Sex, Psychiatry, and the Mental Health Implications of the Epstein Files
Key Takeaways
- Ethical prohibitions against psychiatrist–patient sexual relationships reduced misconduct, yet outcomes remain unpredictably harmful and demand continued vigilance against rationalizations and boundary drift.
- Power disparity is central to understanding exploitation, including coercion, manipulation of victims’ credibility via psychiatric labeling, and network effects linking perpetrators to an enabling social ecosystem.
Psychiatry confronts Epstein’s legacy, urging ethical accountability, prevention, and resources to address power abuse, sex trafficking, and women’s trauma worldwide.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
I suppose that the implications of the voluminous Epstein files were eventually going to connect with psychiatry. It, along with the prominent men involved, has entered about every other profession and walks of life, lately including a classical symphony board and summer music camp. Closer to psychiatry, a wellness expert has recently been questioned and a psychiatrist close to Epstein was sued by an Epstein victim.1,2
From what I can tell, it seems that institutional psychiatry has been silent about the whole affair once it went public. This column did cover “The Epstein Files, the Abuse of Women, and Psychiatry” on November 25, 2025, but that now needs an update and expansion.
Perhaps psychiatry has been silent about the Epstein files because of the so-called “Goldwater Rule.” However, this ethical principle does not apply to the deceased.
Once upon a time, psychiatry was thought to be a field that opened up more public discussion about sex. After all, sexual desire was one of the key aspects of Freudian theory. Psychiatry also grappled with its own ethics about sex with patients, mainly by male psychiatrists and female patients, in 1973 finally establishing an ethical prohibition.3 That accountability and prohibition apparently decreased inappropriate sexual interaction.4 Although there has always been some known exceptions to the anticipated harm of psychiatrist and patient intimate relationships,5 it is very difficult to predict which of such relationships will at times be more beneficial than the usual harms of ensuing shame, guilt, and trauma.
If one also considers the psychiatric aspects of the Epstein files, they seem to go well beyond the sexual desires and implications. As there is in psychiatric treatment, there is the power variable in the disparity of the abusers and victims. The victims, young women and very young girls, have been blamed at times, including inappropriately being accused of having mental disturbances. There is the apparent cultish establishment of connection between both the victims and other perpetrators with Epstein and his accomplice Ghislaine Maxwell. She is now in jail and he apparently died from suicide in 2019. There is the vicarious interest of the public and journalists in the Epstein operation and its extent. Then there is the question of what may still be learned, including what was redacted and why. Courageous associations of women victims have been crucial to even get us this far in the revelations.
Along with this ethical accountability, perhaps psychiatry’s turn to more of an emphasis on the “bio-bio-bio” and psychopharmacology has decreased the challenges and temptations of intimate relationships with patients as compared with when depth psychotherapy was more common. Maybe that shift in focus had something to do with our silence, but silence is complicity. The same ethical accountability is likely necessary for society in its processing of the Epstein files. As the role of men in society is changing, it is also crucial for a different message about the need for power and sexual expectations change in raising male children.
The sexism and abuse of women do not stop with the Epstein operation. It seems to be connected to wider worldwide operations against women and girls, according to the recent report of the United Nations Human Rights Office.6 The experts, though bereft of mental health expert representation, suggest that global sex trafficking operations meet the legal threshold of crimes against humanity.
Although the role of women in sports has improved, as my column yesterday on women athletes in the Winter Olympics conveys, even the American women’s hockey team that also won a gold overtime game received much less positive attention and congratulations from our government. Reproductive rights are another societal area where women are constrained and controlled.7
Given the widespread presence of gender discrimination, abuse, and trauma, it is no wonder that the prevalence of so many mental disorders, including posttraumatic stress disorder, remain much higher among women than men.8 Yes, there have been advances for feminism and women rights in many societies, but sexism is one of those social psychopathologies that still needs much more psychiatric attention, as I have recommended in these columns. Our responsibilities here include paying more attention to prevention, public education, and adequate clinical resources for women worldwide. The time to do so is now.
Dr Moffic is an award-winning psychiatrist who specializes in the social, cultural, ethical, spiritual, and religious aspects of psychiatry, and since 2012 is in retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekdays column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He has been an advocate and activist for mental health issues related to climate instability, physical burnout, and xenophobia, among other social justice causes, serving on many related local and national community and professional Boards. He serves on the Editorial Board of Psychiatric Times.
References
1. Khan M. Deepak Chopra acknowledges ‘poor judgment over emails with Epstein. USA Today. February 23, 2026. Accessed February 24, 2026.
2. Mangan D. Jeffrey Epstein victim sues psychiatrist Henry Jarecki, alleging rape and sex trafficking. NBC News. June 3, 2024. Accessed February 24, 2026.
3. The Principles of Medical Ethics (with Annotations Especially Applicable to Psychiatry. American Psychiatric Association; 2013.
4. Dike C.
5. Gulrajani C.
6. Flawed ‘Epstein Files’ disclosures undermine Accountability for grave crimes against women and girls: UN experts. United Nations Human Rights Office. February 16, 2026. Accessed February 24, 2026.
7. Scotland NL.
8. Yang Y, Fang F, Arnberg FK, et al.
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