The U.S. Supreme Court has just stepped into one of the fiercest battles over LGBTQ+ rights in the country: whether states can ban so‑called “conversion therapy” for minors.
The Legal Landscape Across the Country
For years, the fight over conversion therapy has played out in statehouses and city councils. As more LGBTQ+ people spoke publicly about harm from efforts to change their sexual orientation or gender identity, a wave of state laws began regulating the practice, especially for minors.
Starting in the early 2010s, a cluster of politically blue states and D.C. adopted laws that prohibited licensed mental health professionals from trying to change a minor’s sexual orientation or gender identity. Those early bans sometimes passed with Republican votes or even Republican governors’ signatures, but they were still concentrated in more LGBTQ‑supportive states. Others took narrower steps, such as labeling conversion therapy as unprofessional conduct for licensing purposes or cutting off public funding.
At the same time, many Republican‑leaning legislatures moved in the opposite direction and passed preemption laws to stop cities and counties from banning conversion therapy on their own. The result was a patchwork: some states with full statewide bans for minors, some with only partial limits, many with no statewide regulation at all, and a few that not only declined to regulate the practice but also blocked local governments from doing so.
Circuits Split Over First Amendment
Legal challenges emerged as soon as these laws went into effect. Most of them turned on a single question: when a state tells a licensed counselor what they may and may not say about sexuality or gender with a client, is that regulation of professional conduct or a restriction on free speech?
Therapists and patients who sued argued that the bans targeted speech based on its content and viewpoint. They pointed out that the laws tended to permit affirming counseling while prohibiting counseling aimed at reducing same sex attractions or helping a client live consistently with their sex assigned at birth. States responded that they were simply policing the standard of care, as they do with other unsafe or discredited health care treatments. In their view, any impact on speech was incidental to the regulation of medical and mental health practice.
As similar cases moved through the federal appeals courts, those competing frames produced a clear split. Some circuits upheld conversion‑therapy bans by treating them as regulations of professional conduct that only incidentally affected speech, and therefore did not trigger the highest level of First Amendment scrutiny. Other circuits focused on the fact that the “treatment” was often just talk between counselor and client, and that the laws drew lines based on which perspectives could be expressed. Those courts treated the bans as content based and viewpoint-discriminatory speech restrictions and either struck them down or subjected them to the strictest First Amendment review.
By the time Colorado’s law reached the courts, both state policies and the federal appeals courts were split. That divide set the stage for Chiles v. Salazar.
Colorado in the Spotlight
Let’s back up briefly to see what Colorado’s case was and how it got before SCOTUS. The Court had already passed on several similar challenges, and not because those earlier laws or plaintiffs were meaningfully different. What changed was timing and posture. Chiles reached the Court with a fully developed circuit split and a clean, speech‑only record that squarely posed the First Amendment question the justices had been avoiding for years.
Kaley Chiles’s case looked very familiar to anyone who had followed earlier conversion‑therapy lawsuits. She is a licensed mental health professional who offers only talk‑based counseling, not medication or physical interventions. Her minor clients seek the same kinds of help seen in prior cases. Some want support with relationships or stress around their existing identity; others want to reduce unwanted same sex attractions, change sexual behaviors, or live more closely in line with their sex assigned at birth and their religious beliefs.
Colorado’s law also mirrors the bans other circuits had already confronted. It applies only to licensed providers and to minors. It defines conversion therapy as any practice aimed at changing a minor’s sexual orientation or gender identity, including efforts to change behavior, gender expression, or romantic attraction. At the same time, it allows affirming or exploratory counseling, including support for identity development and gender transition, while singling out change‑oriented counseling for punishment.
Chiles’s experience reflects the same chilling effect that other counselors described. Before the statute, she says she discussed these issues with minors as she did with adults. If a religious client asked for help resisting certain attractions or living more in line with their faith, she tried to support that goal through conversation. After the law took effect, she began to self‑censor with minors, avoiding those topics because they could be seen as attempts to change orientation or gender identity and might lead to complaints or professional discipline.
