. art. 510; Mich. Comp. Laws 
§ 333.16281; Mo. Ann. Stat. § 210.140; Neb. Rev. Stat. Ann. 
§ 27-504; Nev. Rev. Stat. Ann. § 49-213; N.C. Gen. Stat. Ann. 
§ 8-53.3; Or. Rev. Stat. Ann. § 419B.040; Wis. Stat. Ann. 
§ 905.04; Wyo. Stat. Ann. § 33-27-123.)  In these jurisdictions, 
psychotherapists 
may 
reveal 
otherwise 
privileged 
communications not only to law enforcement or child welfare 
agencies in compliance with reporting laws, but also when 
relevant to certain administrative or judicial proceedings.  (See, 
e.g., State ex rel. Juvenile Dept. v. Spencer (Or. 2005) 108 P.3d 
1189, 1192–1193 [finding no privilege where the defendant was 
charged with child abuse in juvenile court proceedings]; State v. 
McMillion (Neb.Ct.App. 2016) 875 N.W.2d 877, 897–898 
[finding no privilege where the defendant was charged with 
sexual assault of a child]; State v. Hyder (Wn.Ct.App. 2011) 244 
P.3d 454, 460–462 [finding no privilege where the defendant 
was charged with child molestation and incest]; In Interest of 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
27 
S.J. (Mo.Ct.App. 1993) 849 S.W.2d 608, 610–611 [finding no 
privilege in a parental termination proceeding where child 
abuse was alleged].)  Although these statutes have often been 
applied to situations involving hands-on abuse or neglect, we are 
unaware of any case law in these jurisdictions that has 
construed a child abuse or neglect exception to cover simple 
possession or viewing of child pornography. 
It thus appears that “law and social custom” (Hill, supra, 
7 Cal.4th at pp. 40–41) have not required child welfare reporting 
or authorized other disclosure of a patient’s admission during 
voluntary psychotherapy treatment that the patient has 
possessed or viewed child pornography.  The Attorney General 
is correct that “certain acts of obtaining child pornography” have 
been reportable for 30 years.  But until the 2014 amendment to 
section 11165.1(c)(3), the reporting statute did not cover simple 
possession or viewing of child pornography.  And today, in the 
vast majority of states, neither legislative enactments nor case 
law indicates that a patient’s admission of such conduct is 
subject to mandatory reporting or covered by some other 
exception to the norm of confidentiality that “is vitally 
important to the successful operation of psychotherapy.”  (In re 
Lifschutz (1970) 2 Cal.3d 415, 422 (Lifschutz).) 
On remand, the parties may develop evidence that further 
informs this inquiry.  The evidence could reveal, for example, 
that prior to 2014 it was not a widespread practice for therapists 
to disclose to patients that they were required to report patients 
who admitted to simple possession or viewing of child 
pornography, and that therapists did not in fact report such 
admissions.  Conversely, the evidence could show that prior to 
2014 therapists already had a general practice of informing 
patients that they would report such revelations to the 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
28 
authorities, and that they did so report.  Either finding might 
bear on relevant customs and practices.  But we have no such 
facts before us at this stage of the litigation.  We conclude that, 
for purposes of demurrer, plaintiffs have established that their 
patients have a reasonable expectation of privacy in admissions 
during voluntary psychotherapy that they have viewed or 
possessed child pornography. 
In reaching the opposite conclusion, the dissenting opinion 
begins with the premise that the 2014 amendment was merely 
a technical update to CANRA.  (Dis. opn., post, at pp. 4–8.)  
Based on that understanding, the dissent concludes that 
patients’ disclosures of having viewed or possessed child 
pornography have been reportable or would have given rise to 
reasonable suspicion of reportable conduct since CANRA was 
enacted in 1987, and thus no “more than a trivial number” of 
plaintiffs’ patients have a reasonable expectation of privacy in 
such disclosures.  (Id. at p. 21.)  As noted, however, the 
legislative history shows that simple possession or viewing of 
child pornography was not previously covered by former section 
11165.1, subdivision (c)(3).  (Ante, at pp. 10–12.) 
The dissent places dispositive weight on plaintiffs’ 
allegation that many of their patients have admitted to 
downloading, not just viewing, child pornography.  (Dis. opn., 
post, at pp. 11–12, 18–19.)  The dissent argues that because 
“downloading or streaming a file inherently involves making a 
‘duplicate[]’ of it” within the meaning of former section 11165.1, 
section (c)(3), such conduct has long been reportable, and a 
patient can have no reasonable expectation of privacy in such 
disclosures.  (Id. at p. 10; see id. at pp. 6–7, 9–10.) 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
29 
We express no view on whether the term “duplicates” as 
used in CANRA when it was enacted in 1987 — before online 
child pornography was considered a serious problem — 
encompasses downloading or streaming a file from the Internet.  
Notably, the dissent cites no California authority that has 
interpreted the term “duplicates” in CANRA to include 
downloading or streaming.  (Dis. opn., post, at pp. 9–10 [citing 
one federal case from New Jersey, a dictionary, and a law review 
article].)  And to the extent the dissent relies on statements by 
legislators who passed the 2014 amendment (id. at pp. 6–7), 
those views “ ‘cannot dictate the proper construction of [CANRA] 
as it stood’ before that amendment.”  (Ante, at p. 12.) 
Importantly here, as the dissent concedes, there was 
“ ‘confus[ion]’ ” about CANRA’s coverage, including the scope of 
the term “duplicates,” before the 2014 amendment (dis. opn., 
post, at p. 6), and the amendment was “designed to clarify” the 
law (id. at p. 7).  In cases where we have relied on a long-
standing practice of disclosure to find no reasonable expectation 
of privacy or a diminished expectation, the long-standing 
practice was clear and served to put individuals on notice.  (See 
Lewis v. Superior Court (2017) 3 Cal.5th 561, 575 (Lewis); 
International Federation of Professional & Technical Engineers, 
Local 21, AFL-CIO v. Superior Court (2007) 42 Cal.4th 319, 331 
(International Federation).)  Here, the dissent points to no 
authority or evidence indicating that the scope of the reporting 
requirement before the 2014 amendment clearly covered a 
patient’s admission of having downloaded, streamed, possessed, 
or viewed child pornography. 
Moreover, we have never held that the existence of a long-
standing practice or requirement of disclosure can, by itself, 
defeat a reasonable expectation of privacy in the circumstances.  
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
30 
In Lewis, we concluded that the practice of sharing patients’ 
personal information under a separate statute made the 
reasonable expectation of privacy in their prescription records 
“less robust.”  (Lewis, supra, 3 Cal.5th at p. 575.)  Nevertheless, 
we held that patients retain a reasonable expectation of privacy 
in their records.  (Ibid.)  Similarly, in International Federation, 
we considered the long-standing practice of disclosing public 
employees’ salaries as a relevant factor in deciding whether the 
employees 
have 
a 
reasonable 
expectation 
of 
privacy.  
(International Federation, supra, 42 Cal.4th at p. 331.)  But we 
also surveyed the widespread practice of disclosing public 
employee salaries across various federal, state, and local 
governments before concluding that the employees do not have 
a reasonable expectation of privacy.  (Id. at p. 332.)  Our case 
law does not support the dissent’s sole reliance on a purported 
long-standing practice or requirement of disclosure to find no 
reasonable expectation of privacy for the vast majority of 
plaintiffs’ patients. 
Finally, the dissent invokes the standard for facial 
challenges (dis. opn., post, at pp. 16–18) and asserts that 
plaintiffs, 
far 
from 
showing 
that 
the 
statute 
raises 
constitutional concerns in the great majority of its applications, 
“fail[] to establish a reasonable expectation of privacy under Hill 
for more than a trivial number of their patients” (id. at p. 21).  
In support of this assertion, the dissent makes a series of factual 
claims:  “A patient’s admission that he has knowingly possessed 
or viewed child pornography online will almost certainly cause 
a psychotherapist to suspect that the patient has duplicated 
such materials” (id. at p. 18); such an admission will “frequently 
entail” a disclosure that the patient has “copied child 
pornography to a computer, phone, or other device” (id. at p. 3); 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
31 
and “it is extremely unlikely that a patient will disclose simply 
possessing or viewing child pornography online, without also 
revealing other reportable conduct” (id. at p. 18–19).  None of 
these claims is supported by evidence; each is conjecture.  At this 
stage of the case, we must “accept as true all properly pleaded 
facts” (Novartis, supra, 4 Cal.5th at p. 156) and “ ‘ “give the 
complaint a reasonable interpretation” ’ ” (Centinela, supra, 1 
Cal.5th at p. 1010).  Plaintiffs’ complaint states that their 
challenge involves patients who admit to possessing or viewing 
child pornography; what therapists will “almost certainly” 
suspect from such admissions and whether such admissions are 
“frequently” accompanied by other disclosures are factual 
matters for the parties to litigate.  The standard of review on 
demurrer does not authorize us to supplement the complaint 
with our own factual claims. 
C. 
The third threshold inquiry is whether mandatory 
reporting of patients’ admissions of possessing or viewing of 
child pornography constitutes “a serious invasion of privacy.”  
(Hill, supra, 7 Cal.4th at p. 40.)  In Hill, we observed that 
“[a]ctionable invasions of privacy must be sufficiently serious in 
their nature, scope, and actual or potential impact to constitute 
an egregious breach of the social norms underlying the privacy 
right.  Thus, the extent and gravity of the invasion is [sic] an 
indispensable consideration in assessing an alleged invasion of 
privacy.”  (Id. at p. 37.)  We conclude that the invasion of privacy 
caused by the reporting requirement is undoubtedly serious.   
As to the scope and potential impact of the invasion, 
CANRA requires extensive reporting of information about 
psychotherapy patients who admit to possessing or viewing 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
32 
child pornography.  Under the statute, a psychotherapist must 
immediately make a report by telephone to a police department, 
sheriff’s department, county probation department, or the 
county welfare department upon learning that a patient has 
possessed or viewed child pornography.  (§§ 11165.9, 11166, 
subd. (a).)  The psychotherapist must then make a written 
report within 36 hours.  (§ 11166, subd. (a).)  The report must 
include “the information that gave rise to the reasonable 
suspicion” that the patient has possessed or viewed child 
pornography and “the source or sources of that information.”  
(§ 11167, subd. (a).)  The report must also include “the name, 
address, telephone number, and other relevant personal 
information” about the patient if any of that information is 
known.  (Ibid.)  If the psychotherapist fails to make such a 
report, he or she is subject to criminal prosecution and 
professional discipline.  (§ 11166, subd. (c); Bus. & Prof. Code, 
§ 4982, subd. (w); Cal. Code Regs., tit. 16, § 1397.1.) 
The agency that receives the initial report must share the 
information with various other agencies.  For example, law 
