Supreme Court rules Colorado's conversion therapy ban violates First Amendment 8-1

In Chiles v. Salazar (2026), the Supreme Court ruled 8-1 that Colorado cannot prohibit conversion therapy based on the therapist's disapproval of same-sex relationships. Justice Gorsuch wrote that the law violates the First Amendment by targeting speech—the therapist's viewpoint—rather than harmful conduct. Colorado's ban applied only to therapists who believe same-sex attraction is changeable; therapists who discourage such change faced no restriction, revealing the law's focus on punishing a particular belief system rather than protecting minors from harm.

Justice Jackson's dissent warned that the majority had weaponized viewpoint discriminationViewpoint DiscriminationWhen the government restricts speech based on the speaker's perspective or ideology rather than a neutral standard.Key ConceptViewpoint DiscriminationWhen the government restricts speech based on the speaker's perspective or ideology rather than a neutral standard.Open conceptBookmark doctrine against civil rights protections. She argued the law targets conduct (coercive therapeutic practices) not speech, and that elevating a therapist's ideological purity over a minor's protection from documented harm inverts First Amendment hierarchy. Jackson emphasized that conversion therapy causes measurable psychological injury—increased suicide attempts, depression, anxiety—and that no constitutional protection shields such abuse from regulation.

The ruling pivots on how courts classify conversion therapy bans: as speech restrictions (targeting the therapist's belief that same-sex attraction can change) or conduct restrictions (prohibiting harmful practices on minors). Gorsuch's majority opinion treats therapist speech as protected viewpoint expression, requiring the state to show the law targets conduct-not-belief. This framework parallels professional-speech doctrine but grants therapists wider First Amendment cover than previous cases afforded other regulated professions.

Kaley Chiles, the licensed therapist and plaintiff, argued she could not counsel clients using her faith-based conviction that same-sex attraction represents disordered development. She framed Colorado's law as ideological censorship of religious therapy. The Court's decision permits Chiles and therapists with similar views to practice without state interference, even though major medical organizations (American Psychological Association, American Medical Association, American Psychiatric Association) concluded conversion therapy is ineffective and harmful.

Patty Salazar, Executive Director of the Colorado Department of Regulatory Agencies (DORA), argued the law protects minors (who cannot consent to risky medical procedures) from documented harm. The American Psychological Association research documents that conversion therapy increases suicide attempt risk by 8x, depression by 3x, and anxiety by 2x. Salazar contended the First Amendment does not require the state to tolerate therapist speech that causes measurable injury to vulnerable children — analogous to how states regulate unlicensed medical practice or child abuse.

The ruling affects approximately 27 states and D.C. that ban conversion therapy on minors, including California, New York, Illinois, and Massachusetts. In remaining states, conversion therapy faces no age restrictions. The 8-1 decision created immediate uncertainty: state attorneys general and medical boards rushed to assess whether bans could survive Chiles. Legal scholars predicted that states must now articulate regulations as conduct-focused (prohibiting harmful practices) rather than viewpoint-focused (prohibiting therapy based on belief systems).

Medical evidence presented in briefs showed: 39% of LGBTQ+ youth in the U.S. have experienced conversion therapy or pressure to suppress identity; 57% of those reported suicidal ideation in the year following therapy; lifetime depression diagnosis rates doubled; 41% attempted suicide by age 25 compared to 8% of untreated peers. The American Psychiatric Association's 2023 position statement condemned conversion therapy as pseudoscience lacking evidence of efficacy for sexual orientation change.

The Alliance Defending Freedom (ADF), a Christian legal advocacy group, funded Chiles' litigation through a network of conservative legal organizations. ADF framed the case as religious liberty v. state overreach, though critics noted the organization has opposed same-sex marriage, transgender rights, and comprehensive sex education. ADF's media strategy emphasized therapist conscience rights rather than the documented medical harms of conversion therapy, shaping how courts and the public understood the constitutional stakes.