Conversion Therapy Ban: What the Court Got Wrong
On March 31, 2026, the Supreme Court ruled 8-1 against Colorado’s ban on conversion therapy for minors. Justice Neil Gorsuch wrote the majority opinion. Justice Ketanji Brown Jackson was the only dissenter. She delivered her dissent from the bench, which is an unusual step.
In effect, states can no longer enforce bans on conversion therapy for minors in the same way. Because roughly two dozen states have enacted similar restrictions, the ruling has immediate national implications.
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Conversion Therapy Ban: Eight to One
This also needs to be said plainly: this was not a conservative supermajority acting alone. Every liberal justice except Brown Jackson joined the majority.
Justice Kagan’s concurrence was not a strategic maneuver to protect gender-affirming care. It reflected a genuine First Amendment position: laws that target one side of a debate are the most constitutionally suspect form of speech regulation, and Colorado’s law did exactly that.
She noted that a conservative state law banning affirming talk therapy would fail on the same grounds, which she appeared to offer as reassurance. The problem is the premise underneath that argument. Kagan accepted, as a starting point, that conversion therapy and affirming care are two sides of a debate.
They are not. One is a discredited practice with documented harm and no evidence of benefit. The other reflects the current standard of care supported by every major medical and mental health organization in the country.
Jackson was the exception. She said the majority failed to appreciate the crucial context of the case. “Chiles is not speaking in the ether,” Jackson wrote. “She is providing therapy to minors as a licensed healthcare professional.”
That distinction is central to the case, and the majority erased it.
Conversion Therapy Ban and the False Free Speech Argument
Bans on conversion therapy regulate professional conduct, not ordinary conversation. Therapy is not simply “talk.” It is a health care intervention governed by licensure, scope of practice, standards of care, and a duty to protect patients from harm.
Conflating therapy with unregulated speech ignores a century of jurisprudence that allows states to set minimum standards for medicine and mental health. When I deliver psychotherapy, I am not a pundit. I am a licensed professional who is ethically and legally bound to use methods supported by evidence and professional consensus.
The First Amendment does not permit a physician to prescribe contraindicated medication simply because they announce it aloud. The majority’s reasoning implies otherwise for mental health care. Gorsuch wrote that the amendment “stands as a shield against any effort to enforce orthodoxy in thought or speech in this country.”
That framing treats clinical standards as thought policing. It is not. It is how professions keep people from getting hurt.
The case was brought by Kaley Chiles, a Christian counselor in Colorado, who argued that the ban violated her First Amendment rights. Her lawyers argued that Colorado’s law was a viewpoint-based infringement because the state disagreed with her views on gender and sexuality, effectively putting itself in her counseling room.
That argument won. It won because the Court accepted the premise that a therapist’s methods and a therapist’s opinions belong to the same legal category. One is speech; the other is treatment.
Conversion Therapy Ban and the Duty to Do No Harm
All major medical and mental health associations have rejected sexual orientation and gender identity change efforts based on decades of evidence. These practices do not achieve their stated aims and are associated with anxiety, depression, self-harm, family rejection, and suicidality. A study by The Trevor Project found that young people who went through conversion therapy were more than twice as likely to have attempted suicide, and to have made multiple attempts, compared to those who had not.
In health care, the absence of benefit combined with the presence of harm ends the discussion. Continuing a practice under those conditions violates the foundational principle of doing no harm.
How Conversion Efforts Cause Harm in Real Life
The harm of conversion efforts is not theoretical. It shows up in clear, damaging ways in the lives of young people.
- Pathologizing the self. Telling a young person that their core attractions or gendered sense of self is disordered undermines self-worth and increases shame. Those consequences do not end when the session ends.
- Coercive dynamics. Minors often participate under pressure from caregivers or religious authority figures. Consent under duress is not consent.
- Clinical misdirection. Time and resources are diverted from evidence-based care. Treatable depression, trauma, and family conflict go unaddressed while the child is told their identity is the problem.
- Family rupture. Change-effort programs often prescribe peer avoidance, behavioral monitoring, and punitive rules that isolate youth from the people most likely to protect them.
- Elevated risk. The data on suicidality is not ambiguous. Those exposed to change efforts have higher rates of suicidal ideation and suicide attempts. For minors, that risk is unacceptable.
Conversion Therapy Ban: Debunking Three Recurring Claims
Several arguments continue to surface in defense of conversion therapy. Each one falls apart under clinical, legal, and ethical scrutiny.
Claim 1: Does a Conversion Therapy Ban Violate Free Speech?
Professional regulations commonly address what licensed clinicians may do, independent of what they believe. A clinician may personally oppose vaccine science. However, they cannot market unsafe protocols. Conversion therapy bans target a prohibited intervention because it fails safety and efficacy standards. They do not bar anyone from preaching, writing, or holding personal beliefs.
Claim 2: Does a Conversion Therapy Ban Discriminate Against Religion or Viewpoint?
Colorado’s law applied to all licensed providers, regardless of religion or politics. A secular counselor could not offer conversion therapy any more than a religious counselor could. Content-neutral health standards that protect minors are not viewpoint discrimination. They are a foundation of professional licensing
Claim 3: Is Medical Consensus Political Ideology?
