Mathews v. Becerra ( 2019 )


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  •         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.
    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
    1
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    “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.
    2
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    (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,
    3
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    4
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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,”
    5
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    6
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    7
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    8
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    9
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    10
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    11
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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)
    12
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    
    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.)
    13
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    14
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    15
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    16
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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.)
    17
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    18
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    19
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    20
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    21
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    22
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    23
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    24
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    25
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    26
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    27
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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.)
    28
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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.
    29
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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);
    30
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    31
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    32
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    33
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    34
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    35
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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.
    36
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    37
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    38
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    39
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    40
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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,
    41
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    42
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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
    43
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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,
    44
    MATHEWS v. BECERRA
    Opinion of the Court by Liu, J.
    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.
    45
    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
    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
    2
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    3
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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,
    4
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    5
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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.)
    6
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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”].)
    7
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    8
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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,
    9
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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.,
    10
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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.
    11
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    12
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    “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
    13
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    14
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    15
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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) 5
    7 Cal. 4th 1
    97, 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.)
    16
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    17
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    18
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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.
    19
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    20
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    21
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    22
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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,
    23
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., 
    dissenting 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,
    24
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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.)
    25
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    26
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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
    27
    MATHEWS v. BECERRA
    Cantil-Sakauye, C. J., dissenting
    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.
    28
    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