Topline
The Supreme Court will hear oral arguments Tuesday on whether to strike down state-level bans on LGBTQ conversion therapy, potentially clearing the way for the controversial practice to be legalized nationwide despite studies suggesting it carries harmful effects for patients.
The court will hear oral arguments in Chiles v. Salazar, a case challenging Colorado’s ban on LGBTQ “conversion therapy” for minors, which broadly refers to practices that aim to influence a patient’s sexual orientation or gender identity, including both emotional practices like talk therapy and physical procedures like electroconvulsive therapy.
Approximately 20 states have passed laws banning or restricting conversion therapy, as repeated studies have shown the practice carries harmful effects for patients—such as elevated risks of suicide, drug abuse and mental health issues—and is not effective at changing patients’ sexual orientation or gender identity.
The case was brought by a Christian counselor who “believes that people flourish when they live consistently with God’s design, including their biological sex,” and argues Colorado’s law is discriminatory by preventing her from counseling people about their sexual orientation and gender identity, while allowing counseling that promotes “[a]cceptance, support, and understanding” around gender identity and transitioning.
Colorado argues it’s legal to regulate professional conduct even if doing so “incidentally burdens speech,” if the regulations prevent medical providers from providing “substandard care.”
The counselor, Kaley Chiles, is asking the court to broadly decide whether laws that “[censor] certain conversations between counselors and their clients based on the viewpoints expressed” are constitutional.
The Supreme Court will hear oral arguments in the case Tuesday morning, but any ruling on the issue likely won’t come for another few months, sometime before the court’s term wraps up in late June 2026.
13%. That’s the share of LGBTQ youth who have either been subjected to or threatened with conversion therapy, according to a 2024 survey conducted by The Trevor Project among more than 50,000 Americans ages 13-24. That includes 5% who have been subjected to the therapy and 8% who were threatened with it. The findings suggest conversion therapy is on the decline as more states have banned the practice, as that 5% share is down from 10% who said in 2020 they were subjected to conversion therapy.
If the Supreme Court rules to outlaw LGBTQ conversion therapy bans and paves the way for the practice to be legalized nationwide, it could have a costly effect. A 2022 study published in JAMA Pediatrics found conversion therapy and its “associated harms” carry an economic burden in the U.S. of approximately $9.23 billion per year. That’s due to both the cost of the actual therapy, which totals some $650 million spent annually in the U.S., and the knock-on effects for those who undergo the therapy, with the study finding each patient pays approximately $83,366 on average to treat the “downstream consequences” associated with the procedure. That comes from costs like treating anxiety, depression and other mental health conditions that arise from the conversion therapy, the cost of alcohol and drug abuse disorders and costs arising from suicide attempts or fatal suicides.
The federal government is not a party in the lawsuit, but the Trump administration filed a brief with the court urging it to side with Chiles. The government didn’t argue the court should directly overturn Colorado’s conversion therapy ban, but suggested the lower court that sided with the state didn’t apply enough scrutiny to whether the law burdens therapists’ speech, and should reconsider the case. The Trump administration also questioned Colorado’s argument that the overwhelming “professional consensus” on conversion therapy is that it’s harmful and ineffective, arguing the state didn’t provide sufficient evidence to prove that and warning of “the dangers of relying on the consensus views of professional organizations to dictate what professionals may lawfully say.” Colorado’s purported “lack of convincing evidence of harm raises the inference that the State’s prohibition actually seeks merely to suppress a disfavored viewpoint,” the Justice Department claimed.
The conversion therapy case is the latest in a string of major LGBTQ cases to come before the 6-3 conservative court in recent years, which similarly have largely weighed LGBTQ rights or alleged discrimination against purported First Amendment violations. Justices ruled in 2023 in favor of a web designer who refused to create websites for same-sex marriage, for instance, and ruled in June in favor of parents being able to object to LGBTQ books in schools. The court also upheld the ability of religious adoption and foster care agencies to discriminate against same-sex couples in 2021. Beyond First Amendment cases, the court upheld bans on gender-affirming care for minors earlier this year. The conversion therapy dispute is one of at least two landmark LGBTQ rights cases the court is set to consider this year, as justices will also weigh whether to uphold state bans on transgender women in sports. The court has also been asked to overturn its precedent allowing same-sex marriage, but has not yet decided whether or not it will hear that case.