The Supreme Court Just Made It Harder to Protect Kids From Conversion Therapy: Here’s You Need to Know

An 8–1 ruling in Chiles v. Salazar reframes a discredited medical practice as constitutionally protected speech and the consequences for families could be severe.

On March 31, 2026, the U.S. Supreme Court handed down a decision in Chiles v. Salazar that may reshape how states regulate one of the most widely condemned practices in modern mental health care: conversion therapy. In an 8–1 ruling authored by Justice Neil Gorsuch, the Court determined that Colorado’s Minor Conversion Therapy Law, which prohibited licensed counselors from subjecting children under 18 to practices aimed at changing their sexual orientation or gender identity, must be reviewed under strict scrutiny, the most demanding standard in constitutional law. The ruling reversed the Tenth Circuit’s earlier decision and sent the case back to the lower courts.

The practical effect: the legal scaffolding that 23 states and Washington, D.C. built to protect minors from these practices is now under direct constitutional threat. For parents in the Midwest and across the country, mothers and fathers navigating difficult questions about their children’s identity, the ruling introduces a new layer of confusion at a time when clear medical guidance already exists.

What Was This Case Actually About?

Kaley Chiles, a licensed professional counselor in Colorado Springs, filed suit against the state, arguing that the conversion therapy ban violated her First Amendment rights. Represented by the Alliance Defending Freedom, Chiles described her practice as “faith-informed counseling” and said she only engaged in talk therapy with clients who sought her out voluntarily. She argued before the Court that governments should not have the authority to dictate what a counselor can say to a client based on the viewpoint expressed.

Colorado countered that its 2019 law regulated a health care treatment, not speech, the same way states regulate what a doctor can prescribe or what procedures a surgeon can perform. Both the U.S. District Court and the Tenth Circuit Court of Appeals agreed with Colorado, finding that the law addressed professional conduct and only incidentally affected speech.

The Supreme Court disagreed. Writing for the majority, Gorsuch held that the Colorado law, as applied to Chiles’s talk therapy practice, regulated speech based on viewpoint. Because the law permitted counseling that affirmed a minor’s sexual orientation or gender identity but prohibited counseling aimed at changing it, the Court concluded this amounted to viewpoint discrimination requiring strict scrutiny review.

Why the Lone Dissent Matters

Justice Ketanji Brown Jackson was the only justice to dissent, and she did so from the bench, a step reserved for cases of deep disagreement. Jackson wrote that states have regulated medical practice for over a century, citing a 1926 precedent establishing that the right to practice medicine is subordinate to state police powers. She warned that treating talk therapy as protected speech rather than regulated medical practice opens what she called “a dangerous can of worms” that could impair states’ ability to regulate health care delivery of any kind.

The American Psychological Association echoed her concerns. In a statement released the same day, the APA said it was “deeply concerned” that the ruling could harm LGBTQ+ individuals, particularly minors, and reiterated that conversion therapy is not a legitimate treatment. Lynn Bufka, the APA’s head of practice transformation, has emphasized that therapy is evidence-based medical treatment delivered by trained professionals, not casual conversation.

What the Medical Community Has Said for Decades

The medical consensus on conversion therapy isn’t ambiguous or contested. Every major professional health organization in the United States has rejected the practice. The American Medical Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the American Psychological Association have all concluded that attempts to change a person’s sexual orientation or gender identity are ineffective and carry serious risks.

A 2022 task force report from the Association for Behavioral and Cognitive Therapies, co-authored by psychologist Dr. Judith Glassgold, found that conversion efforts are “inconsistent with evidence-based practice” and violate ethical principles of nonmaleficence, the duty to do no harm. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) published a 2023 report stating bluntly that these change efforts “are harmful and should never be provided” to children or adolescents.

The data on what happens to young people who undergo these practices is unambiguous. Research by Dr. Caitlin Ryan at San Francisco State University’s Family Acceptance Project found that youth subjected to parent-initiated efforts to change their sexual orientation were more than twice as likely to attempt suicide compared to peers who experienced no such efforts, a rate of 48% versus 22%. When parental change efforts were combined with conversion interventions from therapists or religious leaders, the attempted suicide rate climbed to 63%.