enforcement and county agencies are required to cross-report 
the information to each other, to child welfare agencies, and to 
district attorneys’ offices.  (§ 11166, subds. (j), (k); see B.H. v. 
County of San Bernardino (2015) 62 Cal.4th 168, 181–185.)  The 
statute then requires that “ ‘an investigation be conducted on 
every report received.’ ”  (B.H., at p. 183.)  The reporting statute 
encourages the agencies to continue to share information with 
each other throughout the investigation.  (§ 11166.3, subd. (a).)  
If the investigation substantiates the initial report, the report 
must be forwarded to the Department of Justice, which files the 
information in the Child Abuse Central Index.  (§ 11170, 
subd. (a)(1)–(3).)  The information in the database must then be 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
33 
made available to prosecutors, adoption agencies, government 
agencies conducting certain background checks, and other 
agencies that regulate persons who may have contact with 
children.  (§ 11170, subd. (b).) 
Further, as the Attorney General confirms, psychotherapy 
patients who admit to possessing or viewing child pornography 
may face felony prosecution, which may result in a prison 
sentence and public registration as a sex offender.  (§§ 290, 
311.11.)  The possibility of criminal prosecution carries with it a 
significant potential for further public disclosures.  Indeed, this 
is not an area in which government agents can or should be 
expected to keep the information to themselves.  (See Lewis, 
supra, 3 Cal.5th at pp. 576–577.) 
As to the nature and gravity of the invasion, there is no 
question that revelations made by patients who seek 
psychotherapy to treat sexual disorders, including sexual 
attraction to children, concern the most intimate aspects of 
human thought and behavior, however noxious or depraved.  
What this court observed in Lifschutz seems apt here:  “ ‘ “The 
psychiatric patient confides more utterly than anyone else in the 
world.  He exposes to the therapist not only what his words 
directly express; he lays bare his entire self, his dreams, his 
fantasies, his sins, and his shame.  Most patients who undergo 
psychotherapy know that this is what will be expected of them, 
and that they cannot get help except on that condition.” ’ ”  
(Lifschutz, supra, 2 Cal.3d at p. 431.)  Mandatory reporting of 
such information is a severe invasion, for “[i]f there is a 
quintessential zone of human privacy it is the mind.  Our ability 
to exclude others from our mental processes is intrinsic to the 
human personality.”  (Long Beach City Employees Assn. v. City 
of Long Beach (1986) 41 Cal.3d 937, 944.)  In sum, plaintiffs 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
34 
have alleged a serious invasion of privacy under the third 
threshold inquiry of the Hill framework. 
IV. 
Having determined that plaintiffs’ allegations satisfy the 
threshold inquiry for a cognizable privacy claim, we turn now to 
examine the standard of justification that the reporting 
requirement must meet. 
In Hill, we canvassed our state constitutional privacy 
decisions and observed that some cases had applied a 
“ ‘compelling interest’ ” test while others had applied “less 
intense scrutiny” in the form of general balancing tests.  (Hill, 
supra, 7 Cal.4th at p. 34.)  We explained:  “The particular 
context, i.e., the specific kind of privacy interest involved and 
the nature and seriousness of the invasion and any 
countervailing interests, remains the critical factor in the 
analysis.  Where the case involves an obvious invasion of an 
interest fundamental to personal autonomy, e.g., freedom from 
involuntary sterilization or the freedom to pursue consensual 
familial relationships, a ‘compelling interest’ must be present to 
overcome the vital privacy interest.  If, in contrast, the privacy 
interest is less central, or in bona fide dispute, general balancing 
tests are employed.”  (Ibid.)  The parties dispute which standard 
applies.   
Plaintiffs note that our decision in Hill described 
Stritzinger as having held that a “patient’s privacy interest in 
psychotherapy must yield to compelling state interests” and 
that “detection and prevention of child abuse constitutes such 
an interest.”  (Hill, supra, 7 Cal.4th at p. 35, fn. 11, citing 
Stritzinger, supra, 34 Cal.3d at p. 511.)  Relying on Stritzinger 
and Hill’s citation to that case, the Court of Appeal in 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
35 
Kirchmeyer v. Phillips (2016) 245 Cal.App.4th 1394 concluded 
that “[t]he psychotherapist-patient privilege is a kind of privacy 
interest that may be overcome only on a showing of a compelling 
state interest.”  (Id. at p. 1404.) 
But Stritzinger did not have occasion to apply the 
compelling interest test; we instead held that “on the particular 
facts of his case” a psychotherapy patient’s disclosures of child 
molestation were not subject to mandatory reporting and were 
therefore privileged.  (Stritzinger, supra, 34 Cal.3d at p. 512; see 
id. at pp. 513–514.)  Although Stritzinger cited cases that had 
applied the compelling interest test to constitutional privacy 
claims (id. at p. 511), we subsequently said that not “every 
assertion of a privacy interest under article I, section 1 [of the 
California Constitution] must be overcome by a ‘compelling 
interest’ ” (Hill, supra, 7 Cal.4th at pp. 34–35).  More recently, 
we said it is erroneous to adopt a “de facto starting assumption 
that such an egregious invasion [requiring a compelling interest 
as justification] is involved in every request for discovery of 
private information.  Courts must instead place the burden on 
the party asserting a privacy interest to establish its extent and 
the seriousness of the prospective invasion, and against that 
showing must weigh the countervailing interests the opposing 
party identifies, as Hill requires.  What suffices to justify an 
invasion will . . . vary according to the context.  Only obvious 
invasions of interests fundamental to personal autonomy must 
be supported by a compelling interest.”  (Williams v. Superior 
Court (2017) 3 Cal.5th 531, 557.) 
As defendants note, this case does not involve a privacy 
interest in bodily autonomy and is thus different from American 
Academy of Pediatrics, where we held that a statute requiring a 
pregnant minor to obtain parental consent or judicial 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
36 
authorization before having an abortion “unquestionably 
impinges 
upon 
‘an 
interest 
fundamental 
to 
personal 
autonomy.’ ” (American Academy of Pediatrics, supra, 16 
Cal.4th at p. 340 (plur. opn. of George, C.J.).)  In Hill, we 
similarly said that cases dealing with the “freedom from 
involuntary sterilization or the freedom to pursue consensual 
familial relationships” involve “obvious invasion[s] of an interest 
fundamental to personal autonomy.”  (Hill, supra, 7 Cal.4th at 
p. 34.) 
At the same time, we have never held that personal 
autonomy in the privacy context is limited to matters of bodily 
integrity.  As amici scholars argue here, a core aspect of human 
autonomy is a person’s ability to gain control over his impulses 
or desires so that he does not engage in pathological behaviors.  
Plaintiffs allege that this is what their patients are attempting 
to do:  They are seeking psychotherapy to overcome their 
compulsions to possess or view child pornography so that they 
can conform their conduct to the law and social norms. 
In this respect, the autonomy interest here is similar to 
that underlying “the oldest of the privileges for confidential 
communications known to the common law”:  the attorney-client 
privilege.  (Upjohn Co. v. United States (1981) 449 U.S. 383, 389 
(Upjohn); see Jaffee, supra, 518 U.S. at p. 11.)  Like the 
attorney-client privilege, the interest that plaintiffs seek to 
protect is intended to encourage “the observance of law and 
administration of justice.”  (Upjohn, at p. 389.)  Notably, the 
psychotherapist-patient privilege in 12 jurisdictions is stated in 
terms that place patient communications on the same basis of 
confidentiality as client communications protected by the 
attorney-client privilege, although the former privilege is 
subject to different exceptions than the latter.  (See, e.g., Ariz. 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
37 
Rev. Stat. Ann. § 32-2085 [“The confidential relations and 
communication between a client or patient and a psychologist 
licensed pursuant to this chapter . . . are placed on the same 
basis as those provided by law between an attorney and client.”]; 
see also Ala. Code § 34-26-2; Ga. Code Ann. § 43-39-16; Idaho 
Code Ann. § 54-2314; Kan. Stat. Ann. § 65-5810; Mont. Code 
Ann. § 26-1-807; N.H. Rev. Stat. Ann. § 329:26; N.J. Stat. Ann. 
§ 45:14B-28; N.Y. C.P.L.R. 4507; 42 Pa. Stat. and Cons. Stat. 
Ann. § 5944; Tenn. Code Ann. § 63-11-213; Wn. Rev. Code Ann. 
§ 18.83.110.)  Like the ability of clients to seek advice from 
counsel, the ability of psychotherapy patients to seek treatment 
to prevent future criminal conduct and to live as law-abiding 
members of society implicates a basic interest in self-
determination. 
As we explain, however, there is ultimately no need to 
resolve at this juncture whether the proper standard of 
justification here is the compelling interest test or a general 
balancing test.  No one disputes that the principal purpose of 
the reporting requirement — preventing the sexual exploitation 
and abuse of children — is a weighty one.  (See New York v. 
Ferber (1982) 458 U.S. 747, 757.)  The main issue on which the 
parties disagree is whether the reporting requirement actually 
serves its intended purpose. 
Defendants argue that mandatory reporting advances the 
state’s 
interest 
in 
protecting 
children 
by 
facilitating 
enforcement of the child pornography laws.  As defendants note, 
the purpose of these laws is to protect children by drying up the 
market for images of their sexual abuse.  And according to the 
Attorney General, mandatory reporting also helps to “ensur[e] 
that those with direct access to children do not threaten them 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
38 
with harm” and aids efforts to “rescu[e] children from sexual 
abuse.”   
Plaintiffs, by contrast, contend that there is only a “slim 
possibilit[y]” that the reporting requirement can assist law 
enforcement in identifying and rescuing children depicted in 
child pornography.  They assert that patients who have 
downloaded or viewed child pornography online are “highly 
unlikely” to have any information about the identities, locations, 
or other relevant characteristics of the depicted children.  
Plaintiffs also allege that because child pornography is so freely 
and easily accessible on the Internet, patients who admit to 
viewing child pornography online span a wide range of 
psychological profiles and disorders, and do not present a 
serious danger of hands-on abuse.  Mandatory reporting of 
patients who do not pose a serious danger of hands-on abuse, 
plaintiffs allege, would not serve any interest in preventing 
those patients from causing direct harm to children. 
Moreover, plaintiffs’ complaint alleges that the reporting 
requirement “deter[s] existing or potential patients who have 
serious 
sexual 
disorders 
. . . 
from 
obtaining 
needed 
psychotherapy, despite the lack of any evidence that they have 
engaged in ‘hands-on’ or ‘contact’ sexual abuse of children.”  The 
complaint specifically alleges that “mandated reporting of child 
pornography viewing will unnecessarily deter persons with 
sexual disorders from psychotherapy treatment,” which 
suggests the contribution of those persons to the market for 
