A Dangerous Turn: SCOTUS Reopens the Door to Conversion Therapy for Minors

By Kimberly Lugo*

In March 2026, the Supreme Court of the United States issued an 8–1 decision striking down Colorado’s law banning conversion therapy for minors, holding the law violated the First Amendment rights of licensed counselors.¹ The Court reasoned the statute impermissibly regulated speech based on viewpoint, emphasizing that the First Amendment protects even controversial or unpopular ideas.² This decision is deeply troubling. A law designed to protect vulnerable minors from harmful and discredited practices has been reframed as unconstitutional censorship. By elevating speech rights over well-documented public health concerns, the Court opened the door for practices long condemned by major medical and psychological authorities.

Free Speech Over Patient Safety

In Chiles v. Salazar, a licensed Colorado therapist challenged a state law banning “conversion therapy” for minors, arguing that because her practice consisted only of talk therapy, the law violated her First Amendment rights.³ Writing for the majority, Neil Gorsuch framed the Colorado law as a content and viewpoint-based restriction on speech, requiring strict scrutiny.⁴ The Court emphasized that the First Amendment protects the right of individuals—including licensed professionals—to express their views freely, even in therapeutic settings.⁵ According to the majority, Colorado’s law improperly let counselors affirm a client’s identity while blocking them from expressing opposing views aimed at changing that identity.⁶

The Court rejected the argument that the law regulated professional conduct rather than speech, concluding that, as applied to talk therapy, it directly regulated what counselors could say.⁷ In other words, the law was treated as a direct infringement on protected speech rather than a permissible regulation of medical practice.

The Dissent: A Warning Ignored

Justice Ketanji Brown Jackson, the lone dissenter, warned that the majority’s reasoning undermines the ability of states to regulate medical treatment.⁸ She emphasized that speech used in providing healthcare can be regulated when necessary to protect patients.⁹

Her concern is well-founded. By treating all therapeutic communication as protected speech rather than professional conduct, the Court risks stripping states of their authority to set standards for safe and ethical care. For example, if therapeutic communication is treated purely as protected speech, providers could use harmful or discredited methods and avoid discipline by claiming they are simply expressing ideas. A doctor could also give clearly incorrect or dangerous advice, like discouraging necessary treatment, and argue that it is protected speech instead of subject to professional regulation.

As the dissent suggests, this decision may have far-reaching consequences beyond conversion therapy and could affect broader healthcare regulation.¹⁰ It may limit states’ ability to discipline providers for harmful or misleading advice when that advice is treated as protected speech rather than professional conduct. As a result, regulations addressing medical misinformation, unsafe treatment recommendations, or departures from accepted standards of care could face constitutional challenges, weakening oversight by licensing boards.

What Conversion Therapy Is and Why It Doesn’t Work

Conversion therapy attempts to change an individual’s sexual orientation, gender identity, or related behaviors.¹¹ These practices are rooted in the scientifically discredited belief that being LGBTQ+ is a mental illness that should be cured.¹²

Decades of psychological research demonstrate that these efforts are ineffective. Studies have found little to no evidence that conversion therapy can reliably change sexual orientation or gender identity.¹³ For example, one study found that only 3.2% of participants reported even slight changes, while many reported negative outcomes.¹⁴ Major professional organizations have concluded conversion therapy lacks scientific validity and does not meet the standards of legitimate therapeutic practice.¹⁵

The Harm to LGBTQ+ Minors

Not only is conversion therapy ineffective, but it is also profoundly harmful—especially to minors. Research shows that these practices are associated with depression, anxiety, suicidality, substance abuse, and long-term psychological distress.¹⁶ Youth subjected to such efforts are significantly more likely to attempt suicide and experience lasting negative outcomes in adulthood.¹⁷

Colorado’s law was enacted in response to this overwhelming evidence, aiming to protect minors from practices linked to increased depression, anxiety, and suicide attempts.¹⁸ Yet the Supreme Court’s decision disregards these realities, prioritizing abstract free speech principles over concrete evidence of harm.

The Broader Implications of the Court’s Decision

Ultimately, the Court’s decision represents a profound misstep—one that elevates a rigid conception of free speech over the lived realities and well-being of vulnerable minors. The First Amendment was never intended to shield harmful, ineffective practices masquerading as therapy, particularly when the state acts to protect children from demonstrable harm. By invalidating Colorado’s law, the Court has not merely struck down a statute; it has weakened states’ ability to safeguard public health. This reasoning has normalized practices that the medical community has overwhelmingly rejected, leaving LGBTQ+ youth without critical protections.

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*Kimberly Lugo, J.D. Candidate, University of St. Thomas School of Law Class of 2026 (Articles Editor).

1. Chiles v. Salazar, 607 U.S. 23 (2026). ↩︎
2. Id. ↩︎
3. Id. at 3. ↩︎
4. Id. at 8. ↩︎
5. Id. at 10. ↩︎
6. Id. ↩︎
7. Id. at 6. ↩︎
8. Devin Dwyer, Supreme Court Rules Against Colorado Law Banning “Conversion Therapy” for Minors, ABC News (Mar. 31, 2026), https://abcnews.com/Politics/supreme-court-strikes-colorado-law-banning-conversion-therapy/story?id=129036088. ↩︎
9. Id. ↩︎
10. See Chiles, 607 U.S. at 22 (2026). ↩︎
11. Am. Psych. Ass’n, The Evidence Against “Conversion Therapy,” https://www.apa.org/topics/lgbtq/evidence-against-conversion-therapy (Last updated Apr. 1, 2026). ↩︎
12. Id. ↩︎
13. Id. ↩︎
14. Id. ↩︎
15. Id. ↩︎
16. Id. ↩︎
17. Id. ↩︎
18. Chiles, 607 U.S. at 30 (2026). ↩︎