Eighty-one state psychiatric hospitals in 16 states were surveyed about whether they had policies on sex between inpatients. Thirty-one hospitals responded by sending a copy of their policies, which were analyzed for explicit definitions and distinctions between various sexual behaviors; for the presence and content of statements about patients' rights and personal autonomy, duty to protect, competency to consent, and staff guidance and education; and for instructions on the management of sexual incidents. Fourteen of the 31 policies explicitly forbade inpatient sex; 12 stressed patient autonomy. Only five specified that staff should receive special training. The results indicate that hospitals vary widely in their attention and management approach to inpatients' sexual behavior.