child pornography will continue unabated. 
With no facts developed at this stage of the litigation, we 
are unable to evaluate these competing claims as to whether the 
reporting requirement serves its intended purpose.  Our 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
39 
precedent includes varied assertions on whether mandatory 
reporting 
deters 
psychotherapy 
patients 
from 
seeking 
treatment.  (Compare Tarasoff, supra, 17 Cal.3d at p. 440, fn. 12 
[dismissing as “entirely speculative” the concern that reporting 
of dangerous patients will discourage them from seeking 
counseling] with Stritzinger, supra, 34 Cal.3d at p. 514 [“it is 
impossible to conceive of any meaningful therapy” if the patient 
knows “at the outset that [the therapist] will violate his 
confidence and will inform law enforcement of their 
discussions”] and Lifschutz, supra, 2 Cal.3d at p. 431 [“ ‘ “It 
would be too much to expect [patients] to [reveal intimate 
thoughts and behaviors during treatment] if they knew that all 
they say . . . may be revealed to the whole world from a witness 
stand.” ’ ”].)  The dissent relies on cases that cite decades-old 
studies and involve reporting requirements not at issue here.  
(Dis. opn., post, at pp. 24–25, citing Regents of University of 
California v. Superior Court (2018) 4 Cal.5th 607, 632 
[discussing 2000 article on deterrence effects of reporting 
potentially violent patients], People v. Wharton (1991) 53 Cal.3d 
522, 558 [discussing deterrence effects of reporting patients 
whom psychotherapists believe to be dangerous], Tarasoff, 
supra, 17 Cal.3d at p. 440, fn. 12 [discussing 1974 article that 
found “little if any empirical data” on deterrence effects of 
reporting potentially violent patients], and Lifschutz, at 
pp. 426–427 [discussing deterrence effects in context of 
“compel[ling] disclosure of only those matters which the patient 
himself has chosen to reveal by tendering them in litigation”].)  
No court has yet explored the ramifications of the reporting 
requirement challenged in this case. 
At its core, plaintiffs’ argument is that the reporting 
requirement does not further, and may in fact undermine, its 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
40 
intended purpose of protecting children from sexual abuse and 
exploitation.  If substantiated, this mismatch between means 
and 
ends 
would 
render 
the 
reporting 
requirement 
unconstitutional under any standard.  We thus have no need, in 
advance of factual development on this critical issue, to decide 
whether the reporting requirement must satisfy the compelling 
interest test or a general balancing test. 
On remand, the parties may develop evidence on a variety 
of relevant issues, including but not limited to the number of 
reports that psychotherapists have made regarding the 
possession or viewing of child pornography since the 2014 
amendment; whether the reports have facilitated criminal 
prosecutions, reduced the market for child pornography, aided 
the identification or rescue of exploited children, or otherwise 
prevented harm to children; and whether there are less 
intrusive means to accomplish the statute’s objectives.  The 
parties may also introduce evidence on the extent to which the 
reporting requirement deters psychotherapy patients from 
seeking treatment for sexual disorders, inhibits candid 
communication by such patients during treatment, or otherwise 
compromises the practical accessibility or efficacy of treatment.  
We have recognized the value of such factual development 
in other cases involving the state constitutional right to privacy, 
which were decided on the basis of fully litigated records.  The 
Hill case came to our court after a bench trial that involved 
testimony from numerous “scientists, physicians, and sports 
professionals regarding the merits of the NCAA’s list of 
proscribed drugs and the general efficacy of its drug testing 
program.”  (Hill, supra, 7 Cal.4th at p. 13.)  Our balancing 
analysis relied extensively on evidence developed in the record 
(id. at pp. 45–47), and we declined to go beyond the record 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
41 
evidence in evaluating the availability of less intrusive 
alternatives (id. at pp. 51–52). 
Similarly, in American Academy of Pediatrics, supra, 16 
Cal.4th 307, we had the benefit of an evidentiary record 
developed through a two-month bench trial involving live 
testimony from 25 witnesses and deposition testimony from six 
other witnesses.  (Id. at p. 323 (plur. opn. of George, C.J.); see 
ibid. [“The witnesses represented a broad spectrum of experts 
with training and experience in the fields of health care, 
adolescent development, and the application of judicial bypass 
procedures in other states.  The testimony covered a wide range 
of subjects, including the relative medical and psychological 
risks posed to pregnant minors by abortion and childbirth, the 
general maturity of minors seeking abortion, the existing 
guidelines and practices with regard to the counseling provided 
to minors seeking abortion, and the general efficacy (or lack 
thereof) of the judicial bypass process in other jurisdictions.”].)  
In concluding that the parental consent law would not further 
the asserted interests in the health of minors and the parent-
child relationship, a majority of the court observed that its 
determination 
was 
“supported . . . by 
the 
overwhelming 
evidence, much of it uncontested.”  (Id. at p. 354; see id. at 
pp. 355–356 [discussing trial testimony]; id. at p. 383 (conc. opn. 
of Kennard, J.) [“Benefitting from the experience of other states 
with similar laws, and a well-developed trial record, this court 
is equipped to assess the ‘objective effect’ of the parental consent 
law.”].) 
Despite no evidence bearing on the relevant questions 
here, our dissenting colleagues assert that “plaintiffs are 
unlikely to establish on remand that Assembly Bill 1775 does 
not substantively further its intended purpose.”  (Dis. opn., post, 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
42 
at p. 21.)  To support this conjecture, the dissent engages in its 
own factfinding in disregard of the applicable standard of 
review.  For example, the dissent cites an opinion of the United 
States Department of Justice’s Office of Legal Counsel asserting 
that some images of child pornography are “ ‘homemade 
recordings’ ” of family members or neighbors “ ‘traceable 
through law enforcement investigation to a particular child or 
children.’ ”  (Id. at pp. 25–26.)  But we have no evidence 
indicating how often patients who admit to viewing child 
pornography also disclose that the images are homemade, how 
often such disclosures are successfully traced to a particular 
child, or whether deterrence of patients from seeking treatment 
outweighs any benefits of reporting such disclosures.  Nor does 
the dissent mention a 2009 United Nations report cited in 
plaintiffs’ complaint, which found that among millions of child 
pornography images reviewed in the United States, only 0.01 
percent of victims had been identified.  (See Najat M’jid Maalla, 
Human Rights Council, U.N. Gen. Assembly, Report of the 
Special Rapporteur on the sale of children, child prostitution 
and child pornography (2009) pp. 15–16.) 
Similarly, the dissent endorses the Attorney General’s and 
District Attorney’s assertions that the reporting requirement 
helps law enforcement stop or reduce instances of viewing child 
pornography.  (Dis. opn., post, at p. 27.)  But without evidence 
on how many patients are deterred from seeking treatment for 
every patient who is reported, we have no basis for concluding 
that the reporting requirement reduces viewing of child 
pornography.  Nowhere does the dissenting opinion credit the 
allegations in plaintiffs’ complaint that suggest a deterrent 
effect, even though “[o]n review of a demurrer, we accept as true 
all properly pleaded facts.”  (Novartis, supra, 4 Cal.5th at 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
43 
p. 156.)  As amicus curiae California Medical Association 
observes, this case in its current posture has no record from 
which a court can determine whether the reporting requirement 
actually serves its intended purposes. 
In remanding this matter, we address two additional 
arguments made by the Attorney General.  First, noting that 
plaintiffs do not question the validity of section 11165.1(c)(3) as 
it existed before the 2014 amendment, the Attorney General 
asserts that viewing or possessing online child pornography is 
not “sufficiently different from, and less harmful to children 
than, other forms of reportable abuse that a different 
constitutional balance is required here.”  But even assuming 
that former section 11165.1, subdivision (c)(3) is constitutionally 
valid (plaintiffs appear correct that no case has so held), it is 
possible that persons who merely possess or view online child 
pornography have characteristics distinct from persons who 
knowingly develop, duplicate, print, or exchange child 
pornography.  As noted, plaintiffs claim that their patients pose 
no serious risk of hands-on child abuse; they make no similar 
claim about patients who have engaged in conduct covered by 
former section 11165.1, subdivision (c)(3).  Further, we have no 
evidence as to whether all persons subject to mandatory 
reporting under section 11165.1(c)(3) are inclined to seek 
psychotherapy or are deterred from seeking psychotherapy to 
the same degree.  On remand, the parties may develop facts that 
illuminate whether the balance of factors informing the 
constitutional 
validity 
of 
the 
2014 
amendment 
is 
distinguishable from the balance of factors informing the 
validity of other parts of section 11165.1(c)(3). 
Second, the Attorney General contends that “whether 
expanded reporting obligations or greater therapist-patient 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
44 
confidentiality will better protect children’s safety is a policy 
matter for the Legislature to decide.”  A similar argument 
urging deference to the Legislature’s policy judgment was 
considered and rejected in American Academy of Pediatrics, 
supra, 16 Cal.4th 307:  “As a general rule, ‘[i]t is not the 
judiciary’s function . . . to reweigh the “legislative facts” 
underlying a legislative enactment.’  [Citation.]  When an 
enactment intrudes upon a constitutional right, however, 
greater judicial scrutiny is required.”  (Id. at pp. 348–349 (plur. 
opn. of George, C.J.), fn. omitted.)  Judicial review of duly 
enacted legislation is a delicate task, and our role is not to 
supplant the Legislature’s policymaking role.  But when a 
statute intrudes on a privacy interest protected by the state 
Constitution, it is our duty to independently examine the 
relationship between the statute’s means and ends.  (Id. at 
pp. 349–350.) 
V. 
Plaintiffs also raise a privacy claim under the due process 
clause of the Fourteenth Amendment to the United States 
Constitution.  Having determined that plaintiffs have stated a 
viable privacy claim under the California Constitution and that 
a remand for development of an evidentiary record is necessary 
to resolve this claim, we have no need at this juncture to reach 
plaintiffs’ additional claim under the federal Constitution. 
CONCLUSION 
We conclude that plaintiffs have asserted a cognizable 
privacy interest under the state Constitution such that their 
complaint survives demurrer and the action may proceed to 
factfinding on whether the reporting requirement furthers its 
intended purpose.  Because this case comes to us on demurrer, 
MATHEWS v. BECERRA 
Opinion of the Court by Liu, J. 
 
