Supreme Court to Hear ‘Conversion Therapy’ Ban Case: Free Speech vs. Patient Harm?

The Supreme Court is set to hear arguments on October 7, 2025, in Chiles v. Salazar, a case that could significantly impact the legality of “conversion therapy” bans across the nation. This legal battle pits the First Amendment right to free speech against the state’s interest in protecting minors from harmful practices. At the heart of the matter is Colorado’s ban on conversion therapy for minors, a law challenged by a licensed counselor who argues it violates her right to free speech. But with studies estimating that conversion therapy and its associated harms cost the U.S. an estimated $9.23 billion annually, is this really about free speech?

What is Conversion Therapy?

Conversion therapy, also known as sexual orientation change efforts (SOCE) or gender identity change efforts (GICE), refers to a range of dangerous and discredited practices aimed at changing a person’s sexual orientation or gender identity. These practices are based on the harmful and incorrect assumptions that homosexuality and transgenderism are mental disorders or sinful and that individuals can and must change these behaviors.

These “therapies” encompass interventions aimed at altering an individual’s same-sex attraction, gender identity, and/or gender nonconforming expression in order to promote heterosexuality or a gender expression/identity aligning with sex anatomy. Historically, these interventions have included talk therapy, aversive conditioning (such as electric shocks or induced nausea and vomiting), and other cognitive or behavioral therapy methods, such as hypnosis and biofeedback.

The Legal Landscape

Colorado’s Minor Conversion Therapy Law, passed in 2019, prohibits mental health professionals from providing conversion therapy to clients under the age of 18. The law does not apply to individuals “engaged in the practice of religious ministry.” Twenty-three other states and the District of Columbia have similar bans in place.

Kaley Chiles, a counselor in Colorado Springs, is challenging the law, arguing that it violates her First Amendment rights. Chiles claims she doesn’t try to “convert” her clients but helps them with their “stated desires and objectives in counseling,” which may include reducing unwanted sexual attractions or changing sexual behaviors.

The central legal question is whether talk therapy aimed at changing a minor’s sexual orientation or gender identity is protected by the First Amendment’s guarantee of free speech. Chiles contends that talk therapy is protected speech and that Colorado is impermissibly regulating the content of her potential speech. The law permits her to help minor clients embrace their sexual orientation or gender identity through talk therapy but not to change it.

Colorado, however, insists that the statute regulates medical conduct, which is not protected by the First Amendment, even if there is an incidental burden on speech. The state argues that it can regulate medical activity, such as prescribing medicine and that the conversion therapy ban is part of a broader statute, the Mental Health Practice Act, which prohibits acts that could harm patients.

Free Speech vs. Patient Harm: The Core Arguments

Arguments for Upholding the Ban (Patient Harm):

Protection of Minors: The state has a compelling interest in protecting minors from ineffective and harmful healthcare practices.
Medical Consensus: Major medical organizations, such as the American Psychological Association and the American Medical Association, have concluded that conversion therapy is harmful and ineffective.
Regulation of Conduct: The ban regulates conduct (treatment by a licensed professional) that incidentally involves speech, not speech itself.
High Standard of Care: Patients expect licensed professionals to provide a high standard of care, and the First Amendment has never barred states from prohibiting substandard care.

Arguments Against the Ban (Free Speech):

Censorship of Private Speech: The government cannot censor private speech between an individual and their chosen counselor.
Viewpoint Discrimination: The state is outlawing speech based on its preferred ideology.
Overly Broad Restrictions: The ban restricts a counselor’s ability to help clients achieve their desired goals, even if those goals involve reducing unwanted sexual attractions or changing sexual behaviors.
Lack of Narrow Tailoring: The law is not narrowly tailored because it only applies to licensed mental health professionals and minors, leaving gaps that expose minors to the alleged harms of conversion therapy from other sources.

The Broader Implications

The Supreme Court’s decision in Chiles v. Salazar could have far-reaching consequences:

Legality of Conversion Therapy Bans: The ruling could determine the legality of conversion therapy bans in the 23 states and the District of Columbia that have them.
First Amendment Rights of Therapists: The case could clarify the extent to which the First Amendment protects the speech of licensed professionals.
State Regulation of Medical Treatment: The decision could impact the ability of states to regulate medical treatments within their borders.

If the Court concludes that talk therapy is protected speech, it is likely to find the Colorado ban unconstitutional. Such a decision would contrast sharply with the Court’s 2023 decision in United States v. Skrmetti, which upheld state laws banning gender-affirming care for transgender minors.

Conversely, if the Court upholds the Colorado law, it would reaffirm the state’s authority to regulate healthcare practices to protect minors from harm.

The Harmful Effects of Conversion Therapy

Conversion therapy lacks scientific validity and frequently causes significant long-term psychological harm. Studies have shown that individuals who undergo conversion therapy are more likely to experience:

Depression
Anxiety
Substance abuse
Suicidal thoughts and attempts
Post-traumatic stress disorder (PTSD)
Social isolation
Decreased capacity for intimacy
Shame, self-hatred, and hopelessness

The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health found that 13% of LGBTQ youth reported being subjected to conversion therapy, with 83% reporting it occurred when they were under age 18. Furthermore, a peer-reviewed study by The Trevor Project’s researchers found that LGBTQ youth who underwent conversion therapy were more than twice as likely to report having attempted suicide and more than 2.5 times as likely to report multiple suicide attempts in the past year.

The Role of Medical and Mental Health Organizations

Major medical and mental health organizations, including the American Psychiatric Association, the American Psychological Association, and the American Academy of Pediatrics, have condemned conversion therapy as ineffective and harmful. These organizations support gender-affirming practices that help sexual minorities cope with the impact of stress and stigma.

The Financial Costs of Conversion Therapy

A 2022 study published in JAMA Pediatrics found that the practice of conversion therapy on LGBTQ youth and its associated harms costs the United States an estimated $9.23 billion annually. This includes direct costs of conversion therapy (estimated at $650 million annually) and indirect costs associated with substance abuse and negative mental health outcomes, including depression, anxiety, and suicide attempts (estimated at $8.58 billion annually).

States That Ban Conversion Therapy

As of October 2025, 27 states and the District of Columbia have instituted bans on conversion therapy.

The Bottom Line

The Supreme Court’s decision in Chiles v. Salazar will have a profound impact on the lives of LGBTQ+ youth and the legal landscape surrounding conversion therapy. The Court must carefully weigh the First Amendment rights of therapists against the state’s compelling interest in protecting minors from harmful and ineffective practices. The evidence overwhelmingly demonstrates that conversion therapy is a dangerous and discredited practice that has no place in modern healthcare.

Disclaimer: This blog post is for informational purposes only and does not constitute legal advice. If you have been harmed by conversion therapy, it is important to seek legal counsel from a qualified attorney.