SCOTUS Rules on Conversion Therapy Ban for Minors: First Amendment Analysis

On March 31, 2026, the U.S. Supreme Court issued a decision in Chiles v. Salazar, ruling that a Colorado statute barring licensed health care practitioners from engaging in conversion therapy with minors regulates speech based on viewpoint when applied to “talk therapy.” The statute defines “conversion therapy” as any treatment that “attempts or purports to change an individual’s sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attraction or feelings toward individuals of the same sex.” Counselors engaging in “talk therapy” only speak with their clients. Talk therapy doesn’t involve prescribing medication, using medical devices or employing any physical techniques like electric-shock therapy.

The central question in the case was whether the Colorado law, when applied to talk therapy only, violates licensed counselors’ free speech rights under the First Amendment.

Eight justices agreed with counselor Kaley Chiles, the petitioner, that the Colorado law discriminates based on the viewpoint that mental health practitioners communicate during talk-therapy sessions. Laws that regulate speech based on its content or discriminate based on viewpoint trigger a heightened level of review by courts, known as strict scrutiny.

The Supreme Court sent the case back to the appeals court to determine whether the law satisfies the strict scrutiny test — a "normal” step in the process when the court determines strict scrutiny applies.

Under strict scrutiny, Colorado would have to show that its law:

1. Pursues a compelling state interest, in this case, protecting minors
2. Is narrowly tailored to fit that interest, with many courts interpreting this to mean the law may only achieve its compelling interest by regulating speech in the least restrictive way possible

These requirements make it very difficult for laws that discriminate based on viewpoint to survive strict scrutiny, and the Supreme Court indicated it did not think Colorado’s law would do so here.

What does it mean for the country?

Colorado is not alone in banning conversion therapy for minors. Since California enacted the first full ban on conversion therapy in 2012, 22 other states and the District of Columbia have passed similar laws. Some of these laws have also prompted lawsuits in response, but this marks the first time a case on conversion therapy for minors has reached the Supreme Court.

The court did not definitively strike down Colorado’s law. It instead sent the case back to the lower court to apply heightened scrutiny. The decision also throws into question the validity of other states’ conversion therapy bans when applied to talk therapy.

The justices didn’t ultimately weigh in on Chiles’ claim that Colorado cites “no study showing harm from the speech Chiles wants to provide” nor did the decision directly address claims about the practice’s safety, scientific support or consistency with professional standards of care for healthcare workers.

Justice Ketanji Brown Jackson’s dissent pointed out that the decision could impact the ability of states to regulate other forms of health care and other licensed professionals when services are delivered through speech.

How did this case start?

Colorado’s ban on conversion therapy for minors went into effect in 2019. While the law forbids licensed health care practitioners from trying to “change” a minor’s sexual orientation or gender identity, it allows “practices or treatments that provide … [a]cceptance, support, and understanding for the facilitation of an individual's coping, social support, and identity exploration and development.” In other words, mental health care providers can help minors cope with their feelings or explore questions about their gender identity and sexual orientation, but they cannot try to change that identity or orientation.

Kaley Chiles, a licensed counselor in Colorado, filed a lawsuit arguing that the law violates the free speech clause of the First Amendment. She sought a preliminary injunction to block enforcement of the law as it applied to her counseling work.

How did the case get to the Supreme Court?

Chiles filed her lawsuit in the U.S. District Court for the District of Colorado, which denied the preliminary injunction, refusing to block enforcement of the law. The court found:

• The law regulates professional conduct that incidentally involves speech, not pure speech.
• Because the law regulates conduct, it only needs to satisfy what’s known as the rational basis test, which requires a “legitimate state interest,” in this case, preventing harm to minors and regulating the mental-health profession. A rational basis is a significantly more lenient standard than strict scrutiny.

Chiles appealed to the U.S. Court of Appeals for the 10th Circuit, which affirmed the District Court’s decision. She then petitioned the U.S. Supreme Court, which agreed to hear the case.

What did the licensed professional counselor argue?

Chiles argued conversion therapy pursued through talk therapy is constitutionally protected speech. She noted she views her work as an “outgrowth of her Christian faith” and said Colorado’s law is a form of censorship that discriminates based on the content and viewpoint of her speech, particularly her religiously inspired message about sexual orientation and gender identity.

She rejected the notion that her “counseling conversations” involve any conduct whatsoever, because “[t]he only tool she uses is speech.”

Chiles said Colorado’s law should be subject to strict scrutiny — again, meaning the law must serve a compelling state interest and must be narrowly tailored — and that it fails this test because:

• The law does not serve Colorado’s interest in protecting minors. Chiles alleged Colorado lacks evidence showing conversion therapy causes harm.
• The law is not narrowly tailored. It is “overinclusive” because it forbids conversations between counselors and minors who mutually wish to pursue conversion therapy. And the law is also “underinclusive” because it does not prohibit all harmful counseling and only forbids specific professionals and not unlicensed individuals, such as religious ministers or social media influencers, from offering conversion therapy.

What did the state of Colorado say?

Colorado defended its law as a standard regulation of medical care, arguing that conversion therapy is a discredited and harmful practice. Just as licensed professionals are prohibited from offering other ineffective or dangerous treatments, even if a patient requests them, licensed counselors may not offer conversion therapy as a form of treatment.

On the law’s constitutionality, Colorado argued:

• It survives rational basis review, but even under heightened scrutiny, it is justified.
• It is narrowly tailored to restrict only those treatments that aim to change a minor’s sexual orientation or gender identity.
• It does not prevent licensed professionals from having open conversations with patients that help them examine and explore their sexual orientation and gender identity, or from expressing their views on conversion therapy outside therapy sessions.

What happens now?

The case goes back to the lower court to determine whether the law satisfies the strict scrutiny test. For now, Colorado’s ban on conversion therapy remains in effect.

Benjamin P. Marcus is a fellow for religious freedom at Freedom Forum. He can be reached at [email protected].