Oct 8, 2025 Current Resources

The Supreme Court Is Ruling on Conversion Therapy. What Could Go Wrong!

The nation's highest court is hearing Chiles v. Salazar, and could overturn a ban on the discredited practice

Laws banning conversion therapy for minors in more than 20 states are under threat, thanks to a Supreme Court case challenging Colorado’s legislation against the practice on the basis of free speech. Today, the Supreme Court heard oral arguments in the case of Chiles v. Salazar, in which Kaley Chiles, a licensed therapist from Colorado, who is Christian, claims that the state’s 2019 law prohibiting conversion therapy for minors violates her First Amendment rights. This marks the first time a case has come before the Supreme Court involving conversion therapy — a discredited practice that attempts to change an individual’s sexual orientation or gender identity.

Chiles filed a lawsuit in 2022 claiming that the state prevented her from working with patients who want to live a life “consistent with their faith” — meaning LGBTQ+ individuals seeking therapy to make them heterosexual or cisgender. She is represented by the Alliance Defending Freedom, an anti-LGBTQ+ organization that the Southern Poverty Law Center has designated a hate group.

Meanwhile, the state of Colorado — represented by Patty Salazar, the executive director of the Colorado Department of Regulatory Agencies — argues that the aim of its law is to regulate licensed therapists by prohibiting a practice that’s been scientifically discredited and associated with serious harm. The Colorado law includes a religious exemption for non-licensed therapists “engaged in the practice of religious ministry.”

Over a 90-minute session, representatives for Chiles argued Colorado’s law infringes on her freedom of speech, while the lawyer for the state of Colorado countered that it’s the state’s responsibility to protect its citizens from harmful medical therapies. The Court’s decision is expected in June 2026.

“A key question in this case is whether a state can regulate conversion therapy directed to change a young person’s sexual orientation or gender identity just as it would regulate other harmful efforts by healthcare providers,” says Suzanne B. Goldberg, a law professor and director of the Sexuality and Gender Law Clinic at Columbia Law School. “As Colorado’s lawyer explained, providers are licensed by the state, and members of the public should be able to count on that person to practice within the established standard of care and not cause them harm.”

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Based on the questioning of the six conservative justices, the Court appears poised to rule in favor of Chiles. “A number of justices expressed skepticism about Colorado’s law, including through questions about whether the First Amendment prohibits states from regulating speech based on the speaker’s viewpoint, even if it is speech by a licensed therapist,” says Goldberg.

Still, Casey Pick, director of law and policy at The Trevor Project, the world’s largest nonprofit organization dedicated to suicide prevention and crisis intervention for LGBTQ+ youth, remains hopeful that after today’s arguments, “the justices will listen to the clear and abundant evidence” demonstrating the dangers of conversion therapy, she said in a statement emailed to Rolling Stone. “Mental health treatments, like medical treatments, are supposed to be neutral, competent, and based on evidence.”

Douglas C. Haldeman, PhD, a clinical psychologist who began working with survivors of conversion therapy in 1983, isn’t as confident about the outcome. “We are in an era of unprecedented opposition to science, to reality, to the truth, and given that anything can happen if you say we’re going to start creating public policy based on prejudices or biases, then we’re lost from the get go,” he tells Rolling Stone. “I’m not optimistic about what the outcome will be with this particular Supreme Court.”

The current medical consensus is that conversion therapy doesn’t work and causes harm. According to a 2021 resolution from the American Psychological Association, conversion therapy is associated with an extensive list of long-lasting social and emotional consequences, including depression, anxiety, suicidality, substance abuse, a range of post-traumatic responses, feelings of anger and grief, loss of connection to community, damaged familial relationships, self-blame, guilt, and shame. Similarly, research from The Trevor Project published in the American Journal of Public Health found that when conversion therapists pressure LGBTQ+ youth to change their identity, they are more than twice as likely to attempt suicide.

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“[Conversion therapy] often resorts to guilt, coercion, and trauma in a disturbing effort to make someone believe they are less than simply because of who they are,” Human Rights Campaign President Kelley Robinson said in a statement. “These appalling practices can destroy families, worsen mental health outcomes, and rob people of their faith communities.”

Haldeman saw the harms of conversion therapy firsthand during the more than 30 years that he had a psychological counseling practice in Seattle where he treated survivors. “One of the things I noticed that made it so difficult is that not only were [clients] not able to change their sexual orientation, but they felt even worse about themselves because they couldn’t,” he says. “And that was a double shame that caused many people to become acutely suicidal.”

Today’s oral arguments come nearly four months after the Supreme Court voted 6-3 to uphold a Tennessee law banning gender-affirming care for minors in U.S. vs. Skrmetti.

In Skrmetti, the Court held that a state legislature could prohibit a form of healthcare — gender-affirming healthcare — based on its view of the medical evidence. Justice Ketanji Brown Jackson brought this up during proceedings. “I’m wondering why this regulation at issue here isn’t really just the functional equivalent of Skrmetti,” Jackson asked an attorney for the Trump administration, which sided with Chiles. “It just seems odd to me that we might have a different result here.”

Goldberg agrees. “Here, the state of Colorado has prohibited conversion therapy to minors based on the very strong evidence that conversion therapy is harmful to minors,” she explains. “It would arguably be inconsistent for the Court to allow some states to prohibit specific forms of gender-affirming healthcare because they believe it’s harmful, while stopping other states from prohibiting conversion therapy because they believe it’s harmful.”

When the Court decides in June, in addition to ruling in favor of Chiles or the state of Colorado, the justices could also opt to send the case back to the lower court to review Colorado’s reasons for banning conversion therapy for minors, Goldberg explains.

“If the Court issues a narrow ruling and sends the case back to a lower court to evaluate the state’s arguments in favor of the law, that would suggest that states can continue to take seriously their responsibility to evaluate standards of care used by their licensed healthcare providers,” Goldberg says. “If the Court strikes down Colorado’s law because it interferes with Chiles’ freedom of speech, that would risk interfering with states’ authority to protect their residents from harmful practices by licensed therapists.”

Haldeman believes the Supreme Court ruling in favor of Chiles would be disastrous. “There are more than 20 states and numerous local jurisdictions that prohibit conversion therapy by licensed practitioners,” he says. “All of those ordinances would then be challenged and we would likely no longer have those protections. And when those guardrails are gone, it’s open season again, and we are back 50, 100 years.”

As Goldberg points out, it’s important to keep in mind that conversion therapy bans are not a partisan issue. “They have been supported by both Republicans and Democrats who have been persuaded by extensive professional evidence showing that the so-called therapy is ineffectual and harmful, and by individual young people and their families who have shared heartbreaking stories of suffering harm from therapists attempting to change their sexual orientation or gender identity,” she says.

Regardless of the Supreme Court’s decision in this case, Haldeman says that it’s not time to be discouraged.