45 
we have assumed the facts pleaded as true, and we have given 
the complaint a reasonable interpretation.  Whether plaintiffs 
will succeed on the merits after the development of an 
evidentiary record remains to be seen, and we express no view 
on the ultimate validity of Assembly Bill 1775.  Furthermore, 
plaintiffs have challenged CANRA’s validity only to the extent 
it requires mandatory reporting of patients suspected of simple 
possession or viewing of child pornography.  We do not question 
the validity of other reporting obligations encompassed by 
former section 11165.1, subdivision (c)(3).  We also note that a 
psychotherapist violates no privilege when reporting a patient 
whom the psychotherapist believes to be dangerous.  (Evid. 
Code, § 1024.)  And, we repeat, there is no privacy interest in 
the underlying conduct at issue here; knowing possession or 
control of child pornography is a crime.  (§ 311.11.) 
We reverse the judgment of the Court of Appeal and 
remand for further proceedings consistent with this opinion. 
 
 
 
 
 
LIU, J. 
 
We Concur:  
CUÉLLAR, J. 
KRUGER, J. 
GROBAN, J. 
 
 
MATHEWS v. BECERRA 
S240156 
 
Dissenting Opinion by Chief Justice Cantil-Sakauye 
 
“ ‘Child pornography harms and debases the most 
defenseless of our citizens’ ” (In re Grant (2014) 58 Cal.4th 469, 
477 (Grant) quoting United States v. Williams (2008) 533 U.S. 
285, 307), and “causes the child victims continuing harm by 
haunting the children in years to come” (Osborne v. Ohio (1990) 
495 U.S. 103, 111).  Although child pornography is not a new 
problem, “smartphone cameras, social media and cloud storage 
have made it much worse.  [¶]  Before the digital age, offenders 
had to rely on having photographs developed and sending them 
through the postal system, but new technologies have lowered 
the barriers to creating, sharing and amassing the material, 
pushing it to unprecedented levels.”  (Dance & Keller, An 
Explosion in Online Child Sex Abuse: What You Need to Know, 
N.Y. Times (Sept. 30, 2019)  [as of Dec. 20, 2019].)1 
To combat the spreading plague of child pornography over 
the Internet, in 2014 the Legislature amended the Child Abuse 
and Neglect Reporting Act (Pen. Code,2 § 11164 et seq.; 
CANRA).  This measure clarifies that the statute’s preexisting 
                                        
1  
All Internet citations in this opinion are archived by year, 
docket number and case name at . 
2  
All further statutory references are to the Penal Code 
unless otherwise indicated. 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
2 
requirement that psychotherapists report to an appropriate 
authority a patient’s admission of duplicating photographs or 
videos of child pornography also applies when a patient discloses 
having downloaded or otherwise obtained such material over 
the Internet.  Plaintiffs challenge this amendment — but not the 
original disclosure requirement.  The majority concedes that as 
originally enacted, CANRA requires psychotherapists to 
disclose the fact that a patient knowingly “ ‘duplicates’ ” an 
image of child pornography (maj. opn., ante, at p. 10), which 
occurs whenever a patient copies an online file containing child 
pornography to a computer, phone, or other device.  Yet without 
calling into question the long-standing original requirement, the 
majority concludes that plaintiffs have stated a cause of action 
that the amendment facially violates their patients’ privacy 
rights.   
I disagree.  In concluding that plaintiffs’ complaint 
survives demurrer, the majority misapplies the inquiry set forth 
in Hill v. National Collegiate Athletic Assn. (1994) 7 Cal.4th 1, 
39-40 (Hill) and the standard that governs facial challenges to a 
statute.  Hill demands that a plaintiff in a state constitutional 
privacy case establish that the challenged conduct infringes 
upon a reasonable expectation of privacy.  (Id. at p. 40.)  But I 
do not perceive any such expectation among the cohort of 
patients whose interests are pressed by the psychotherapist 
plaintiffs here.  On the contrary, the requirement before us is 
akin 
to 
other 
mandatory 
reporting 
rules 
governing 
psychotherapists that have never been understood as infringing 
upon their patients’ reasonable privacy expectations.  And 
although the majority responds to the well-established reporting 
requirement by perceiving a possible privacy expectation among 
only those patients who admit to viewing or possessing child 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
3 
pornography, without more, these statements will as a general 
matter still encompass conduct that long has been understood 
as triggering the reporting requirement.   
Even assuming for the sake of argument that a small class 
of patients could claim a reasonable expectation of privacy upon 
communicating their possession or viewing of child pornography 
online, plaintiffs still have not met the rigorous standard that 
applies to claims alleging that a statute is facially 
unconstitutional.  A plaintiff who brings a facial challenge to a 
statute must demonstrate at a minimum that the statute 
creates constitutional concerns “in the generality or great 
majority of cases.”  (T-Mobile West LLC v. City and County of 
San Francisco (2019) 6 Cal.5th 1107, 1117, fn. 6 (T-Mobile).)  It 
is apparent even on demurrer that plaintiffs cannot satisfy this 
burden.  A disclosure that one has knowingly possessed or 
viewed child pornography will frequently entail a disclosure 
that one has copied child pornography to a computer, phone, or 
other device.  Even more often, such admission will cause a 
therapist to reasonably suspect that a patient has engaged in 
other reportable conduct — with such suspicion, by itself, being 
sufficient to trigger the reporting requirement.  Because there 
is no dispute that mandatory disclosure of the copying is 
constitutionally permissible, those who admit to possessing or 
viewing child pornography online will often be subject to 
mandatory reporting in any event.  Applying CANRA, as 
amended, to those child pornography possessors and viewers 
poses no constitutional problem, defeating any facial challenge 
concerning child pornography viewers as a group. 
Last, even assuming that remand is appropriate to allow 
the trial court to balance plaintiffs’ asserted privacy concerns 
against important competing interests (Hill, supra, 7 Cal.4th at 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
4 
pp. 37-38), the compelling state interest in protecting children 
from the harm caused by sexual exploitation over the Internet 
will almost certainly outweigh the alleged privacy invasion. 
For these reasons, I respectfully dissent. 
I.  ASSEMBLY BILL 1775 MERELY UPDATED 
CANRA TO FURTHER PROTECT CHILDREN FROM 
SEXUAL EXPLOITATION OVER THE INTERNET 
I begin with a discussion of the 2014 amendment to 
CANRA.  As will be explained, this amendment merely updated 
the statute’s definition of “sexual exploitation” to keep pace with 
modern technology. 
“The intent and purpose of [CANRA] is to protect children 
from abuse and neglect.”  (§ 11164, subd. (b).)  All persons 
participating in the investigation of suspected child abuse or 
neglect must “consider the needs of the child victim and . . . do 
whatever is necessary to prevent psychological harm to the child 
victim.”  (Ibid.)  To that end, CANRA requires certain 
individuals, including psychotherapists, to report incidents of 
suspected “child abuse or neglect” to a specified agency.  
(§ 11166, subd. (a); see § 11165.7, subd. (a)(21).)  The statute 
defines the term “child abuse or neglect” to include “sexual 
abuse” (§ 11165.6), which in turn includes “sexual exploitation” 
(§ 11165.1, subd. (c)).  From 1987 to 2014, CANRA defined 
“sexual exploitation” as including “[a]ny person who depicts a 
child in, or who knowingly develops, duplicates, prints, or 
exchanges, any film, photograph, video tape, negative, or slide” 
depicting child pornography.  (Stats. 1987, ch. 1459, § 5, p. 5518 
(former section 11165.1, subd. (c)(3)).)   
In the decades after CANRA was enacted, new 
technologies 
appeared 
that 
facilitated 
the 
production, 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
5 
distribution, and consumption of child pornography through 
online or digital means.  In 2014, responding to this concern, the 
Legislature unanimously passed Assembly Bill No. 1775 (2013-
2014 Reg. Sess.) (Assembly Bill 1775).  The bill amended 
CANRA’s definition of “sexual exploitation” to also apply to any 
person who knowingly “downloads, streams, [or] accesses 
through any electronic or digital media” child pornography.  
(§ 11165.1, subd. (c)(3), as amended by Stats. 2014, ch. 264, § 1.)  
Like the prior version of CANRA, the legislative history of 
Assembly Bill 1775 reflects an intent to protect victims of 
suspected child abuse.  According to the bill’s author, Assembly 
Bill 1775 was designed to “ ‘further ensure the protection of 
children from the proliferation of sexual exploitation through 
internet child pornography.  The State Legislature has a duty to 
ensure it does everything within its power to make certain the 
most vulnerable of our society, our children, are protected.’ ”  
(Assem. Conc. Sen. Amends. to Assem. Bill No. 1775 (2013-2014 
Reg. Sess.) as amended May 13, 2014, p. 3.)3  
                                        
3  
Numerous organizations representing mental health 
professionals subject to CANRA’s mandatory reporting 
requirement supported Assembly Bill 1775.  The California 
Association of Marriage and Family Therapists (CAMFT), on 
behalf of its 30,000 members, sponsored the legislation.  (Senate 
Rules Com., Office of Sen. Floor Analyses, 3d reading analysis 
of Assem. Bill No. 1775 (2013-2014 Reg. Sess.) as amended May 
13, 2014, p. 1.)  In a letter of support, CAMFT declared that 
Assembly Bill 1775 would “ensure that the law adequately 
reflects changes in technology to better protect children from 
being sexually exploited through internet child pornography.”  
(Cathy Atkins, CAMFT, letter in support of Assem. Bill No. 1775 
(2013-2014 Reg. Sess.) Feb. 19, 2014, p. 1.)  Several other 
organizations representing mandatory reporters, including the 
 
 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
6 
The legislative history of Assembly Bill 1775 shows that 
“[t]he purpose of th[e] bill is to update the definition of ‘sexual 
exploitation’ in the mandated child abuse reporting law with 
respect to visual depictions of children in obscene sexual conduct 
to reflect modern technology. . . .”  (Sen. Com. on Public Safety, 
Analysis of Assem. Bill No. 1775 (2013-2014 Reg. Sess.) as 
amended May 13, 2014, p. 1.)  Committee and floor analyses of 
Assembly Bill 1775 uniformly describe the amendment as 
making “purely technical revisions” to the definition of “sexual 
exploitation” to “reflect modern technology.”  (Sen. Com. on 
Public Safety, Rep. on Assem. Bill No. 1775 (2013-2014 Reg. 
Sess.) as amended May 13, 2014, pp. 1-2; see id. at p. 7 [terms 
added to definition of sexual exploitation “ensure the reporting 
requirements related to internet child pornography are defined 
to reflect modern technology”].)  Indeed, the bill’s history further 
suggests that the updated definition covers conduct “that would 
likely [be] include[d] . . . even absent the update.”  (Assem. Com. 
on Appropriations, Analysis of Assem. Bill No. 1775, supra, as 
amended Mar. 19, 2014, p. 1.)  As the bill’s author explained, the 
“downloading or streaming of child pornography” is the 
“modern” equivalent of the “printing or copying of such 
materials,” and the Legislature wished to eliminate any existing 
“confus[ion]” of “mandated reporters . . . on whether they should 
report the downloading or streaming of child pornography, as 
                                        
California Association for Licensed Professional Clinical 
Counselors, the Board of Behavioral Sciences, and the 
California Psychological Association, publicly expressed support 
for the bill.  (Senate Rules Com., Office of Sen. Floor Analyses, 
3d reading analysis of Assem. Bill No. 1775, supra, as amended 
May 13, 2014, p. 3.) 
 
