Are Conversion Therapy Bans Constitutional? LGBTQ+ Rights and SCOTUS Ruling

In Chiles v. Salazar (2026), the U.S. Supreme Court ruled that Colorado could not enforce its ban on conversion therapy as applied to a counselor whose practice involves providing only talk therapy to minors.

The ruling requires the lower court to reconsider Colorado’s ban on conversion therapy under a more rigorous standard of First Amendment scrutiny. The decision will likely cause other states with similar bans to reevaluate how they regulate what licensed professionals say.

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What Is Conversion Therapy?

Conversion therapy is a method of treatment that attempts to change a person’s sexual orientation or gender identity.

The scientific and medical community has largely rejected conversion therapy, and the Substance Abuse and Mental Health Administration (SAMHSA) has reported no peer-reviewed research showing any benefits to gender-minority youth.

Medical professionals, including every major medical and mental health association in the United States, including the American Psychiatric Association, the American Psychological Association, and the American Medical Association, have condemned these practices. In fact, survivors and researchers have reported serious harm from the method, including lifelong emotional scars.

Although harsh forms of conversion therapy, such as painful physical interventions, have largely fallen out of favor, the most common form at issue today is talk therapy. It seeks to reduce or eliminate same-sex attraction or discourage a person from identifying as transgender.

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Colorado’s Law Banning Conversion Therapy

The Colorado ban on conversion therapy originates from its Minor Conversion Therapy Law (MCTL), passed in 2019. It defines conversion therapy broadly to include any attempt, including through speech, to change a minor’s sexual orientation, gender identity, gender expression, or to reduce same-sex attraction.

The MCTL prohibits mental health professionals from engaging in conversion therapy with clients under the age of 18. While many members of the LGBTQ+ community, LGBTQ+ rights supporters, and mental health proponents saw the law as a step in the right direction, others were not in favor of the law.

Chiles v. Salazar: Case Background

Kaley Chiles is a licensed counselor in Colorado who practices talk therapy. Her goal was to help clients reach their stated objectives, whether to accept their identity or to reduce unwanted attractions.

Alliance Defending Freedom, representing Chiles, argued that Colorado’s MCTL infringed on her constitutional rights. Chiles asserted that it interfered with her ability to treat clients with same-sex attractions or gender identity confusion who wanted help pursuing their own stated goals related to sexual orientation or gender identity.

The courts disagreed with Chiles. A federal district court denied her motion for a preliminary injunction to enjoin enforcement of the MCTL. She subsequently appealed, but the Tenth Circuit Court of Appeals affirmed the district court’s decision. The Tenth Circuit found that the MCTL only involves speech incidentally. Chiles appealed to the Supreme Court, which agreed to hear her case.

The Supreme Court’s Ruling in Chiles v. Salazar

In an 8-1 decision, the justices sided with Chiles. Justice Neil Gorsuch wrote the majority opinion. Justice Elena Kagan, joined by Justice Sonia Sotomayor, wrote a concurrence, and Justice Ketanji Brown Jackson dissented.

The Court ruled that Colorado’s conversion therapy law, as applied to Chiles’s talk therapy, regulated speech based on viewpoint and therefore required more rigorous First Amendment scrutiny. The Court reversed and remanded the case to the lower court for further legal proceedings under the proper First Amendment standard of review.

Viewpoint Discrimination

The Court reasoned that, as applied to Chiles’s talk therapy, Colorado’s law censors speech based on viewpoint. The law allowed a therapist to affirm a client’s identity but forbade speech aimed at changing it. The Court found that this distinction was a form of speech regulation that the First Amendment protects against.

When a regulation is considered viewpoint discrimination, it triggers strict scrutiny, a demanding test that state regulations rarely satisfy. It requires the law to be narrowly tailored to serve a governmental interest.

The Court rejected Colorado’s contention that calling therapy “professional conduct” or a “therapeutic modality” changed the analysis. The Court found that licensed therapists enjoy the same free-speech rights as everyone else.

Justice Elena Kagan, joined by Justice Sonia Sotomayor, agreed with the outcome but wrote separately to flag a narrower issue. Justice Kagan noted that a content-based but viewpoint-neutral law might raise a more difficult question. But that question would need to be answered in another case.

Justice Jackson’s Dissent

Justice Ketanji Brown Jackson dissented. She believed that Colorado was regulating a medical treatment, not speech.

Justice Jackson argued that conversion therapy is a dangerous approach that does not meet established standards of ethical care and that the ban is “based on the medical profession’s broad consensus that this medical treatment…is ineffective and harmful.”

Justice Jackson explained that states have long set standards for licensed professionals. She believed that the majority’s reasoning could make it more difficult to enforce speech-based medical rules and that “because the majority plays with fire in this case, I fear that the people of this country will get burned.”

The Implications of the Chiles v. Salazar Ruling

The Salazar ruling reaffirms the fundamental principle that the government cannot generally enforce official orthodoxy of ideas, even in the office of a licensed counselor or a licensed mental health professional. The ruling has further implications for other groups.

State Regulation of Medicine

The ruling is narrow in the sense that it addressed the law only as applied to Chiles’s talk therapy. Questions remain as to how states can regulate other treatments that rely solely on talk therapy.

LGBTQ+ Youth and Their Families

Child advocacy and mental-health groups voiced concern that the ruling removes a safeguard against a practice linked to serious psychological harm. The decision may make it harder for states to prohibit certain forms of talk therapy for minors when those restrictions are framed in viewpoint-based terms. Advocacy groups are concerned about the effect on LGBTQ+ kids.

Other State Laws

The decision does not directly impact other state laws with bans on conversion therapy. However, it raises concerns that they will be challenged on constitutional grounds.

More than two dozen states have similar bans. That means this ruling may prompt lawmakers to consider how their laws are drafted to avoid judicial review and a finding of unconstitutionality.

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