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

The Decision

The U.S. Supreme Court ruled 8-1 on Tuesday in Chiles v. Salazar that Colorado's ban on conversion therapy for LGBTQ+ minors violates the First Amendment's free speech protections. Justice Neil Gorsuch authored the majority opinion, with Justice Ketanji Brown Jackson issuing a solo dissent.

The case was brought by Kaley Chiles, a licensed Christian counselor who argued that Colorado's 2019 law prevented her from offering voluntary, faith-based talk therapy to minors struggling with their sexual orientation or gender identity. Chiles was represented by the Alliance Defending Freedom, a conservative legal organization that has secured multiple high-profile Supreme Court victories in recent years.

The ruling reversed a lower court decision that had upheld the law. The justices sent the case back to the lower court for further proceedings under a more rigorous First Amendment standard — one that few laws survive.

What the Justices Said

Gorsuch framed the case squarely as a free speech issue. In his majority opinion, he wrote: "Colorado's law addressing conversion therapy does not just ban physical interventions. In cases like this, it censors speech based on viewpoint." He continued: "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 drew a distinction between physical interventions — such as the aversive techniques historically associated with conversion therapy, including electroshock — and pure talk therapy. The ruling left open the possibility that Colorado's law could still apply to certain physical forms of conversion therapy, but not to the kind of conversational counseling Chiles provides.

Justice Jackson dissented sharply, taking the unusual step of reading a summary of her opinion from the bench. She argued that states have long held the power to regulate medical treatments provided by licensed professionals, even when those treatments involve speech. Jackson wrote that the decision "opens a dangerous can of worms" and "threatens to impair states' ability to regulate the provision of medical care in any respect."

She warned of broader consequences: "In concluding otherwise, the court's opinion misreads our precedents, is unprincipled and unworkable, and will eventually prove untenable for those who rely upon the long-recognized responsibility of states to regulate the medical profession for the protection of public health."

Justice Elena Kagan, a liberal, concurred with the majority but wrote separately to note that the ruling would also protect therapists on the other side — meaning that any hypothetical state law banning therapy that affirms a teen's gender identity would face the same constitutional scrutiny. "Once again, because the state has suppressed one side of a debate, while aiding the other, the constitutional issue is straightforward," Kagan wrote.

What Colorado's Law Did

Colorado's law, signed by Governor Jared Polis in 2019, prohibited licensed mental healthcare providers from using therapy intended to change a minor's sexual orientation or gender identity according to a predetermined outcome. Each violation was punishable by a fine of up to $5,000 and potential license suspension, according to AP reporting. No one had been sanctioned under the law.

The law did permit treatments that provide "assistance to a person undergoing gender transition" and therapies centered on "acceptance, support and understanding" for "identity exploration and development." It also exempted religious ministries and family members — only licensed therapists were covered.

Colorado argued that the law regulated professional conduct, not protected speech, and that states have a longstanding responsibility to protect patients from substandard care. Colorado Solicitor General Shannon Stevenson told the court during October oral arguments that states should not lose their power to regulate healthcare safety "just because they are using words," as reported by Reuters.

The Medical Consensus

Conversion therapy has been widely discredited by major medical organizations. The American Medical Association, the American Psychological Association, and the American Academy of Pediatrics have all opposed the practice, according to NBC News reporting. The American Psychological Association has cited studies showing that conversion therapy is ineffective and has been associated with increased harm, including a higher likelihood of transgender minors attempting suicide or running away from home, per AP.

More than 20 states and the District of Columbia currently restrict or prohibit conversion therapy for patients under 18, according to Reuters. The ruling is expected to eventually make similar laws in those states unenforceable when applied to talk therapy.

National Implications

The decision continues a pattern at the Supreme Court in which the 6-3 conservative majority has sided with religious conservatives in free speech cases that intersect with LGBTQ+ rights. The Alliance Defending Freedom previously represented a Colorado baker and a website designer who successfully challenged state anti-discrimination laws because they did not want to serve same-sex couples, as AP reported.

The Trump administration backed Chiles in the challenge, according to Reuters.

The ruling arrives during a Supreme Court term with several cases touching on LGBTQ+ issues. In March, the court blocked a series of California laws limiting the sharing of information with parents about the gender identity of transgender public school students, according to Reuters. The court also heard arguments in January over the legality of state laws banning transgender athletes from female sports teams, with a decision expected by the end of June.

Jackson's dissent raised concerns that extend beyond LGBTQ+ issues. She argued the ruling could affect states' ability to regulate medical practice more broadly, including informed consent requirements that mandate doctors inform patients of treatment risks. NBC News reported her warning that the decision could be "ushering in an era of unprofessional and unsafe medical care."

What Comes Next

The case returns to the lower courts, where Colorado's law will be evaluated under strict scrutiny — the most demanding standard of judicial review. Under this standard, the state must demonstrate that the law serves a compelling government interest and is narrowly tailored to achieve that interest. Few laws survive this test.

For the more than 20 states with similar bans on the books, the practical effect is significant. While the ruling does not immediately strike down every conversion therapy ban nationwide, it establishes that talk-therapy-based bans are subject to heightened First Amendment scrutiny — a standard that legal analysts across the political spectrum acknowledge is extremely difficult for the government to meet.