 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
7 
they are required to with the printing or copying of such 
materials.”  (Sen. Com. on Pub. Safety, Rep. on Assem. Bill 
No. 1775, supra, as amended May 13, 2014, p. 7.)4     
The legislative history thus makes plain that Assembly 
Bill 1775 was designed to clarify that CANRA protects children 
from being sexually exploited through online child pornography.  
Consistent with this purpose, the measure merely updated a 
definition to keep in step with modern technology and to specify 
that the modern equivalent of conduct already reportable under 
the existing statute is, in fact, reportable.  Indeed, as noted, 
copying a file from the Internet (i.e., downloading) was already 
covered by the term “duplicates” in the former version of 
CANRA.  This background informs an appropriate evaluation of 
whether plaintiffs have successfully alleged a violation of their 
                                        
4  
Despite acknowledging that “some legislative history 
assert[s] that the 2014 amendment was a mere technical update 
to CANRA” (maj. opn., ante, at p. 12), the majority presumes 
instead that the Legislature intended to change the meaning of 
the law (ibid.).  But we have recognized that the purpose of 
amendatory changes “is not necessarily to change the law.”  
(Williams v. Garcetti (1993) 5 Cal.4th 561, 568.)  “While an 
intention to change the law is usually inferred from a material 
change in the language of the statute [citations], a consideration 
of the surrounding circumstances may indicate, on the other 
hand, that the amendment was merely the result of a legislative 
attempt to clarify the true meaning of the statute.  [Citation.]”  
(Ibid.; see also W.R. Grace & Co. v. Cal. Emp. Com. (1944) 
24 Cal.2d 720, 729 [“The fact that the statute was . . . amended, 
however, does not necessarily indicate that the law was different 
before the amendment.  Although courts ordinarily infer an 
intent to change the law from a material change in the language 
of a statute [citations], the circumstances may indicate merely a 
legislative intent to clarify the law”].) 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
8 
patients’ constitutional right to privacy under the framework set 
forth in Hill, supra, 7 Cal.4th 1.  
II.  CANRA’S LONG-STANDING REPORTING 
REQUIREMENT SIGNIFICANTLY LIMITS PATIENTS’ 
REASONABLE PRIVACY EXPECTATIONS 
“[A] plaintiff alleging an invasion of privacy in violation of 
the state constitutional right to privacy must establish each of 
the following:  (1) a legally protected privacy interest; (2) a 
reasonable expectation of privacy in the circumstances; and 
(3) conduct by defendant constituting a serious invasion of 
privacy.”  (Hill, supra, 7 Cal.4th at pp. 39-40.)  With regard to 
the second of these elements, as discussed above, the 
psychotherapist-patient relationship has for more than three 
decades featured a reporting requirement that is triggered when 
a patient discloses having acquired child pornography in any of 
several ways.  In my view, the majority fails to supply a 
convincing explanation concerning how a patient can have a 
reasonable expectation of privacy in similar disclosed conduct 
when the consumption of pornography occurs through online 
channels. 
“ ‘The extent of [a privacy] interest is not independent of 
the circumstances.’  [Citation.]  Even when a legally cognizable 
privacy interest is present, other factors may affect a person’s 
reasonable expectation of privacy.”  (Hill, supra, 7 Cal.4th at 
p. 36.)  “[C]ustoms, practices, and physical settings surrounding 
particular 
activities 
may 
create 
or 
inhibit 
reasonable 
expectations of privacy.”  (Ibid., citing Whalen v. Roe (1977) 
429 U.S. 589, 602 (Whalen), Fraternal Order of Police, Lodge 
No. 5. v. City of Philadelphia (3d Cir. 1987) 812 F.2d 105, 114.)  
In the context of a disclosure requirement analogous to the one 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
9 
before this court, a relevant consideration is whether similar 
disclosures have been required in the past.  (Whalen, at p. 602.)   
Since its enactment, CANRA has expressly excepted 
information regarding suspected child abuse or neglect from the 
psychotherapist-patient privilege.  (§ 11171.2, subd. (b).)  For 
more than 30 years, mental health professionals in California 
have been required to make a report under CANRA when they 
reasonably suspect that a patient has sexually abused or 
exploited a child, including by knowingly “develop[ing], 
duplicat[ing], print[ing] or exchang[ing]” photographs or videos 
depicting child pornography.  (Former § 11165.1, subd. (c)(3).)  
Plaintiffs do not challenge this established rule.  (Maj. opn., 
ante, at pp. 6-8.)   
Given this decades-old reporting requirement, a patient 
cannot reasonably expect that psychotherapists will not report 
the patient’s disclosures of engaging in the same conduct over 
the Internet.  As the legislative history illustrates, Assembly 
Bill 1775 made “purely technical revisions” (Sen. Com. on Public 
Safety, Rep. on Assem. Bill No. 1775, supra, as amended May 
13, 2014, pp. 1-2) to CANRA’s definition of sexual exploitation 
to clarify that conduct which was “likely include[d]” in the 
definition “even absent the update” must be reported (Assem. 
Com. on Appropriations, Analysis of Assem. Bill No. 1775, 
supra, as amended Mar. 19, 2014, p. 1). 
The 2014 amendment consequently added the words 
“downloads, streams, [or] accesses through any electronic or 
digital media” to section 11165.1, subdivision (c)(3).  By 
definition, the terms “download[ing]” and “stream[ing]” child 
pornography online involve the act of “duplicat[ing]” a file to a 
user’s personal technology device.  (§ 11165.1, subd. (c)(3); see, 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
10 
e.g., Video Pipeline, Inc. v. Buena Vista Home Entertainment, 
Inc. (D.N.J. 2003) 275 F.Supp.2d 543, 549, fn. 2 [downloading “is 
a process by which a complete audio or video clip is delivered to 
and stored on a consumer’s computer”]; Barron’s Dict. of 
Computer and Internet Terms (12th ed. 2017) p. 152 
[“download” means “to transmit a file or program from a central 
computer to a smaller computer or a computer at a remote site”]; 
Martin & Newhall, Criminal Copyright Enforcement Against 
Filesharing Services (2013) 15 N.C.J. L. & Tech. 101, 119, fn. 97 
[“Stream[ing]” content from the Internet involves making a 
“temporary ‘buffer’ copy of a video file, which is destroyed as the 
video is played”]; Barron’s Dict. of Computer and Internet 
Terms, at p. 472 [defining “streaming” as “delivering audio or 
video signals in real time, without waiting for a whole file to 
download before playing it”].)   
Accordingly, downloading or streaming a file inherently 
involves making a “duplicate[]” of it (former § 11165.1, subd. 
(c)(3)), and the majority does not contend otherwise.  Ever since 
1987, CANRA has required psychotherapists to report when 
their patients disclose duplicating photographs or videos of child 
pornography.  The Legislature did not expand this rule when it 
added the terms “downloads” and “streams” to the statute’s 
definition of “sexual exploitation”; it merely clarified that the old 
rule also applies to newer technologies.  (§ 11165.1, subd. (c)(3).)  
Under the circumstances, a patient cannot have a reasonable 
expectation of privacy in disclosing information that has for so 
long been the subject of mandatory reporting.   
Perhaps in an effort to avoid addressing the more obvious 
similarities between the current and former versions of CANRA, 
the majority emphasizes that plaintiffs are challenging “simple 
possession or viewing” of child pornography online (maj. opn., 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
11 
ante, at p. 10), which plaintiffs assert was made reportable only 
by Assembly Bill 1775.  Although it is not clear that any of terms 
in the 2014 amendment are synonymous with simple possession 
or viewing (because even the phrase “knowingly . . . accesses 
through electronic or digital media” (§ 11165.1, subd. (c)(3)) 
describes affirmative conduct in seeking to obtain child 
pornography online), even assuming that the amendment covers 
such conduct, the majority’s approach suffers from several 
deficiencies.5   
As a preliminary matter, it is unclear how a person can 
possess child pornography accessed through electronic or digital 
means without also having downloaded it.  Indeed, we must 
accept as true the factual allegations in plaintiffs’ complaint 
that “ ‘many’ ” of their patients “ ‘have admitted downloading 
and viewing child pornography on the Internet.’ ”  (Maj. opn., 
ante, at p. 6, italics added; see Yvanova v. New Century Mortgage 
Corp. (2016) 62 Cal.4th 919, 924 [“For purposes of reviewing a 
demurrer, we accept the truth of material facts properly pleaded 
in the operative complaint”] (Yvanova).)  As discussed above, 
downloading child pornography is simply the modern term for 
duplicating such material, which has been reportable conduct 
for decades.  Accordingly, even as to patients who admit to 
knowingly possessing child pornography obtained online, they 
                                        
