The United States Supreme Court ruled Tuesday that Colorado's law banning licensed therapists from practicing conversion therapy on minors violates the First Amendment's free speech clause. The decision — rendered 8-1 — was handed down on March 31, 2026, the global Transgender Day of Visibility, and immediately triggered outcry from LGBTQ+ rights organizations and medical associations who had championed such laws as essential youth health protections.
The lone dissenter was Justice Ketanji Brown Jackson. She read her dissent aloud from the bench — a rare gesture reserved for decisions a justice considers seriously wrong.
The Case: Kaley Chiles v. Colorado
The case was brought by Kaley Chiles, a Colorado-licensed Christian counselor who argued that the state's 2019 law unconstitutionally silenced her based on the viewpoint she expressed in therapy sessions. Chiles said she provides talk therapy to minors who voluntarily seek help reconciling their religious beliefs with questions about sexual orientation or gender identity. She does not use physical interventions — only conversation.
Colorado's law, signed by Governor Jared Polis in 2019, prohibited licensed mental health professionals from using any therapeutic practice that attempts to change a minor's sexual orientation or gender identity toward a predetermined outcome. Violations carried fines of up to $5,000 per infraction. Critically, the law exempted religious organizations and family members — it applied only to state-licensed practitioners.
Lower federal courts upheld the law, reasoning that it regulated professional conduct rather than protected speech. The Supreme Court reversed that reasoning entirely.
What the Court Decided
Writing for the eight-justice majority, Justice Neil Gorsuch characterized Colorado's law not as a neutral healthcare regulation but as viewpoint-based censorship. The distinction matters enormously under First Amendment doctrine: a law that bans speech based on what a speaker says — rather than how they say it, or the general category of conduct — is subject to the highest level of constitutional scrutiny and is almost always struck down.
"Colorado's law addressing conversion therapy does not just ban physical interventions," Gorsuch wrote. "In cases like this, it censors speech based on viewpoint. Colorado may regard its policy as essential to public health and safety. Certainly, censorious governments throughout history have believed the same. But the First Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech in this country."
The court did not categorically invalidate all applications of Colorado's law. Gorsuch's opinion left open the possibility that the law might constitutionally apply to physical aversive interventions — non-speech forms of conversion therapy — and directed the lower courts to conduct further proceedings under a more rigorous First Amendment framework. But for the talk therapy at issue in Chiles' practice, the court found the law unconstitutional.
The Trump administration had filed a brief supporting Chiles. Chiles was represented by Alliance Defending Freedom (ADF), a conservative religious legal organization that has secured multiple high-profile Supreme Court wins in recent years, including cases involving a baker and a wedding website designer who refused service to same-sex couples based on religious beliefs.
The Lone Dissent
Justice Ketanji Brown Jackson's solo dissent was pointed. She argued the majority had misread decades of First Amendment precedent that has long permitted states to regulate the conduct of licensed medical and mental health professionals, even when that conduct necessarily involves speech.
"No one directly disputes that Colorado has the power to regulate the medical treatments that state-licensed professionals provide to patients," Jackson said from the bench. "So, in my view, it cannot also be the case that Colorado's decision to restrict a dangerous therapy modality that, incidentally, involves provider speech is presumptively unconstitutional."
Jackson warned of cascading effects: if professional medical speech is now subject to the same rigorous First Amendment scrutiny as political or artistic expression, the ruling could destabilize a wide range of healthcare regulations — including informed consent requirements that compel doctors to disclose risks before treatment. "The fallout could be catastrophic," she wrote.
Justice Elena Kagan, joined by Justice Sonia Sotomayor, wrote a notable concurrence. While agreeing the Colorado law violated the First Amendment, Kagan signaled that states may have a path forward: if they redraft their laws in a viewpoint-neutral manner — banning both pro-change and pro-affirmation interventions — such laws might survive constitutional scrutiny. "Once again, because the state has suppressed one side of a debate, while aiding the other, the constitutional issue is straightforward," she wrote.
What the Medical Community Says
Every major American medical and psychological organization has taken a clear stance on conversion therapy: it does not work, and it causes harm.
