Supreme Court Strikes Down Colorado Conversion Therapy Ban in 8-1 Ruling

The Supreme Court drew a new constitutional boundary between regulating what therapists do and what they say, ruling 8-1 in Chiles v. Salazar that Colorado's 2019 ban on conversion therapy, as applied to talk-based counseling, violated the First Amendment.

Justice Neil Gorsuch, writing for the majority, framed the state's law not as a permissible health regulation but as viewpoint discrimination. Colorado's statute "does not just ban physical interventions," he wrote; it "censors speech based on viewpoint." The decision, issued March 31, reverses a ruling by the U.S. Court of Appeals for the 10th Circuit and sends the case back to that court to apply strict scrutiny, the most demanding constitutional standard, replacing the deferential rational basis test the appeals court had used.

The case centered on Kaley Chiles, a licensed professional counselor and practicing Christian who challenged the 2019 law when Colorado moved to enforce it against her. Chiles argued she was not practicing coercive conversion techniques but rather helping clients "with their stated desires and objectives in counseling, which sometimes includes clients seeking to reduce or eliminate unwanted sexual attractions." Her lawsuit contended the law effectively silenced her based on the viewpoint her counseling expressed.

Colorado and at least 25 other states had enacted similar bans, all grounded in a broad medical consensus that conversion therapy is ineffective and harmful to LGBTQ+ minors. That consensus, however, did not shift the majority. Legal scholars analyzing the ruling noted that Colorado's attempt to defend the statute as a health-and-safety measure "was transparently driven by the government's views about the inefficacy and harmful effects of conversion therapy," a framing that placed the state on the losing side of the Court's professional speech jurisprudence.

Justice Elena Kagan joined the majority but wrote separately, with Justice Sonia Sotomayor, calling Chiles' case a "textbook" example of viewpoint discrimination. Kagan flagged the constitutional symmetry: a state law barring therapy that affirms a young person's sexual orientation or gender identity would raise identical First Amendment concerns. Justice Ketanji Brown Jackson, the lone dissenter, was unpersuaded by that framing. She wrote 35 pages arguing that states have long held broad authority to regulate how licensed medical professionals treat patients and read her dissent from the bench, a deliberate signal of her disagreement's depth.

The ruling does not invalidate Colorado's law outright. It requires the 10th Circuit to re-examine it under strict scrutiny, a standard that rarely favors the government. For the more than 20 states with substantially similar statutes, that distinction offers little comfort: the decision is a direct invitation to constitutional challenges.

State legislatures and professional licensing boards are expected to respond by rewriting existing laws to target specific harmful techniques as conduct rather than the viewpoints those techniques express, an approach that may withstand the new standard. Whether courts will accept that framing, and how they treat related questions around mandatory counseling disclosures, licensing conditions, and religious exemptions, will define the next wave of litigation at the intersection of mental health regulation and the First Amendment.