5  
Although the majority repeatedly characterizes the 
challenged conduct as “simple possession or viewing” (maj. opn., 
ante, at pp. 10, 11, 24, 27) of child pornography, it bears 
emphasizing that CANRA only requires the reporting of a 
person who “knowingly” engages in the specified conduct 
(§ 11165.1, subd. (c)(3)).  It would not, for example, apply to a 
person who wanders into a room and unexpectedly sees child 
pornography displayed on another’s computer. 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
12 
have no reasonable expectation of privacy in disclosing such 
behavior under the circumstances because their conduct —
possessing online images or videos of child pornography by 
downloading (i.e., duplicating) them — has been reportable 
since CANRA was enacted more than 30 years ago. 
Yet even assuming that Assembly Bill 1775 makes 
reportable a narrow category of conduct that psychotherapists 
were not previously required to disclose — a patient who admits 
only knowingly viewing child pornography online — it remains 
doubtful that under normal circumstances these patients could 
claim a reasonable expectation of privacy.  CANRA requires a 
mandated reporter to report whenever he or she “has knowledge 
of . . . a child whom the mandated reporter knows or reasonably 
suspects has been the victim of child abuse or neglect.”  (§ 11166, 
subd. (a), italics added.)  A patient’s admission that he has 
knowingly viewed child pornography online will almost if not 
always give rise to reasonable suspicion that the patient has 
downloaded or duplicated such materials, or otherwise engaged 
in conduct that has been reportable for decades under CANRA.  
And, only rarely, if ever, will a patient disclose simply viewing 
child pornography online, without also revealing other 
reportable conduct (i.e., duplicating those images or videos to 
the patient’s computer).  Indeed, plaintiffs’ complaint is replete 
with 
admissions 
that 
“many” 
of 
their 
patients 
have 
“download[ed] and view[ed]” child pornography online.  (Italics 
added.)   
Whalen, supra, 429 U.S. 589 is instructive.  (See Hill, 
supra, 7 Cal.4th at p. 36.)  In Whalen, the Supreme Court held 
that the mandatory reporting of certain drug prescriptions to 
the New York Department of Health did not violate a patient’s 
constitutional right to privacy because such disclosures were not 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
13 
“significantly different” from those that were required under a 
prior law or “meaningfully distinguishable” from other 
invasions of privacy that are associated with health care.  
(Whalen, at p. 602.)  The same is true here.  At least the vast 
majority of conduct that, as communicated to a psychotherapist, 
is subject to reporting under the 2014 amendment was already 
subject to mandatory reporting under the 1987 version of 
CANRA.   And to the extent that Assembly Bill 1775 can be 
construed to include admissions limited to having knowingly 
viewed child pornography online, this behavior is not 
“significantly different” or “meaningfully distinguishable” from 
what has triggered required reporting for decades.  (Whalen, at 
p. 602.) 
There are also practical problems with the majority’s 
approach.  Consider the following hypotheticals.  A patient 
admits to knowingly duplicating a single photograph containing 
child pornography: reportable.  A patient admits to knowingly 
viewing 
1,000 
images 
of 
child 
pornography 
online: 
constitutionally protected.  A patient discloses knowingly 
viewing 
and 
printing 
one 
photograph 
depicting 
child 
pornography: reportable.  A patient discloses knowingly 
possessing 3,000 images of child pornography on his computer, 
which he only could have obtained by downloading them: 
constitutionally protected.  These anomalous results further 
suggest that the majority’s approach is out of step with what a 
reasonable expectation of privacy actually entails. 
In an effort to sidestep the conclusion that CANRA’s 
legislative history compels, the majority claims that we 
“considered and rejected” a similar argument in American 
Academy of Pediatrics v. Lungren (1997) 16 Cal.4th 307.  (Maj. 
opn., ante, at p. 23.)  It is true that a three-justice plurality in 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
14 
that case rejected the idea that “a defendant could defeat a 
constitutional claim simply by maintaining that statutory 
provisions or past practices that are inconsistent with the 
constitutionally protected right eliminate any ‘reasonable 
expectation of privacy’ with regard to the constitutionally 
protected right.”  (American Academy, at p. 339 (plur. opn. of 
George, C. J.).)  But American Academy is not dispositive on the 
issue.  There, the plurality opinion was referring to a far more 
general statutory rule requiring parental consent for medical 
care, not — as here — comparing two versions of the same 
statute regulating substantially similar if not identical conduct.  
In other words, a minor could still have a reasonable privacy 
expectation in her decision to obtain an abortion, even if her 
parents had to be notified about quite different medical 
procedures.   
Moreover, contrary to the majority’s assertion (maj. opn., 
ante, at p. 23), nothing in American Academy prohibits courts 
from considering relevant laws as “customs” and “practices” 
surrounding particular activities in determining whether a 
plaintiff has a reasonable expectation of privacy.  (Hill, supra, 
7 Cal.4th at p. 36.)  Indeed, our precedent endorses such an 
approach. 
In Lewis v. Superior Court (2017) 3 Cal.5th 561 (Lewis), 
we determined that patients retained a “less robust” expectation 
of privacy in their prescription records under the Controlled 
Substance Utilization Review and Evaluation System report, in 
part, because patients are on notice that their personal 
information may be shared under a different statute.  (Lewis, at 
p. 575, citing Civ. Code, § 1798.24, subd. (e).)  In International 
Federation of Professional & Technical Engineers, Local 21, 
AFL-CIO v. Superior Court (2007) 42 Cal.4th 319, we likewise 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
15 
held that public employees do not have a reasonable expectation 
of privacy in the amount of their salaries because the Attorney 
General has held the long-standing position that government 
payroll information was a matter of public record.  (Id. at 
pp. 331-332.)  Consistent with these decisions, because 
psychotherapists in California have long been required to report 
a patient’s disclosure that he knowingly “duplicate[d]” 
photographs or videos of child pornography, the patient cannot 
reasonably expect that disclosures of having knowingly 
“download[ed], stream[ed], [or] access[ed]” such images online 
will be kept confidential.  (§ 11165.1, subd. (c)(3).) 
For all of the foregoing reasons, it seems extremely 
doubtful that plaintiffs’ patients who disclose only having 
possessed or viewed child pornography can claim a reasonable 
expectation of privacy.  But we need not dwell on the possibility 
that a small contingent of these patients might have such an 
expectation, because as discussed below, plaintiffs must allege 
far more to proceed with their facial challenge.6 
                                        
6  
Although the preceding discussion addresses Hill’s second 
threshold element — a reasonable expectation of privacy in the 
circumstances  — it also undermines plaintiffs’ claim regarding 
Hill’s third threshold element — the invasion of privacy must be 
serious.  Given the strong likelihood that plaintiffs’ patients will 
disclose conduct that is reportable under the former version of 
CANRA, which plaintiffs do not challenge, to the extent the 2014 
amendment reaches any otherwise nonreportable conduct, any 
invasion of privacy would be minimal at best, not serious.  
 
The majority’s contrary conclusion, based largely on Long 
Beach City Employees Assn. v. City of Long Beach (1986) 
41 Cal.3d 937, 944, is misguided.  The majority reasons that the 
privacy invasion here is “severe” because reporting invades 
 
 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
16 
III.  BECAUSE A SIZABLE NUMBER OF PATIENTS LACK 
A REASONABLE EXPECTATION OF PRIVACY IN THEIR 
DISCLOSURES REGARDING CHILD PORNOGRAPHY, 
PLAINTIFFS’ FACIAL CHALLENGE FAILS 
As noted, plaintiffs challenge Assembly Bill 1775 to the 
extent it covers “psychotherapists who treat persons who have 
possessed or viewed child pornography but [in the therapists’ 
view] present no serious danger of hands-on sexual abuse or 
exploitation of children.”  (Maj. opn., ante, at p. 13.)  The 
majority acknowledges that plaintiffs’ claim and the relief that 
would follow “ ‘reach beyond the particular circumstances of 
these plaintiffs’ and ‘must therefore satisfy [the] standards for a 
facial challenge to the extent of that reach.’ ”  (Ibid., citing Doe 
v. Reed (2010) 561 U.S. 186, 194.)  Yet the majority fails to 
explain how plaintiffs have sustained this heavy burden. 
“The standard for a facial constitutional challenge to a 
statute is exacting.”  (Today’s Fresh Start, Inc. v. Los Angeles 
County Office of Education (2013) 57 Cal.4th 197, 218 (Today’s 
Fresh Start).)  The courts will presume a statute is valid unless 
                                        
