The U.S. Supreme Court on Tuesday backed a legal challenge to Colorado’s statute that prohibits licensed mental health professionals from using so-called conversion therapy to alter a minor’s sexual orientation or gender identity, siding with a Christian counselor who argued the law violates the First Amendment.
The court issued an 8-1 decision reversing a lower court ruling that had sustained the state law. The litigation was brought by Kaley Chiles, a licensed counselor who contended the measure unlawfully restricts speech by preventing therapists from counseling minors in ways that seek a predetermined change in sexual orientation or gender expression.
Colorado’s law, enacted in 2019 and signed by Governor Jared Polis, bans licensed psychotherapists from pursuing treatments intended to change a minor’s sexual orientation or gender identity to a predetermined outcome. Each violation of the statute is subject to a fine of up to $5,000. The statute explicitly addresses attempts to reduce or eliminate same-sex attraction and to change behaviors or gender expressions.
The state said in court filings that a decision for Chiles would weaken states’ power to protect patients from unsafe or substandard care. Colorado is among more than two dozen states and the District of Columbia that have laws restricting or prohibiting conversion therapy for those under 18.
Medical organizations cited in litigation, including professional psychological groups, have submitted evidence indicating talk therapies aimed at changing sexual orientation or gender identity are associated with harms. Those submissions link this kind of therapy with increases in behaviors such as running away from home and, in the case of transgender minors, a higher likelihood of attempting suicide. Colorado’s law, while prohibiting conversion therapy, allows treatments that assist a person undergoing gender transition and permits therapies focused on acceptance, support and understanding for identity exploration and development.
Chiles has stated that she "believes that people flourish when they live consistently with God’s design, including their biological sex." She brought the challenge after the state adopted the ban and was represented by the Alliance Defending Freedom, a conservative religious rights organization that previously litigated high-profile cases at the Supreme Court on behalf of Christian business owners who refused services to same-sex couples on religious grounds.
The case raised a central legal question about whether Colorado’s law regulates professional conduct or impermissibly targets speech. During oral arguments in October, Colorado Solicitor General Shannon Stevenson argued the law regulates professional conduct and that states must retain their longstanding authority to ensure safety in healthcare - "just because they are using words," she said, should not strip states of that power. Conservative members of the court pushed back on that position, with Chief Justice John Roberts responding that court precedent establishes that engaging in conduct does not automatically remove constitutional protections for words - "just because they’re engaged in conduct doesn’t mean that their words aren’t protected," he said.
James Campbell, counsel for Chiles, told the justices the Colorado statute "forbids counselors like Kaley Chiles from helping minors pursue state-disfavored goals on issues of gender and sexuality." Conservative Justice Samuel Alito observed during argument that the law appeared to allow therapists to help a patient become comfortable with being gay, while prohibiting assistance for patients who seek to "end or lessen" same-sex attraction.
The Supreme Court’s action in this case comes amid other high court decisions and pending matters involving LGBT-related policies. On March 2, the court blocked a set of California laws that limited school officials from sharing information with parents about a transgender student’s gender identity without the student’s permission, a move that favored Christian parents who challenged those protections. The court also heard arguments in January in a case concerning state bans on transgender athletes competing on female sports teams; the justices are expected to issue a ruling in that matter by the end of June.
Legal advocates and state officials framed the dispute in contrasting terms. Colorado emphasized its interest in protecting minors from therapeutic practices it deems unsafe and ineffective, while Chiles and her counsel framed the law as an unconstitutional restriction on a therapist’s right to counsel clients according to their beliefs and objectives.
The Supreme Court’s decision to reverse the lower court does not resolve the broader legal questions raised; it returns the matter to the lower court for further proceedings consistent with the high court’s ruling. The outcome leaves in place a legal debate over the limits of state regulation of healthcare professions when such regulation intersects with speech protected by the First Amendment.
This ruling demonstrates the court’s willingness to scrutinize the line between professional regulation and protected expression in therapeutic settings. The case will proceed in the lower courts under the framework the Supreme Court established in its decision.