Supreme Court lifts state bans on ‘conversion therapy’ on free speech grounds
WASHINGTON — The Supreme Court ruled Tuesday that state laws forbidding “conversion therapy” for minors may violate the free speech rights of licensed counselors.
The 1st Amendment ruling is likely to undercut similar laws in California and 23 other states.
In an 8-1 decision, the justices said Colorado’s ban on “talk therapy” may prevent Christian counselors from helping teens work through their feelings about sexual attractions or their gender identity.
State lawmakers passed the new measures in response to healthcare professionals who said that efforts to change a teenager’s sexual orientation were both ineffective and harmful.
Kaley Chiles, a licensed counselor in Colorado Springs, sued and argued the state’s law violated her rights to free speech and the free exercise of religion.
She said she does not seek to “cure” young clients of same-sex attractions or to “change” their sexual orientation. Instead, she said she is guided by their goals.
“As a talk therapist, all Ms. Chiles does is speak with clients; she does not prescribe medication, use medical devices or employ any physical methods,” Justice Neil M. Gorsuch said for the court.
But she could run afoul of the state’s law because she said she may help some of her clients “reduce or eliminate unwanted sexual attractions or change sexual behaviors.”
If so, the law “censors speech based on viewpoint” and is therefore unconstitutional, he said.
“Colorado may regard its policy as essential to public health and safety. But the 1st Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech in this country,” Gorsuch wrote.
Justice Ketanji Brown Jackson dissented alone in a 35-page opinion. She said the issue was one of regulating medical practice.
“The 1st Amendment cares about government efforts to suppress ‘speech as speech’ (based on its expressive content), not laws, like [Colorado’s] that restrict speech incidentally, due to the government’s traditional, garden-variety regulation of such speakers’ professional conduct,” Jackson wrote. “States have traditionally regulated the provision of medical care through licensing schemes and malpractice regimes without constitutional incident.” she continued.
The Trevor Project, a crisis intervention organization for LGBTQ+ young people, condemned the ruling.
“The Supreme Court’s decision to treat the dangerous practice of conversion therapy as constitutionally protected speech is a tragic step backward for our country that will put young lives at risk. These efforts, no matter what proponents call them, no matter what any court says, are still proven to cause lasting psychological harm,” Chief Executive Jaymes Black said in a statement.
The conservative First Liberty Institute called the ruling a “great victory for religious liberty.”
“Americans should never have their professional speech censored simply because the government disfavors that speech,” said Kelly Shackelford, the group’s president.
The ruling is the third significant defeat for LGBTQ+ rights advocates in the last year.
The conservative majority upheld state laws that prohibit puberty blockers and other “gender affirming” care for minors. And last month, the justices said parents in California have a right to know about their child’s gender identity at school.
They said California’s student privacy policy violated parents’ rights, including the free exercise of religion.
The Alliance Defending Freedom appealed her case to the Supreme Court and described her as “a practicing Christian [who] believes that people flourish when they live consistently with God’s design.”
Her clients “seek her counsel precisely because they believe that their faith and their relationship with God establishes the foundation upon which to understand their identity and desires,” they said. “But Colorado bans these consensual conversations based on the viewpoints they express.”
The state law defines “conversion therapy” as “any practice or treatment by a licensee that attempts or purports to change an individual’s sexual orientation or gender identity, including efforts to … eliminate or reduce sexual or romantic attraction or feelings toward individuals of the same sex.”
Violators may be fined up to $5,000, but no one had been fined, the state says.
The challengers had lost in the lower courts.
A federal judge and the 10th Circuit Court of Appeals in Denver rejected the free speech claim. By a 2-1 vote, the appeals court said the state law was not a ban on free expression. Rather, it regulated the conduct of licensed medical professionals. States have the authority to regulate the practice of medicine.
In their appeal to the high court, lawyers for Chiles said the state was “censoring” voluntary conversations and forbidding speech on only one side of a controversy.
The Trump administration supported the 1st Amendment challenge because the state seeks “to suppress a disfavored viewpoint.”
In response, the state said its law “safeguards public health” by prohibiting “a discredited practice” that was shown to be harmful. It stressed the law regulates licensed professionals only and does not extend to religious ministers or others who provide private counseling to young people.
In 2012, California was the first state to ban licensed counselors from using conversion therapy for minors.
Then-Gov. Jerry Brown said these “change” therapies “have no basis in science or medicine and they will now be relegated to the dustbin of quackery.”
Equality California condemned the court’s ruling and said it “has weakened the ability of state licensing boards to intervene if clinicians use unproven, misleading, or coercive techniques.”
The group urged support for a pending bill in Sacramento that would “extend the statute of limitations for survivors to pursue civil claims against licensed mental health providers who subjected them to these harmful practices.”
Tuesday’s ruling was also criticized for undercutting state regulations of medical practice a year after taking the opposite view in a Tennessee case.
In June 2025, the court in a 6-3 decision upheld laws in Tennessee and 24 other red states that prohibit “gender affirming” puberty blockers and hormone treatments for minors.
The majority said then it was deferring to the state and their lawmakers who decided to prohibit such medical treatments for minors.
But in the Colorado case, the court majority did not defer to the state’s judgment that conversion therapy was harmful and potentially dangerous.
The decision is also the third victory for the Arizona-based Alliance Defending Freedom in its free speech challenges to Colorado laws. A maker of custom wedding cakes and the designer of websites won suits seeking an exemption from the state law that required them to provide equal service for same-sex weddings.
