The U.S. Supreme Court ruled 8-1 that Colorado’s ban on conversion therapy for minors violates the free speech rights of a licensed Christian counselor, weakening a state effort to regulate a practice that medical authorities widely describe as harmful and ineffective. The ruling in Chiles v. Salazar allows a constitutional challenge to proceed against a law designed to protect LGBTQ youth from a discredited therapeutic approach condemned by leading health organizations and human rights bodies.
Colorado’s law prohibited licensed therapists from attempting to change a minor’s sexual orientation or gender identity through conversion therapy. The policy applied to licensed mental health providers and did not restrict religious institutions or family members. State officials defended the law as a public health measure intended to protect minors from harmful mental health practices.
Conversion therapy has been rejected by the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics. Research cited in the provided materials indicates that the practice is ineffective and can cause serious psychological harm, including increased suicide risk among individuals subjected to it. The United Nations has deemed conversion therapy torture and recommended it be banned.
The case was brought by Kaley Chiles, a Christian counselor who argued that Colorado’s law improperly regulated speech rather than medical conduct. Chiles said she provides only talk therapy and does not use physical interventions or prescribe medication. The Supreme Court accepted this framing, concluding that the law restricts speech based on viewpoint rather than regulating professional conduct.
Justice Neil Gorsuch, writing for the majority, stated that the First Amendment limits the government’s authority to regulate speech even in professional settings.
“Colorado may regard its policy as essential to public health and safety. Certainly, censorious governments throughout history have believed the same,” Gorsuch wrote. “But the First Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech in this country. It reflects instead a judgment that every American possesses an inalienable right to think and speak freely, and a faith in the free marketplace of ideas as the best means for discovering truth.”
The Court determined that Colorado’s law “does not just ban physical interventions,” and instead “censors speech based on viewpoint.” According to the majority, the constitutional protection for free expression applies equally to licensed professionals as it does to other Americans.
After the ruling, Chiles said the decision expands choices available to families seeking counseling aligned with their beliefs.
“I hope this win for free speech will fuel a greater pursuit of truth,” Chiles told reporters after the ruling. “Because of today’s ruling, families will have more options and states won’t be able to shut those options down.”
Colorado Attorney General Phil Weiser, who defended the law in court, described the outcome as harmful to families seeking evidence-based care.
Weiser said the ruling was a “setback for Colorado’s efforts to protect children and families from harmful and discredited mental health practices.”
Advocacy organizations expressed concern that the ruling could expose more LGBTQ youth to treatments that medical organizations have long warned against. Human Rights Campaign President Kelley Robinson criticized the Court’s decision.
“Today’s reckless decision means more American kids will suffer,” Robinson said. “The Court has weaponized free-speech in order to prioritize anti-LGBTQ+ bias over the safety, health and well-being of children.”
Although the ruling represents a legal victory for the therapist who challenged the law, legal experts note that it does not invalidate all state restrictions on conversion therapy. Twenty-three states and Washington, D.C., currently maintain laws restricting conversion therapy for minors. The Court did not strike down those statutes.
Shannon Minter, legal director of the National Center for LGBTQ Rights, said the decision removes one regulatory strategy but leaves others intact.
“This decision is narrowly about how conversion therapy can be regulated. It does not mean that conversion therapy is safe or legal. Conversion therapy is still medical malpractice and consumer fraud,” Minter said. “Every major medical organization in this country condemns it. Survivors can still bring malpractice and consumer fraud claims.”
Justice Ketanji Brown Jackson was the sole dissenter. She argued that the majority did not adequately consider the role of licensed professionals and the authority of states to regulate medical care.
“Chiles is not speaking in the ether; she is providing therapy to minors as a licensed healthcare professional,” Jackson wrote.
Jackson emphasized that neither party disputed Colorado’s authority to regulate healthcare providers. She warned that treating therapeutic communication as fully protected speech could undermine longstanding regulatory frameworks designed to protect patients.
“So, in my view, it cannot also be the case that Colorado’s decision to restrict a dangerous therapy modality that, incidentally, involves provider speech is presumptively unconstitutional,” Jackson wrote. “In concluding otherwise, the Court’s opinion misreads our precedents, is unprincipled and unworkable and will eventually prove untenable for those who rely upon the long-recognized responsibility of states to regulate the medical profession for the protection of public health.”
She also warned that the decision could weaken other forms of medical regulation involving speech, including informed consent requirements.
“The fallout could be catastrophic,” Jackson wrote.
Justice Elena Kagan wrote separately, agreeing that the Colorado law implicated free speech concerns but noting that constitutional questions could also arise if states attempted to restrict therapy that affirms gender identity.
“Once again, because the state has suppressed one side of a debate, while aiding the other, the constitutional issue is straightforward,” Kagan wrote.
Polly Crozier, director of family advocacy at GLAD Law, said the ruling does not eliminate legal consequences for providers whose practices harm patients.
“The stories of conversion therapy survivors are filled with heartbreaking examples of shattered family connections and separation from faith communities that once sustained them,” Crozier said.
The Supreme Court currently holds a 6-3 conservative majority that has frequently ruled in favor of religious free speech claims when they conflict with anti-discrimination laws protecting LGBTQ people. The ruling follows a 2018 decision in which the Court sided with anti-abortion pregnancy centers challenging a California law requiring them to inform clients about abortion services.
The Court has also issued landmark decisions expanding LGBTQ rights, including the legalization of same-sex marriage in 2015 and a 2020 ruling holding that federal employment discrimination law applies to gay and transgender workers. At the same time, recent cases have shown increasing judicial willingness to prioritize religious expression and free speech claims when they intersect with protections for LGBTQ individuals.
Chiles v. Salazar is the first of three major LGBTQ-related cases before the Court this term. Two additional cases involving transgender athletes were argued earlier this year.
While the ruling does not declare conversion therapy safe or effective, it removes one of the primary legal mechanisms states have used to restrict the practice. Legal experts say states may continue regulating conversion therapy through malpractice law, consumer protection statutes, and professional licensing oversight.
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