Topline
The Supreme Court heard oral arguments Tuesday on whether to strike down state-level bans on LGBTQ conversion therapy, with justices on the majority-conservative court suggesting they may be willing to rule against Colorado’s law restricting the practice, at least as it applies to talk therapy.
The court heard 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, though this case concerns talk therapy specifically.
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 when it comes to medical professionals, even if it involves speech, in order to prohibit treatment that doesn’t meet the standard of care.
The counselor, Kaley Chiles, who’s being backed by the Trump administration, 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.
While it’s still unclear how the court could rule, the 6-3 conservative court signaled it may be more inclined to rule in Chiles’ favor, with justices expressing concerns about regulating speech and whether Colorado’s law discriminates based on viewpoint.
The Supreme Court’s ruling likely won’t come for another few months, sometime before the court’s term wraps up in late June 2026. The justices could rule in favor of upholding or striking down Colorado’s law, or could decide to punt on the case and send it back to a lower court for further review.
Multiple justices on the court made comments Tuesday suggesting they may be hesitant to accept Colorado’s arguments that it’s allowed to regulate therapists’ speech. Justice Amy Coney Barrett questioned whether concerns about the harms of conversion therapy could be addressed by filing malpractice lawsuits, if the Colorado law was struck down, for instance, and suggested the possibility that there’s medical evidence on both sides of the debate over LGBTQ-related medical care, asking if states should be allowed to “pick a side.” Justice Samuel Alito similarly suggested medical consensus about an issue can be “taken over by ideology,” and multiple justices questioned whether Colorado’s justification for upholding the law would apply in the opposite scenario, if a state passed a law that forbade therapists from affirming patients’ sexual orientations or gender identities. While the court’s conservative justices expressed the bulk of the skepticism during Tuesday’s oral arguments, even liberal-leaning Justice Elena Kagan appeared to suggest Colorado’s law could be discriminatory, arguing that if one doctor is allowed to help a patient affirm their sexuality while another is barred from helping a patient change it, “That seems like viewpoint discrimination in the way we would normally understand viewpoint discrimination.” The justices accepted Chiles’ argument that talk therapy is separate from any more physical medical treatments around conversion therapy, like electroconvulsive therapy, suggesting any ruling they may issue against Colorado’s law would not affect treatments outside of talk therapy.
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 Trump administration has intervened in the case, filing a brief with the court urging it to side with Chiles and taking time during oral arguments to speak in favor of the counselor’s case. The government argues the lower court that sided with the state didn’t apply enough scrutiny to whether the law burdens therapists’ speech and Colorado’s law should be overturned, or, at a minimum, the case should be sent back to a lower court. In its brief to the court, 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.