The Supreme Court Decision That Allows Licensed Therapists to Practice Conversion Therapy on Children Has Experts Horrified

The United States Supreme Court issued a decision on the morning of March 31, 2026, which coincided with the worldwide Transgender Day of Visibility. This decision will be debated for years in medical schools, legal publications, and family living rooms. Kaley Chiles, a counselor in Colorado Springs, claimed that the state’s limitations on her talk therapy practice violated her First Amendment right to free speech, and the court overturned Colorado’s ban on conversion therapy by an 8-1 vote. Protesters and supporters had gathered outside the Washington court building, waiting in the cold with signs. When the decision was made, it seemed to be something that everyone had anticipated but wasn’t quite ready to accept.

Since 2022, Chiles, a licensed counselor and devout Christian, has contested Colorado’s legislation, claiming that it forbade her from assisting clients who voluntarily sought to “reduce or eliminate unwanted sexual attractions” in a manner consistent with their religious beliefs. Her attempts to halt the ban’s enforcement had been denied by several lower courts. She continued to make appeals. The Supreme Court consented to hear the case last year. Additionally, observers present at the October 2025 oral arguments observed that a number of justices seemed openly skeptical of the state’s position, indicating that this outcome, though still painful for many, was not wholly unexpected. However, this knowledge does not make it any simpler to comprehend.

Chiles v. Salazar — US Supreme Court Ruling on Conversion Therapy (March 31, 2026)

Justice Neil Gorsuch, writing for the majority, came to the conclusion that Colorado’s law “censors speech based on viewpoint”—that is, it forbade one kind of therapeutic message while permitting another, which the court determined to be unconstitutional. According to Gorsuch, the First Amendment “stands as a bulwark against any effort to prescribe an orthodoxy of views.” Eight of the nine justices ultimately rejected the state’s argument that the law regulated professional conduct rather than speech. Colorado officials and the majority of the medical community watching the case found significance in this distinction. Although the decision returns the case to the lower courts, the constitutional framework it creates has already altered the landscape for laws of a similar nature across the nation. Similar prohibitions on conversion therapy for minors have been passed by more than 20 states. They are all now up against a challenge.

Justice Ketanji Brown Jackson, who took the unusual step of reading a synopsis of her opinion aloud from the bench—a gesture that, in Supreme Court practice, denotes profound disagreement rather than routine objection—was the only dissenting opinion. Jackson’s argument addressed the fundamental problem that many medical experts believed was being overlooked: Chiles is not a private citizen expressing her opinions in a public setting.

She works in a regulated professional setting as a licensed healthcare provider in a formal therapeutic relationship with a minor. Jackson wrote, “Chiles is not speaking in the ether; she is providing therapy to minors as a licensed healthcare professional,” noting that licensure already requires these professionals to accept limitations on their practice. She cautioned that the majority’s framework might lead to a broad reduction in the state’s authority to control medical speech, which she called potentially “catastrophic.”

The term “therapy” can be confusing, so it’s important to consider what conversion therapy really entails in practice. The American Medical Association, the American Psychological Association, and the American Academy of Pediatrics, among others, have officially denounced the practice, which aims to alter a person’s sexual orientation or gender identity, usually in minors. Research has repeatedly shown that it doesn’t accomplish what it says it does and that there are real risks associated with it, including depression, psychological damage, strained family ties, and an increased risk of suicide in young people who participate. These are not theoretical issues. These are recorded, peer-reviewed conclusions gathered over many years of research. It is extremely challenging to classify the practice as solely a speech issue because it directly conflicts with the professional standards that regulate every other facet of a licensed therapist’s work.

As this develops, there is a sense that the way courts view the connection between professional licensing and constitutional protection has changed significantly. Justice Elena Kagan, who agreed with the majority, made a noteworthy observation of her own: under this decision, a “mirror image” law that attempted to outlaw therapy that affirmed a teen’s gender identity would be subject to the same constitutional scrutiny. Regardless of the evidence regarding harm, this symmetry creates a framework in which courts are extremely reluctant to control what licensed therapists say to vulnerable minors. It’s still unclear how this decision will be applied by subordinate courts in the future and whether states will come up with different regulatory strategies that pass First Amendment scrutiny.

The decision was described as “a setback for Colorado’s efforts to protect children and families from harmful and discredited mental health practices” by Attorney General Phil Weiser, who represented Colorado in court.”Jaymes Black, head of the Trevor Project — which reported in 2023 that more than 1,300 practitioners across the country offer conversion therapy — described the decision as” a tragic step backward.

A more limited kind of assurance was provided by GLAD Law’s Polly Crozier, who pointed out that therapists who genuinely cause harm to patients through this practice may still be subject to medical malpractice lawsuits. That might be accurate. Given what the ruling permits in the interim, it is also cold comfort for many families and advocates. The lower courts take up the case again. Under this new constitutional framework, the more general question of what states can do to safeguard minors in a therapeutic setting is still genuinely open.