The Chiles Lawsuit
In 2022, Chiles filed a federal lawsuit against the Colorado officials who oversee mental health licensing. She argued that, as applied to her speech‑only counseling with minors, the law violates the First Amendment because it targets her words based on content and viewpoint. Like plaintiffs in other circuits, she was not asking courts to protect coercive or physically aversive methods, but to decide whether the state can punish a licensed counselor for what they say in voluntary talk‑therapy sessions with minors when the treatment is nothing but words.
The lower courts handled Chiles’s case the way some other courts had. They treated Colorado’s law as a regulation of professional conduct that only incidentally affected speech and refused to issue a preliminary injunction. In 2024, the Supreme Court agreed to hear Chiles because those familiar facts arose just as the federal appeals courts were sharply divided over whether such laws regulate professional conduct or instead impose viewpoint‑based limits on speech.
SCOTUS Draws a New Line
The Court used Chiles’s case to make clear that conversion‑therapy bans like Colorado’s are speech restrictions (not just professional‑conduct rules) and that singling out certain counseling goals or viewpoints for punishment triggers the highest level of First Amendment scrutiny. In doing so, the Court rejected the professional‑conduct framework that several courts of appeals had used to uphold similar laws and sided with the circuits that treated these bans as content‑ and viewpoint‑based limits on speech.
You might have expected this case to divide along partisan lines, but the justices instead produced a broad, cross‑ideological majority with only a single dissent (Justice Jackson). Writing for the majority in the 8-1 decision, Justice Gorsuch emphasized that Colorado’s law allowed counselors to encourage minors to affirm or explore LGBTQ+ identities while forbidding counseling aimed at reducing same‑sex attraction or helping clients live in line with their sex assigned at birth. In the Court’s view, that asymmetry was not a neutral standard‑of‑care rule, but a content‑based and ultimately viewpoint‑based line about which ideas on sexuality and gender could be discussed in a licensed setting.
Once the law was characterized as a content‑ and viewpoint‑based restriction on speech, the majority applied strict scrutiny and concluded Colorado could not justify its rule. The state pointed to professional consensus opposing conversion therapy and to reports of harm, but the Court said those interests, while weighty, did not permit the government to ban a particular side of an ongoing moral and religious debate in the therapist’s office.
Concurrence and Dissent
Justice Kagan, joined by Justice Sotomayor, wrote separately to narrow the decision’s reach. Her concurrence stressed that Colorado’s statute was unusual because it so clearly favored one set of counseling goals over another, and she emphasized that the ruling should not be read to upend more neutral health‑and‑safety regulations for licensed professionals.
Justice Jackson, in dissent, rejected the majority’s speech‑centered framing of the case. She treated Colorado’s law as a permissible effort to bar a harmful treatment for minors, warned that the Court’s approach risks constitutionalizing professional standards of care, and argued that the Constitution does not require states to leave young patients exposed to practices their own medical experts have discredited.
What the Decision Means for the Country
The SCOTUS decision therefore reversed the lower courts and barred Colorado from enforcing its law against speech‑only counseling like Chiles’. At the same time, the majority described its ruling in relatively narrow terms. It focused on voluntary talk therapy with minors, on a statute that explicitly favored one counseling goal over another, and on professional discipline tied directly to the content of a therapist’s words. That framing left open how far the ruling reaches beyond conversion‑therapy bans to other regulations of professional advice.
So what happens to all those earlier conversion‑therapy cases in the other federal appeals courts, outside Colorado? Formally, the decisions that upheld similar bans in those circuits are still on the books; the Supreme Court did not vacate or remand them, so they remain published and citable as precedent. In practice, though, the parts of those opinions that downplayed speech and treated these bans as ordinary professional‑conduct rules have effectively been wiped out by Chiles.
Going forward, when new challenges reach those same courts, panels will be bound to apply the Supreme Court’s rule that speech‑only conversion‑therapy bans are content‑ and viewpoint‑based restrictions subject to strict scrutiny. In practical terms, that means judges will have to set aside any older reasoning that pointed in the opposite direction. The harder question, now, is how lawmakers, regulators, and therapists choose to navigate a landscape where the fights over conversion therapy increasingly turn on what happens inside the counseling room.
Related Resources
- LGBTQ+ Legal Resource Hub
- History of State Same-Sex Marriage Laws: A Look Back (FindLaw’s Learn About the Law)
- Discrimination Against LGBTQ+ Students (FindLaw’s Learn About the Law)