“ ‘the mind’ ” and the patient’s “ ‘mental processes,’ ” which 
constitute “ ‘a quintessential zone of human privacy.’ ”  (Maj. 
opn., ante, at p. 33.)  But the amendment here at issue requires 
the reporting, not of mental processes, but of criminal conduct 
— downloading, streaming, or accessing child pornography by 
electronic means — that actually and directly inflicts harm on 
the child.  The reporting of that conduct reveals a patient’s 
mental process no more than does any other requirement that a 
specified act be reported.  Because this case involves the 
reporting of voluntary disclosures to treating professionals 
regarding criminal acts, it is nothing like Long Beach, which 
involved 
the 
mandatory 
administration 
of 
polygraph 
examinations 
to 
“compel[] 
communication 
of 
‘thoughts, 
sentiments, and emotions’ which the examinee may have chosen 
not to communicate.”  (Long Beach, at p. 944, italics added.) 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
17 
its “ ‘ “unconstitutionality clearly, positively, and unmistakably 
appears.” ’ ”  (In re Ricky H. (1970) 2 Cal.3d 513, 519.)  Plaintiffs 
making a facial challenge “ ‘ “cannot prevail by suggesting that 
in some future hypothetical situation constitutional problems 
may possibly arise as to the particular application of the 
statute.” ’ ”  (Tobe v. City of Santa Ana (1995) 9 Cal.4th 1069, 
1084; see also Zuckerman v. State Bd. of Chiropractic Examiners 
(2002) 29 Cal.4th 32, 38-39.)  “These formidable rules insulating 
a statute from facial attack are understandable in light of the 
severe remedy for a successful facial challenge. . . .”  (In re 
Marriage of Siller (1986) 187 Cal.App.3d 36, 48.)   
“Facial challenges are disfavored for several reasons.  
Claims of facial invalidity often rest on speculation.  As a 
consequence, they raise the risk of ‘premature interpretation of 
statutes on the basis of factually barebones records.’  [Citation.]  
Facial challenges also run contrary to the fundamental principle 
of judicial restraint that courts should neither ‘ “anticipate a 
question of constitutional law in advance of the necessity of 
deciding it” ’ nor ‘ “formulate a rule of constitutional law broader 
than is required by the precise facts to which it is to be applied.” ’  
[Citations.]  Finally, facial challenges threaten to short circuit 
the democratic process by preventing laws embodying the will 
of the people from being implemented in a manner consistent 
with the Constitution.  We must keep in mind that ‘ “[a] ruling 
of unconstitutionality frustrates the intent of the elected 
representatives of the people.” ’ ”  (Washington State Grange v. 
Washington State Republican Party (2008) 552 U.S. 442, 450-
451.) 
This court has not settled on a precise formulation of the 
applicable standard for facial challenges.  (See T-Mobile, supra, 
6 Cal.5th at p. 1117, fn. 6.)  But even under the least onerous 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
18 
phrasings of the test, plaintiffs must show that the 2014 
amendment will create constitutional concerns “in the 
generality or great majority of cases” involving patients who 
have admitted possessing or viewing child pornography but who 
(in the therapists’ estimation) present no serious danger of 
hands-on sexual abuse or exploitation of children.  (Ibid.; see 
Gerawan Farming, Inc. v. Agricultural Labor Relations Bd. 
(2017) 3 Cal.5th 1118, 1145-1146 [“[I]n order to succeed on a 
facial challenge, it is not enough to show that some hypothetical 
applications of the . . . statute might result in arbitrary or 
discriminatory treatment.  Instead, [a plaintiff] must show that 
the statute ‘inevitably pose[s] a present and total fatal conflict’ 
with equal protection principles [citation] or, at the least, that 
the statute violates equal protection ‘in the generality or great 
majority of cases’ ”]; Guardianship of Ann S. (2009) 45 Cal.4th 
1110, 1132 [courts may not invalidate a statute simply because 
“[t]here are imaginable scenarios” in which a constitutional 
problem may arise].)   
For many of the reasons stated ante, no such showing has 
been made here.  As noted, a psychotherapist must make a 
report under CANRA whenever he or she “has knowledge of . . . 
a child whom the mandated reporter knows or reasonably 
suspects has been the victim of child abuse or neglect.”  (§ 11166, 
subd. (a), italics added.)  A patient’s admission that he has 
knowingly possessed or viewed child pornography online will 
almost certainly cause a psychotherapist to suspect that the 
patient has duplicated such materials.  The majority does not 
dispute that downloading and streaming child pornography 
online involves making a duplicate of such content, nor that the 
only way to “possess” images accessed over the Internet is to 
download a copy of them.  Moreover, it is extremely unlikely that 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
19 
a patient will disclose simply possessing or viewing child 
pornography online, without also revealing other reportable 
conduct (i.e., downloading those images or videos to the patient’s 
computer).  Indeed, as discussed previously, plaintiffs’ 
complaint alleges that “ ‘many’ ” of their patients “ ‘have 
admitted downloading and viewing child pornography on the 
Internet.’ ”  (Maj. opn., ante, at p. 6, italics added.)  Thus, 
Assembly Bill 1775 does not create constitutional concerns “in 
the generality or great majority of cases” to which it applies (T-
Mobile, supra, 6 Cal.5th at p. 1117, fn. 6), even if plaintiffs’ facial 
challenge is properly viewed as concerning only those who have 
viewed or possessed child pornography through electronic or 
digital media.  (See, e.g., Kasler v. Lockyer (2000) 23 Cal.4th 472, 
502 [“While due process requirements might arguably prevent 
prosecution in a particular case . . . plaintiffs’ facial attack is 
inadequate because they have not demonstrated a deprivation 
of due process in the ‘vast majority’ [citation] or ‘ “generality” ’ 
[citation] of cases”].) 
The majority maintains that these facts are “conjecture” 
and not supported by evidence.  (Maj. opn., ante, at p. 31.)  But 
it need look no further than the factual allegations in plaintiffs’ 
complaint, which we must accept as true.  (Yvanova, supra, 
62 Cal.4th at p. 924.)  The complaint concedes that “ ‘many’ ” of 
plaintiffs’ patients “ ‘have admitted downloading and viewing 
child pornography on the Internet.’ ”  (Maj. opn., ante, at p. 6.)  
Giving the complaint a reasonable interpretation, as we must, 
it is obvious that “ ‘many’ ” of plaintiffs’ patients have disclosed 
not only viewing child pornography online, but also downloading 
such material.  (Ibid.)  Accordingly, those patients have no 
reasonable expectation of privacy, and, even on demurrer, 
plaintiffs’ facial challenge fails.   
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
20 
Moreover, 
other 
long-standing 
exceptions 
to 
the 
psychotherapist-patient privilege may well require reporting a 
patient 
who 
has 
simply 
“possessed 
or 
viewed” 
child 
pornography, even if the psychotherapist believes there is no 
“serious danger of hands-on sexual abuse.”  (Maj. opn., ante, at 
p. 13.)  The dangerous patient exception provides that there is 
no privilege if the patient is in such a mental or emotional 
condition as to be “dangerous” to himself or others.  (Evid. Code, 
§ 1024.)  It does not require the danger to be serious, nor limit it 
to hands-on abuse.  As a result, under Evidence Code section 
1024 a patient who presents some danger of hands-on abuse to 
a child victim would have no reasonable expectation of privacy 
in disclosing to a psychotherapist that he viewed or possessed 
child pornography online.  Similarly, given the severe harm that 
simple viewing causes to the child victim (Grant, supra, 
58 Cal.4th at p. 477; New York v. Ferber (1982) 458 U.S. 747, 
757 (Ferber)), a patient who presents no risk of “hands-on” abuse 
but displays a “hands-off” danger may also have no reasonable 
expectation in disclosing that he viewed child pornography 
online under the dangerous patient exception. 
The majority summarily concludes that the dangerous 
patient exception does not apply because “plaintiffs’ complaint 
makes clear that they do not believe the patients whose privacy 
is at issue pose ‘a serious danger’ . . . to themselves or to others.”  
(Maj. opn., ante, at p. 21, citation omitted.)  But the exception 
set forth in Evidence Code section 1024 is not limited to seriously 
dangerous patients, and plaintiffs have not alleged that their 
patients pose no danger.  In any event, plaintiffs’ complaint 
refers only to the dangers “ ‘of engaging in “hands-on” sexual 
abuse or exploitation of children or the distribution of child 
pornography to others.’ ”   (Maj. opn., ante, at pp. 6-7.)  It says 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
21 
nothing about the danger these patients pose in causing non-
“hands-on” harm by viewing the material.  As the majority 
elsewhere acknowledges, consumers of child pornography 
“perpetuate the victimization with every viewing.”  (Id. at p. 3.) 
An example illustrates the peril underlying the majority’s 
approach.  Imagine a patient discloses to his psychotherapist 
that he recently logged into a live-streaming platform to watch 
a man sexually assault a six-year-old boy.  The patient admits 
that he cheered and masturbated as he watched the boy be 
orally raped and violently penetrated.  (See Keller & Dance, 
Child Abusers Run Rampant as Tech Companies Look the Other 
Way, N.Y. Times (Nov. 9, 2019)  [as of 
Dec. 20, 2019].)  Under plaintiffs’ approach, such disclosure 
would be constitutionally protected, so long as, in the 
psychotherapist’s estimation, the man himself posed no 
“serious” danger of “hands-on” abuse.  Such a man is 
constitutionally entitled to have a psychotherapist keep his 
secret, plaintiffs reason — unless, of course, the man admits to 
copying a recording of the event (“duplicat[ing] . . . any . . . video” 
under former section 11165.1, subd. (c)(3)), in which case the 
constitutional balance is somehow different, and reporting must 
occur. 
IV.  PLAINTIFFS ARE UNLIKELY TO ESTABLISH ON 
REMAND THAT ASSEMBLY BILL 1775 DOES NOT 
SUBSTANTIVELY FURTHER ITS INTENDED PURPOSE 
In light of plaintiffs’ failure to establish a reasonable 
expectation of privacy under Hill for more than a trivial number 
of their patients, or to satisfy the “exacting” standards of a facial 
challenge to a statute (Today’s Fresh Start, supra, 57 Cal.4th at 
p. 218), the demurrers may be properly sustained on either of 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
22 
these grounds.  Even assuming, however, that plaintiffs have 
satisfied Hill’s three threshold elements for an invasion of 
privacy claim and successfully challenged Assembly Bill 1775 on 
its face, they have a difficult hill to climb on remand to 
demonstrate that the asserted privacy concern constitutes a 
violation of the state constitutional right to privacy.   
“Privacy concerns are not absolute; they must be balanced 
against other important interests.  [Citations.]  ‘[N]ot every act 
which has some impact on personal privacy invokes the 
protections of [our Constitution] . . . .  [A] court should not play 
the trump card of unconstitutionality to protect absolutely every 
assertion of individual privacy.’ ”  (Hill, supra, 7 Cal.4th at 
p. 37.) 
“A defendant may prevail in a state constitutional privacy 
case by negating any of the three elements [of an invasion of 
privacy claim] . . . or by pleading and proving, as an affirmative 
defense, that the invasion of privacy is justified because it 
substantively furthers one or more countervailing interests.”  
(Hill, supra, 7 Cal.4th at p. 40.)  “Invasion of a privacy interest 
is not a violation of the state constitutional right to privacy if 
the invasion is justified by a competing interest.  Legitimate 
interests derive from the legally authorized and socially 
beneficial activities of government and private entities.”  (Id. at 
p. 38.)  “Conduct alleged to be an invasion of privacy is to be 
evaluated based on the extent to which it furthers legitimate 
competing interests.”  (Ibid.) 
“Only obvious invasions of interests fundamental to 
personal autonomy must be supported by a compelling interest.”  
(Williams v. Superior Court (2017) 3 Cal.5th 531, 557.)  If a 
privacy interest is less central, or in bona fide dispute, courts 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
23 
conduct a general balancing test.  (Hill, supra, 7 Cal.4th at 
p. 34.)  Cases dealing with “freedom from involuntary 
sterilization or the freedom to pursue consensual familial 
relationships” are examples of such invasions.  (Hill, supra, 
7 Cal.4th at p. 34.)  In all cases but one, we have applied a 
general balancing test.  (See Lewis, supra, 3 Cal.5th at p. 573.)   
By remanding the matter for further proceedings, the 
majority acknowledges that “surviving demurrer is no 
assurance of success on the merits once evidence is developed 
and considered.”  (Maj. opn., ante, at p. 4.)  I agree.  Based on 
the demonstrated countervailing state interest in protecting 
children from the harm caused by sexual exploitation over the 
Internet and plaintiffs’ speculative contentions regarding 
whether the 2014 amendment furthers that interest, it is 
apparent that the state interest will almost certainly outweigh 
the alleged privacy invasion. 
As a preliminary matter, “[n]o one disputes that the 
principal purpose of the reporting requirement — preventing 
the sexual exploitation and abuse of children — is a weighty 
one.”  (Maj. opn., ante, at p. 37.)  In People v. Stritzinger (1983) 
34 Cal.3d 505 (Stritzinger), we made clear that the 
constitutionality of the child abuse reporting exception to the 
psychotherapist-patient privilege and the compelling state 
interest in protecting children were not in question.  
(Stritzinger, at p. 513.)  We recognized that a psychotherapist 
who reasonably suspects an incident of sexual abuse is “of 
course” required to report these suspicions under CANRA.  
(Stritzinger, at p. 513.)  Decisions of the high court have 
similarly held that the state’s interest in “ ‘ “safeguarding the 
physical 
and 
psychological well-being of a 
minor” 
is 
“compelling.” ’ ”  (Osborne, supra, 495 U.S. at p. 109; see Ferber, 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
24 
supra, 458 U.S. at p. 757 [“The prevention of sexual exploitation 
and abuse of children constitutes a government objective of 
surpassing importance”].)   
Moreover, this court has already laid bare plaintiffs’ 
conjecture that mandatory reporting of psychotherapist-patient 
communications will deter patients from seeking therapy.  Most 
recently in Regents of University of California v. Superior Court 
(2018) 4 Cal.5th 607, 632, we explained:  “To a large extent, . . . 
the conditions that might influence [patient] perceptions about 
confidentiality already exist. Psychotherapists’ duty to warn 
about patient threats is well established in California.  Indeed, 
despite fears that this duty would deter people from seeking 
treatment and irreparably damage the psychotherapist-patient 
relationship [citation], empirical studies have produced ‘no 
evidence thus far that patients have been discouraged from 
coming to therapy, or discouraged from speaking freely once 
there, for fear that their confidentiality will be breached.’ ”  
(Ibid.; see also People v. Wharton (1991) 53 Cal.3d 522, 558.)  
Similarly, in In re Lifschutz (1970) 2 Cal.3d 415 (Lifschutz), we 
rejected the petitioner’s claim that if the state could compel 
disclosure 
of 
some 
psychotherapeutic 
communications, 
psychotherapy could no longer be practiced successfully.  We 
observed “that the practice of psychotherapy has grown, indeed 
flourished, in an environment of non-absolute privilege,” and 
“psychotherapists certainly have been aware of the limitations 
of their recognized privilege for some time.”  (Id. at p. 426.)  In 
Tarasoff v. Regents of University of California (1976) 17 Cal.3d 
425, we observed that “it does not appear that our decision [in 
Lifschutz] 
in 
fact 
adversely 
affected 
the 
practice 
of 
psychotherapy in California.  Counsels’ forecast of harm in the 
present case strikes us as equally dubious.”  (Tarasoff, at p. 440, 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
25 
fn. 12.)7  And, as discussed above, arguments based on a 
hypothetical future harm are not cognizable in a facial 
challenge.  (T-Mobile, supra, 6 Cal.5th at p. 1125.)   
Furthermore, even though the task of identifying sexually 
exploited children online is challenging, it does not mean that 
Assembly Bill 1775 fails to advance its purpose, as plaintiffs 
assert.  In examining a similar federal statute, the Office of 
Legal Counsel determined that “[p]ornography may well involve 
‘a’ specific, potentially identifiable child even if neither covered 
professionals nor their patients know the child’s identity.  Even 
if covered professionals (or their patients) do not know the 
identity of any children depicted in pornography viewed by a 
patient, a report may lead authorities to specific, identifiable 
children.  While some child pornography may be the work of 
professionals and therefore difficult to link to specific 
identifiable children, other such images are homemade 
recordings, taken in domestic contexts, of sexually abusive acts 
‘committed against young neighbors or family members’ and 
                                        
