Proposed Spousal Exemption Regulatory Change

The College of Massage Therapists of Ontario (CMTO) is planning to submit a proposal to the Government of Ontario for a spousal exemption, a regulatory change to the Massage Therapy Act, 1991, that would allow Registered Massage Therapists/Massage Therapists (RMTs/MTs) to treat their spouse without it automatically being considered sexual abuse. Please note that this change has not yet been made, and until it is, treating a spouse will continue to be considered sexual abuse.

Note: An RMTs’/MT’s treatment of a patient involves providing Massage Therapy, and a combination of actions including charging or receiving payment from them, contributing to their health record, and receiving consent to providing them a healthcare service. It also includes developing a treatment plan containing information such as treatment goals; a focused area of the body they plan to treat and the planned frequency and length of the treatment.

Spousal Exemption

The Regulated Health Professions Act, 1991 (RHPA), defines “sexual abuse of a patient” as sexual conduct between a patient and a health professional. The RHPA‘s zero-tolerance approach means a registrant cannot treat a patient with whom they have a sexual relationship. This means that if an RMT’s/MT’s patient is their spouse, it is considered sexual abuse. Under the RHPA, a spouse is:

1. a person to whom the member is married; or
2. a person who has lived with the member in a conjugal relationship continuously for at least three years.

In 2013, the Ontario government amended the RHPA to give each regulated health professional college the authority to apply for a regulatory change allowing registrants to treat spouses. Amending the regulation would exempt such treatment from the sexual abuse provision of the RHPA. Nine regulated health professional regulators currently have a spousal exemption in place.

Additional Information

• Obtaining a spousal exemption does not mean that CMTO will encourage RMTs/MTs to treat their spouses on an ongoing basis. However, it would mean that if an RMT/MT were to treat their spouse, it would not automatically be considered sexual abuse.
• This does not mean an RMT/MT can enter a sexual relationship with a patient. The order is clear: an RMT/MT must become someone’s spouse (meeting the RHPA definition of marriage or three years of conjugal cohabitation) first, and only then can they treat them. An RMT/MT cannot begin a relationship with an existing patient even if a spousal exemption is in place.
• All Standards of Practice still apply to an RMT/MT when treating their spouse. The fact that treatment is no longer automatically classified as sexual abuse does not exempt an RMT/MT from their professional obligations. RMTs/MTs must still obtain consent, keep proper records, avoid conflicts of interest, and adhere to all of CMTO’s Standards of Practice.
• A spousal exemption will help CMTO focus its resources on cases of sexual abuse of patients.

Proposed Spousal Exemption Regulation under the Massage Therapy Act, 1991

“Conduct, behaviours or remarks that would otherwise constitute sexual abuse of a patient by a member under the definition of “sexual abuse” in subsection 1(3) of the Health Professional Procedural Code of the Regulated Health Professions Act, 1991, shall not constitute sexual abuse, if

1. The patient is the member’s spouse; and
2. The member is not engaged in the practice of the profession at the time the conduct, behaviour or remarks occur.”

You are invited to provide feedback via the Survey about CMTO’s proposal to seek a spousal exemption. You may also join the discussion by submitting your comments on our discussion board below. The deadline to submit your feedback is July 10, 2026 at 5 p.m. If you have any questions, please contact us at feedback@cmto.com.

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