Scientific consensus emerges from replicated studies, peer review, and clinical outcomes. Broad agreement that a practice is unsafe is not a partisan position. Calling the evidence-gathering process ideological enforcement does not change the data.
Conversion Therapy Ban: What the Science Shows
The scientific and clinical record does not support conversion efforts. It points in the opposite direction.
Sexual orientation and gender diversity are part of human variation. They have been documented across cultures and historical periods. Contemporary research shows that sexual orientation exists along a spectrum and that gender identity involves a complex interplay of biology, development, and social context.
Gender is not simply binary. Biological sex itself has natural variation. Intersex conditions and chromosomal differences are documented in medical literature. Gender, as the way people experience and express themselves in relation to social expectations, is shaped by culture as well as individual development. The existence of nonbinary and transgender people is not a modern invention. It is a long-observed human reality.
Professional classifications have evolved with evidence. Modern diagnostic manuals removed homosexuality from mental disorder categories decades ago after research showed it was not pathological. International health standards have relocated gender-related diagnoses to reduce stigma and focus on access to care. These changes reflect evidence-based medicine, not politics.
Developmental science supports identity exploration. Adolescence is a period of identity formation. Supportive, exploratory therapy helps youth and families navigate distress without prescribing an outcome. Attempts to force an identity “change” interrupt healthy development and increase risk.
Science Is Not a Menu for Ideology
Sound practice demands that we follow the weight of the evidence, not cherry-pick outlier studies to confirm personal beliefs.
Selectively citing weak or misinterpreted findings while ignoring systematic reviews and position statements from every major professional body is not neutral. It is unethical.
Courts should be deeply skeptical of legal arguments that rest on fringe interpretations rather than consensus reviews and clinical outcomes.
Conversion Therapy Ban: What This Ruling Does to the Field
The consequences projected before the ruling are now in motion.
- Licensing chaos. States may lose a clear tool for enforcing minimum standards in youth mental health care. Licensing boards may face lawsuits when they discipline dangerous conduct framed as “conversation.”
- Rapid policy backslide. Existing protections in dozens of states and cities may be invalidated. Youth in the most vulnerable communities may lose safeguards first.
- Insurance and liability uncertainty. Payers may refuse coverage for evidence-based gender-affirming and LGBTQ-affirming care if courts blur the line between professional standards and personal opinion. Clinicians who refuse change efforts may face retaliatory complaints.
- Training degradation. Graduate programs and internships may be pressured to present discredited practices as legitimate “alternatives,” lowering the standard for competence.
- Clinic ideology. Movement actors may open centers that market identity “correction” to families under the veneer of licensed care. The harm would fall on minors.
- Chilling effects on ethical practice. Clinicians may avoid working with LGBTQ+ youth for fear of harassment, complaints, or compelled-speech battles, reducing access to competent care.
What Responsible Therapy Looks Like After the Conversion Therapy Ban Ruling
I have sat with families in acute crisis. The path toward well-being runs through acceptance, evidence-based treatment, and patient-led goals. It does not run through shame, surveillance, or the false promise that identity can be corrected. Children’s lives and futures are not a forum for theoretical speech experiments. They are a trust we are all bound to protect.
Responsible therapy for youth distressed about sexuality or gender is exploratory, developmentally attuned, and family-inclusive. It centers the client’s own goals and autonomy, reduces distress, treats co-occurring conditions, and does not impose a predetermined identity outcome. It invites questions. It never prescribes who a young person must be.
What the Field Must Do Now
The ruling does not end the field’s responsibility. It raises the stakes for how clinicians, educators, advocates, and families respond.
- Maintain and expand what can still be defended. State protections not yet under direct challenge should be actively supported. Advocacy at the legislative level has not lost its purpose or influence.
- Document everything. Clinical outcomes, survivor testimony, and research findings all matter. The legal fights ahead will require evidence presented under the standard the Court has now imposed. Build that record now, systematically, while still protecting the client.
- Invest in training that does not wait for legal mandates. Graduate programs and supervision structures can model ethical, exploratory, and developmentally grounded practice regardless of what licensing boards are forced to permit.
- Support families directly. Parents searching for help who end up in the wrong offices will need accurate information about what evidence-based care looks like and where to find it. That outreach is more urgent now than it was this morning.
- Name the risk clearly and publicly. The harm conversion-oriented practices cause to young people is documented, specific, and speakable. Every available channel should be used.
Council for Relationships’ commitment to LGBTQ+ individuals, families, and communities is not contingent on what the law permits. It is grounded in evidence, ethics, and the understanding that belonging is not a clinical question. We will continue to advocate for affirming, competent, evidence-based care for every person who walks through our doors and to support the field in holding that standard regardless of the legal terrain.
Editor’s Note: This blog represents the author’s professional perspective and aligns with Council for Relationships’ ongoing commitment to Diversity, Equity, Inclusion, Access, and Belonging.
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About New Jersey Therapist Kristine Seitz, MEd, MSW, LSW
Kristine Seitz is Council for Relationships’ Diversity, Equity, Inclusion, Access, & Belonging (DEIAB) Manager, where she helps strengthen inclusive, affirming, and accessible care across CFR.
She is also a Staff Therapist at CFR who sees clients in New Jersey. Kristine offers an affirming, thoughtful, and relationship-centered approach to therapy for people seeking support around identity, emotional stress, and personal growth.
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