This morning the U.S. Supreme Court set aside a Colorado state law restricting the power of licensed mental health professionals to provide conversion therapy to children. The decision in Chiles v. Salazar was 8-1.
In 2019, Colorado adopted a law prohibiting licensed counselors from engaging in “conversion therapy” with minors. Colo. Rev. Stat. §12–245–224(1)(t)(V) (2025). The State reports that it adopted the law “in response to a growing mental health crisis among Colorado teenagers and mounting evidence that conversion therapy is associated with increased depression, anxiety, suicidal thoughts, and suicide attempts.” Any Coloradan who thinks a licensed counselor is engaging in conversion therapy may file a complaint with a regulatory board. See §12–245–226(1)(a)(II)(B). A complaint, in turn, triggers a disciplinary review process.
A licensed psychologist brought an action to set aside parts of the statute.
With respect to gender identity, she claimed, the law permits her to speak in ways that encourage a client “‘undergoing gender transition,’” but then prohibits her from speaking in ways that help a client “realign [his] identity with [his] sex.” 4 CHILES v. SALAZAR Opinion of the Court Brief for Petitioner 11; With respect to sexual orientation, Ms. Chiles continued, Colorado’s law similarly allows her to affirm a client’s sexual orientation, but prohibits her from speaking in any way that helps a client “change” his sexual attractions or behaviors. Brief for Petitioner 11; Even though Colorado’s law surely has other constitutional applications, she insisted, these constraints strip her of her First Amendment right to speak freely with her clients in ways she believes might help them meet “their own goals.”
The decision rendered for the Court by Justice Gorsuch makes clear that this is not a ruling on anything other than conversational therapy- and that’s what brings it within the penumbra of 1st Amendment protection of free speech. Opinion at p. 7.
The majority concludes that Colorado seeks to regulate the content of Ms. Chiles’s speech. When it comes to issues of human sexuality, some of her clients “are content with” their sexual identity and orientation and want help only “with social issues [or] family relationships.” Id., at 207a, 214a. But other clients seek her counsel on how to “reduce or eliminate unwanted sexual attractions, change sexual behaviors, or grow in the experience of harmony with [their] bod[ies].” Id., at 207a. And in those cases, Colo- rado regulates how Ms. Chiles may respond. Under its law, she may not speak in any way that attempts to change a client’s “sexual orientation or gender identity”—including a client’s “behaviors or gender expressions”—or in any way that seeks to “eliminate or reduce” a client’s “sexual or ro mantic attraction or feelings toward individuals of the same sex.” §12–245–202(3.5)(a).
As applied here, Colorado’s law does not just regulate the content of Ms. Chiles’s speech. It goes a step further, prescribing what views she may and may not express. For a gay client, Ms. Chiles may express “[a]cceptance, support, and understanding for the facilitation of . . . identity exploration.” §12–245–202(3.5)(b)(I). For a client “undergoing gender transition,” Ms. Chiles may likewise offer words of “[a]ssistance.” §12–245–202(3.5)(b)(II). But if a gay or transgender client seeks her counsel in the hope of changing his sexual orientation or gender identity, Ms. Chiles cannot provide it. The law forbids her from saying anything that “attempts . . . to change” a client’s “sexual orientation or gender identity,” including anything that might represent an “effor[t] to change [her client’s] behaviors or gender expressions or . . . romantic attraction[s].” §12–245 202(3.5)(a). Colorado disputes none of this; neither does the dissent proffered by Justice Jackson. The Jackson opinion would hold that Colorado has the power to regulate the treatment based upon a state’s right to regulate “licensed” treatment.
The majority responds to that argument forcefully noting it to be a far cry from how Colorado’s law operates here. As applied to Ms. Chiles, the State seeks neither to regulate her speech incident to any conduct, nor does it seek to compel disclosure of factual and uncontroversial information. Instead, it seeks to silence a viewpoint she wishes to express. Free speech is what brought about the transformation of homosexuality from a mental disorder to an understood preference.
“The First Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech in this country. It reflects instead a judgment that every American possesses an inalienable right to think and speak freely, and a faith in the free marketplace of ideas as the best means for discovering truth. However well-intentioned, any law that suppresses speech based on viewpoint represents an
“egregious” assault on both of those commitments.”
The language employed in the majority opinion is a ringing endorsement of 1st Amendment privilege in the context of medical treatment. It would also seem to clear a path for school counselors to address this topic with students since they also have free speech rights. But the Court carefully notes the controversy associated with other forms of intervention associated with sexual dysphoria (e.g., medication and surgical) and it is not wading into that controversy i today’s opinion.
The opinions: 24-539 Chiles v. Salazar (03/31/2026)
Two quick additions. Technically the ruling today does not overturn the Colorado law but remands the case to review the statute under a “strict scrutiny” standard. Commentators seem to agree that standard will end the statute. Pennsylvania has a similar law enacted in 2024. It can be found here.