The American Psychological Association (APA), the American Medical Association (AMA), and the American Academy of Pediatrics have all concluded that conversion therapy is ineffective and associated with serious risks to mental health, including elevated rates of depression, anxiety, and suicidal ideation among minors subjected to it. The APA first formally repudiated it in 2009.
A 2020 study published in the JAMA Psychiatry journal found that LGBTQ+ adults who had been subjected to conversion therapy as minors were more than twice as likely to report suicidal ideation compared to those who had not. Research has consistently found no credible evidence that sexual orientation or gender identity can be changed through therapeutic intervention.
Kelley Robinson, president of the Human Rights Campaign, called the ruling a direct threat to child safety. "The court has weaponized free speech in order to prioritize anti-LGBTQ+ bias over the safety, health and wellbeing of children," Robinson said in a statement. "So-called 'conversion therapy' is pseudoscience, not real therapy."
Shannon Minter, legal director for the National Center for LGBTQ Rights, noted the inconsistency with the court's 2025 Tennessee ruling, which allowed the state to ban gender-affirming medical care for transgender minors. "I do not understand how the same Supreme Court can, with one breath, say it's fine for Tennessee to ban a type of medical care for transgender young people and on the other hand say it is not OK for Colorado to protect gay and transgender young people against a type of treatment that really no one could possibly defend."
The National Stakes
Colorado is one of more than two dozen states — along with the District of Columbia — that have enacted laws restricting or prohibiting conversion therapy for minors. The precise count, as of the time of this ruling, is approximately 22 states plus D.C., according to the Movement Advancement Project, which tracks LGBTQ+ policy across the country.
Tuesday's ruling puts all of those state laws in legal jeopardy. Any licensed therapist in any of those states can now mount a First Amendment challenge modeled on Chiles' case, citing Tuesday's Supreme Court precedent. Courts in those states will be required to apply the stricter scrutiny standard the Supreme Court has now mandated.
Colorado Governor Jared Polis — the first openly gay man elected as a U.S. governor — said he was evaluating the ruling and working to determine how to better protect LGBTQ+ youth. He did not commit to redrafting the law immediately. "Conversion therapy doesn't work, can seriously harm youth, and Coloradans should beware before turning over their hard-earned money to a scam," Polis said.
Colorado Attorney General Phil Weiser called the decision "a setback for Colorado's efforts to protect children and families from harmful and discredited mental health practices."
A Pattern at the Court
Tuesday's ruling fits a recognizable pattern at the current Supreme Court, which has a 6-3 conservative supermajority. Over the past several years, conservative religious plaintiffs — often represented by ADF or similar organizations — have used the First Amendment as a vehicle to challenge anti-discrimination and health-protective laws. The court has repeatedly sided with them.
In 2018, the court backed a California law challenge from anti-abortion pregnancy centers that had been required to notify clients about abortion services. In 2023, the court sided with a web designer who refused to create same-sex wedding websites. In 2024, the court ruled in favor of a Maryland school district challenge to LGBTQ-inclusive elementary school books. Tuesday's ruling is the latest in this line.
Polly Crozier, director of family advocacy at GLAD Law, noted that the ruling does not eliminate all legal recourse: "This does not change the fact that conversion therapists who harm patients will still face legal consequences" through medical malpractice suits. But civil litigation is a far slower and more uncertain protection than a statutory ban.
What Happens Next
The case now returns to lower courts to apply the more rigorous First Amendment standard the Supreme Court has mandated. Those proceedings could result in the Colorado law being struck down entirely or partially preserved as to non-speech interventions.
More broadly, legal challenges to conversion therapy bans in other states can now proceed with the backing of this precedent. Whether state legislatures attempt to redraft their laws — following Justice Kagan's implicit roadmap toward viewpoint-neutral language — remains to be seen.
What is already clear is that Tuesday's ruling marks a significant retrenchment of the legal protections that 22 states and D.C. had put in place for LGBTQ+ youth over the past decade — and a major victory for the religious conservative legal movement that has methodically built this body of precedent case by case.