A 2022 JAMA Pediatrics study estimated the total annual economic burden of conversion therapy among LGBTQ youth in the United States at $9.23 billion, accounting for associated harms including substance abuse, emergency health care, and lost productivity. The same study found that affirmative therapy, by contrast, yielded cost savings and improved quality of life.

How Advocacy Organizations Responded

The Trevor Project, which operates the country’s largest crisis intervention service for LGBTQ young people and filed an amicus brief in the case alongside the American Foundation for Suicide Prevention and the National Alliance on Mental Illness, condemned the ruling immediately. CEO Jaymes Black called it “a tragic step backward for our country that will put young lives at risk,” adding that young people subjected to conversion therapy are more than twice as likely to attempt suicide and that protections against the practice have been enacted in more than 20 states with the backing of every major medical and mental health association in the country.

Trevor Project survey data has consistently documented the scale of the problem. Their 2024 survey of more than 50,000 LGBTQ Americans ages 13–24 found that 5% had undergone conversion therapy and an additional 8% had been threatened with it. A 2023 report identified more than 1,300 active conversion therapists still operating in 48 states, with more than 600 holding active professional licenses.

The National Center for LGBTQ Rights, which launched its Born Perfect campaign in 2014 to end conversion therapy state by state, has been at the center of this legal fight for more than 30 years. NCLR helped secure protections in 27 states, Washington D.C., Puerto Rico, and more than 100 municipalities, with bipartisan support in states including Utah, where the legislature voted unanimously to ban conversion therapy for minors, and Kentucky, Colorado, and Virginia. Since 2012, Republican legislators have supported prohibitions on the practice introduced into state legislatures more than 1,000 times.

In its pre-ruling analysis, NCLR made a distinction that remains critical in the aftermath of the decision: regardless of how the Court ruled on First Amendment grounds, conversion therapy remains malpractice, consumer fraud, and a violation of the ethical standards governing licensed mental health professionals. In the 2015 case Ferguson v. JONAH, a New Jersey jury unanimously found that conversion therapy constituted consumer fraud and unconscionable business practices, ordering the organization to shut down permanently. Not a single “success story” witness at trial testified to experiencing regular opposite-sex attraction after completing the program.

What This Means for Families Right Now

The Court’s ruling did not strike down Colorado’s law outright; it sent the case back to lower courts with instructions to apply strict scrutiny, the highest standard of constitutional review. Under strict scrutiny, the state must demonstrate that the law is narrowly tailored to serve a compelling government interest. That’s a bar that most regulations struggle to clear.

For a parent sitting in Ohio, Indiana, or Missouri, a mother praying about what’s best for her son who has come to her with questions about his identity, the legal landscape just became harder to navigate. The ruling does not change the underlying medical evidence. It does not make conversion therapy safe or effective. What it does is weaken the regulatory framework that prevents licensed professionals from offering it to minors.

Justice Kagan, in a concurrence joined by Justice Sotomayor, suggested that a differently written law, one that was content-based but viewpoint-neutral, might survive constitutional scrutiny. That narrow window may give state legislatures a path to redraft protections. But in the meantime, families are left to make decisions with fewer legal guardrails than they had 24 hours ago.

The Real-World Harm Behind the Legal Arguments

Legal frameworks can feel abstract. The damage conversion therapy inflicts on families is not.

Paulette Trimmer, whose son Adam underwent multiple conversion programs, described the experience in a sworn statement to the Supreme Court. After each program, Adam grew more distant from his parents. One program blamed his father for Adam’s identity, telling Adam his dad was “the worst father in the world.” The Trimmers spent thousands of dollars on programs that promised healing and delivered alienation. Paulette later told the Court that these programs don’t change who your child is; they change how your child sees you.

Linda Robertson, an evangelical mother who chronicled her family’s experience on her blog “Just Because He Breathes,” wrote about teaching her son Ryan to hate himself in the name of faith. After Ryan turned to drugs in self-destruction, the Robertsons spent ten months learning to love their son without conditions. Ryan later died from a drug overdose linked to the trauma he’d carried for years.