7  
The 
majority’s 
characterization 
of 
Stritzinger 
as 
supporting plaintiffs’ argument that mandatory reporting 
deters psychotherapy patients from seeking treatment (maj. 
opn., ante, at p. 38) is not well taken.  In Stritzinger, the 
therapist contacted authorities and disclosed the details of 
alleged abuse as related to him by the victim.  (Stritzinger, 
supra, 34 Cal.3d at p. 509.)  The therapist later disclosed the 
details of his conversations with the defendant regarding the 
same abuse.  (Ibid.)  The defendant challenged CANRA’s 
reporting requirement only as applied to the second, redundant 
disclosure.  We did not question the propriety of an initial report 
of abuse under CANRA, despite concerns that even these reports 
could deter patients from therapy.  (Stritzinger, at pp. 512-514.) 
      
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
26 
therefore traceable through law enforcement investigation to a 
particular child or children.”  (Duty to Report Suspected Child 
Abuse Under 42 U.S.C. § 13031 (May 29, 2012) Office of Legal 
Counsel, pp. 12-13  
[as 
of 
Dec. 20, 2019].)  Indeed, we have recognized that “[o]ftentimes, 
reporting by third parties [under CANRA] is the only way the 
proper authorities become aware of an incident of child abuse.”  
(B.H. v. County of San Bernardino (2015) 62 Cal.4th 168, 190.)  
Therefore, plaintiffs’ claim — that the reporting statute does not 
actually serve its intended purpose because identifying children 
online is difficult — is unconvincing. 
In addition, by asserting that, on the record before us, we 
cannot “evaluate . . . whether the reporting requirement serves 
its intended purpose” (maj. opn., ante, at p. 38), the majority 
completely ignores the direct (albeit “hands-off”) harm caused 
by the viewing of child pornography over the Internet.  (Grant, 
supra, 58 Cal.4th at p. 477.)  Child pornography is not limited 
to hands-on abuse.  “ ‘[T]he “victimization” of the children . . . 
does not end when the pornographer’s camera is put away.  The 
consumer, or end recipient, of pornographic materials may be 
considered to be causing the children depicted in those materials 
to suffer as a result of his actions in at least three ways.  [¶]  
First, the simple fact that the images have been disseminated 
perpetuates the abuse initiated by the producer of the 
materials. . . .  The consumer who “merely” or “passively” 
receives or possesses child pornography directly contributes to 
this continuing victimization.  [¶]  Second, . . . [t]he recipient of 
child pornography obviously perpetuates the existence of the 
images received, and therefore the recipient may be considered 
to be invading the privacy of the children depicted, directly 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
27 
victimizing these children.  [¶]  Third, the consumer of child 
pornography instigates the original production of child 
pornography by providing an economic motive for creating and 
distributing the materials . . . .  The underlying point . . . is that 
there is no sense in distinguishing . . . between the producers 
and the consumers of child pornography.  Neither could exist 
without the other.’ ”  (Grant, supra, 58 Cal.4th at pp. 477-478, 
quoting U.S. v. Norris (5th Cir. 1998) 159 F.3d 926, 929-930 
(Norris).)   
As the Attorney General argues, the 2014 amendment to 
CANRA “reflects the accepted position that ‘every viewing of 
child pornography is a repetition of the victim’s abuse.’  
[Citation.]  Mandated reporting of such behavior helps 
authorities locate and confiscate these images and stop 
instances of this harmful conduct.”  Consequently, even were it 
true, as plaintiffs assert, that the new reporting requirement 
will not reduce hands-on abuse or facilitate the rescue of 
exploited children, “the State’s interest in protecting against the 
harms visited upon children when sexual images of them are 
downloaded, accessed, or streamed is alone sufficient to 
outweigh any asserted privacy interest.”  As the District 
Attorney similarly asserts, “Obviously, the reduction of persons 
who duplicate, print, exchange, download, access or stream child 
pornography, will reduce the ongoing sexual exploitation of 
children.”  That should be enough to establish that the 
amendment furthers the state’s compelling interest in 
protecting children and reducing abuse.  The majority’s contrary 
view depends, not on allegations in the complaint, but on the 
majority’s speculation that “the contribution . . . to the market 
for child pornography” of persons allegedly deterred by the 
reporting requirement from seeking treatment for their sexual 
MATHEWS v. BECERRA 
Cantil-Sakauye, C. J., dissenting 
28 
disorders “will continue unabated.”  (Maj. opn., ante, at p. 38.)  
Such judicial speculation should not be a basis for allowing 
plaintiffs to proceed with their constitutional attack on the 
statute. 
V.  CONCLUSION 
The children depicted in child pornography “are re-
victimized every time the content is accessed.”  (Bursztein et al., 
Rethinking the Detection of Child Sexual Abuse Imagery on the 
Internet (2019) p. 1   [as of Dec.  20, 2019].)  The consumer who 
possesses or views images of child pornography online “ ‘directly 
contributes to this continuing victimization.’ ”  (Grant, supra, 
58 Cal.4th at p. 477, quoting Norris, supra, 159 F.3d at p. 930.) 
The Legislature made a technical update to CANRA in 
order to help identify and rescue these child victims.  In light of 
the long-standing customs and practices surrounding the 
mandatory reporting of the consumption of child pornography, 
and given the formidable rules insulating a statute from a claim 
of facial constitutionality, plaintiffs have not alleged a 
constitutional violation of privacy.  I would so hold. 
 
 
CANTIL-SAKAUYE, C. J. 
 
We Concur: 
CHIN, J. 
CORRIGAN, J. 
 
 
See next page for addresses and telephone numbers for counsel who argued in Supreme Court. 
 
Name of Opinion  Mathews v. Becerra 
_______________________________________________________________________________ 
 
Unpublished Opinion 
Original Appeal 
Original Proceeding  
Review Granted  XXX 7 Cal.App.5th 334   
Rehearing Granted 
_______________________________________________________________________________ 
 
Opinion No. S240156 
Date Filed:  December 26, 2019 
_______________________________________________________________________________ 
 
Court:  Superior 
County:  Los Angeles 
Judge:  Michael L. Stern 
 
_______________________________________________________________________________ 
 
Counsel: 
 
Nelson Hardiman, Mark S. Hardiman and Salvatore Zimmitti for Plaintiffs and Appellants. 
 
Arnold & Porter Kaye Scholer, Trenton H. Norris and Oscar Ramallo for Scholars as Amicus 
Curiae on behalf of Plaintiffs and Appellants. 
 
Kamala D. Harris and Xavier Becerra, Attorneys General, Michael J. Mongan and Edward C. 
DuMont, State Solicitors General, Aimee Feinberg, Deputy State Solicitor General, Thomas S. 
Patterson and Douglas J. Woods, Assistant Attorneys General, Paul Stein, Marc A. LeForestier 
and S. Michele Inan, Deputy Attorneys General, Max Carter-Oberstone, Associate Deputy State 
Solicitor General, for Defendant and Respondent Xavier Becerra, as Attorney General. 
 
Hurrell Cantrall, Thomas C. Hurrell, Melinda Cantrall and Maria Z. Markova for Defendant and 
Respondent Jackie Lacey, as District Attorney. 
 
Cole Pedroza, Curtis A. Cole and Cassidy C. Davenport for California Medical Association, 
California Dental Association and California Hospital Association as Amici Curiae. 
 
 
 
 
 
 
 
 
 
 
 
 
Counsel who argued in Supreme Court (not intended for publication with opinion): 
 
Mark S. Hardiman 
Nelson Hardiman LLP 
1100 Glendon Avenue, 14th Floor 
Los Angeles, CA 90024 
(310) 203-2800 
 
Trenton H. Norris 
Arnold & Porter Kay Scholer LLP 
Three Embarcadero Center, 10th Floor 
San Francisco, CA 94111-4024 
(415) 471-3303 
 
Aimee Feinberg 
Deputy State Solicitor General  
1300 I Street, Suite 125 
Sacramento, CA 94244-2550 
(916) 445-9555