The Supreme Court’s Conversion Therapy Ruling (Chiles v Salazar) and What It Could Mean for LGBTQ+ Community
On March 31, the U.S. Supreme Court issued a disappointing ruling in Chiles v. Salazar, striking down Colorado’s ban on licensed professionals providing so-called “conversion therapy” to minors. In an 8–1 decision written by Justice Neil Gorsuch, the Court concluded that these practices fall under protected speech—meaning states may have limited ability to regulate what therapists say to patients, even in a clinical setting.
To understand why this matters, it helps to first clarify what “conversion therapy” actually is. Despite the name, it is not considered legitimate therapy by mainstream medicine. Major organizations such as the American Psychiatric Association and the American Medical Association have long stated that attempts to change a person’s sexual orientation or gender identity are ineffective and can be harmful. These practices have been linked to increased rates of depression, anxiety, shame, and even suicidal thoughts. They also emphasize a core point: being LGBTQ+ is not a disorder and does not require treatment.
It does not appear that the court questioned the well documented harms associated with conversion therapy practices. I could find nothing in the court’s decision that contradicts what children, youth, families, and researchers have consistently demonstrated; that there is nothing therapeutic about any form of conversion therapy. So, how did they come to this decision?
It appears that the heart of the Supreme Court’s decision rests on how it views psychotherapy. The majority opinion treated conversion therapy as “just talking,” and therefore protected speech. Because the Constitution strongly protects speech (even that which is controversial or offensive speech), the Court concluded that the government cannot restrict what therapists say to their clients. If the Supreme Court had taken the time to define psychotherapy and acknowledged all of the lives that “conversion therapy” has impacted and harmed, then it might have understood that it isn’t just “talking”; that, in reality, this deceptive practice is falsely presented as a “treatment.”
The lone dissenting opinion of Associate Justice Ketanji Brown Jackson rightfully argued that therapy is not “casual conversation” but is actually a form of medical care. She writes, “what Colorado is doing here is actually regulating medical care, not suppressing messages,” And that, as such, what a licensed clinician says in a therapy session is part of treatment and should be held to professional standards, just like prescribing medication or performing a procedure. She goes on to argue that if states can regulate medical care to protect patients, then shouldn’t they also be able to regulate harmful therapeutic practices. Jackson warns that with this ruling, “the court could be ushering in an era of unprofessional and unsafe medical care administered by effectively unsupervised healthcare providers.”
Sadly, this ruling will have deeply troubling real-world consequences for LGBTQ+ individuals, especially young people. One of the most immediate effects may be a loss of protection. Prior to this ruling, many states had laws in place to prevent licensed professionals from engaging in conversion therapy with minors. Those protections are now uncertain. In some areas, therapists may once again be legally allowed to offer these services, even though they are widely considered harmful.
The ruling may also contribute to confusion and mixed messages. When the highest court in the country frames conversion therapy as protected speech, it can unintentionally suggest that these practices are legitimate or open to debate. That stands in contrast to decades of medical consensus. For LGBTQ+ individuals, this disconnect can feel invalidating and may reinforce stigma.
There are also concerns about how this decision could affect the broader standard of care in mental health treatment. Traditionally, licensed professionals are expected to provide care based on evidence and established guidelines. If therapy is increasingly viewed as unrestricted “speech,” there is a risk that personal beliefs could take precedence over science in some clinical settings. This could make it harder for patients to determine whether the care they are receiving is based on evidence or ideology.
Geography may now play an even larger role as well. Some states will likely look for new ways to protect patients, while others may not. As a result, access to affirming, evidence-based care could vary significantly depending on where someone lives.
Even for those who never encounter conversion therapy directly, the broader impact may still be felt. Legal decisions like this can shape cultural attitudes. For some LGBTQ+ individuals, it may deepen feelings of being misunderstood or unsupported. It may also erode trust in the healthcare system, particularly if there is uncertainty about whether providers are guided by science or personal belief.
While we must unfortunately accept this ruling for now, we must not lose hope or give up. At its core, the ruling does not change the scientific consensus. Conversion therapy remains widely discredited and associated with harm. What has changed is how the law interprets it. By framing it as protected speech rather than regulated medical treatment, the Court has shifted where responsibility lies—from the legal system back toward professional standards, public awareness, and individual decision-making.
Looking ahead, this decision will undoubtedly prompt further legal challenges, policy changes, and advocacy efforts; ones that we should advocate for. The Professional medical organizations, American Psychiatric Association and the American Medical Association continue emphasizing that affirming care (that which supports a person’s identity rather than trying to change it) is the safest and most effective approach.
For LGBTQ+ individuals and those who care for them, all of this will feel terribly uncertain. But one point remains clear: access to thoughtful, respectful, and evidence-based care is more important than ever.
In the meantime we all need to use our votes and our voices to reshape the world around us. When we get involved, whether it is at the ballot box or with organizations, we can make a real difference. We need to come together, get involved, lift each other up, and push for the values and issues that matter to us most. Every action counts and we have to believe that together we can create a better future for ALL of us.