Joyce Calvo, another parent who submitted testimony in the case, described crying out to God not only for the loss of her daughter, Alana, but for what conversion therapy did to the bonds between parent and child, between child and God, and between a child and herself.

These are not edge cases. They are the documented, recurring pattern of what happens when families place their trust in practitioners offering a service that every mainstream medical organization has rejected.

What “Faith-Informed Counseling” Actually Looks Like in Practice

Conversion therapy today rarely involves the electroshock or aversion techniques that defined the practice decades ago. Modern practitioners describe what they do as talk therapy, prayer counseling, or “exploratory psychotherapy.” The rebranding is deliberate, and the Conversion Truth for Families resource hub has documented how these relabeled practices continue to cause the same harms under gentler-sounding names.

What these practices share, regardless of label, is a predetermined therapeutic goal: to change, suppress, or redirect a young person’s sexual orientation or gender identity. A licensed therapist sits across from a child and, through conversation, guides that child toward the conclusion that something about who they are is broken and needs fixing. When a mental health professional uses their position of authority to convince a child that their identity is a problem to be solved, the result, documented repeatedly in peer-reviewed literature, is guilt, self-hatred, anxiety, depression, and elevated risk of suicidal thoughts and behavior.

The question the Court addressed was whether the government can prohibit a licensed counselor from engaging in that specific type of speech. The question it did not address, because it was never in dispute, is whether the practice works. It doesn’t. The APA’s 2009 task force report found no evidence that sexual orientation change efforts are effective and documented evidence that they cause harm. SAMHSA’s 2023 report reached the same conclusion about both sexual orientation and gender identity change efforts. No randomized controlled trial has ever demonstrated efficacy, and the medical community agrees that conducting such a trial would be unethical given the documented risks.

The Broader Implications

The Chiles v. Salazar decision arrives at a moment of deep tension in American health care policy. As Vox noted in its analysis, the ruling creates a difficult-to-reconcile contradiction: in United States v. Skrmetti (2025), the Court allowed states to prohibit certain forms of gender-affirming care because legislatures believed those treatments were harmful. In Chiles v. Salazar, the Court prevented a state from prohibiting conversion therapy for the same reason. The asymmetry raises questions about whether the constitutional principle at stake is genuinely about speech, or about which health care interventions the current Court views favorably.

Harvard Law professor Noah Feldman warned in Bloomberg that treating talk therapy as protected speech could undermine regulations governing professional conduct performed verbally in fields well beyond mental health, including law and financial services.

For LGBTQ young people, the practical risk is immediate. Without state bans, families may encounter more practitioners willing to offer conversion services, especially in states where no protections existed before and where the ruling emboldens new market entrants. The Trevor Project has documented that even the threat of conversion therapy harms young people: among those threatened with it, rates of depression, anxiety, and suicidal ideation are elevated compared to peers who faced no such threat.

What Parents Can Do

The ruling does not mean parents are powerless. Several facts remain true regardless of the Supreme Court’s decision:

Conversion therapy remains classified as malpractice by every major licensing body in the country. A licensed therapist who subjects a patient to a treatment that every mainstream professional organization has condemned is practicing below the standard of care. Parents retain the option of filing complaints with state licensing boards and pursuing consumer fraud claims in civil court.

Parents looking for therapists should ask direct questions about the counselor’s approach to identity-related issues. A therapist who approaches treatment with a predetermined outcome, changing or suppressing a child’s orientation or identity, is practicing outside the boundaries of evidence-based care, regardless of whether the state they practice in has a specific ban on the books.

For families of faith seeking guidance that honors both their beliefs and their child’s wellbeing, organizations like Conversion Truth for Families offer resources specifically designed for parents navigating these conversations. The 988 Suicide & Crisis Lifeline (call or text 988) and The Trevor Project’s crisis services (call 1–866–488–7386 or text START to 678–678) remain available around the clock.

The medical evidence has not changed. The stories of families harmed by these practices have not changed. What changed on March 31 is the legal mechanism states can use to prevent that harm, and whether the next family caught in this situation will have fewer protections than the last.

Members of the editorial and news staff of the Daily Caller were not involved in the creation of this content.

Originally published at https://dailycaller.com.