Supreme Court to decide whether states can ban anti-LGBTQ conversion therapy on kids.

In what could foreshadow a major new onslaught against queer and trans children, the US Supreme Court announced on Monday that it will hear a case challenging a 2019 Colorado law forbidding licensed therapists from trying to turn LGBTQ kids straight and cisgender.

The court’s decision to hear the case next fall is a major victory for practitioners of “conversion therapy,” a term used colloquially to describe attempts to shift a person’s sexual orientation or gender identity. Before the 1970s, when being gay was still considered a mental illness, conversion therapy was the standard treatment—sometimes involving “aversion” techniques like electric shocks or chemically induced nausea paired with images of gay porn. Today, conversion therapy mostly involves talk therapy, often between conservative religious clients and practitioners.

Still, talk-based conversion therapy can cause immense harm to LGBTQ people’s mental health, according to leading experts. The American Psychological Association has concluded that efforts to change peoples’ sexual orientation lack “sufficient bases in scientific principles” and that people who have undergone such therapies are “significantly more likely to experience suicidality and depression.”

The same goes for therapies aimed at making trans people identify with the gender they were assigned at birth. In 2015, the federal Substance Abuse and Mental Health Services Administration, part of the US Department of Health and Human Services, published a report concluding that “none of the existing research supports the premise that mental or behavioral health interventions can alter gender identity or sexual orientation.” Interventions aimed at a fixed outcome, such as gender conformity or heterosexual orientation “are coercive, can be harmful, and should not be part of behavioral health treatment,” the authors concluded. (Since President Donald Trump took office and ordered government websites stripped of information related to so-called “gender ideology,” the SAMHSA report has been taken down.)

States started banning conversion therapy on minors in 2012, as gay rights was achieving widespread acceptance and the scientific community increasingly recognized that efforts to change sexual orientation both didn’t work and could cause harm. Today, according to the Movement Advancement Project, 23 states have passed laws to revoke licenses from mental health professionals practicing conversion therapy on queer and trans people under the age of 18, and more states have executive orders restricting the practice.

But as soon as those laws began to pass, conversion therapists began fighting back, filing at least 11 lawsuits in eight states from 2012 through 2023. Typically, those cases have argued that the restrictions on therapists’ conversations with minors infringes on the therapists’ First Amendment right to free speech.

Federal appeals courts mostly haven’t bought that argument, ruling that that states have the power to regulate medical treatment, even when that treatment consists entirely of spoken words. But in 2020, the 11th Circuit went the other way, overturning a local conversion therapy ban in Florida in response to a lawsuit by the former president of the Alliance for Therapeutic Choice and Scientific Integrity, the leading US advocacy group for licensed conversion therapists.

During an ATCSI conference I attended in late 2023, presenters showed a video illustrating what their therapy technique, which they called “mindfulness,” looked like:

A young adult client, played by an actor, sits nervously across from [counselor Joseph] Nicolosi Jr. in a room filled with books. Nicolosi Jr. asks him to describe his ideal sexually attractive man. The client responds that the man would be strong, confident, informal. “I would definitely say a guy who’s like, um, on the taller side,” he says.

Then, Nicolosi Jr. asks the client what he would change about himself: Shorter or taller? Stronger or weaker arms? More or less confident? He urges the client to compare himself to the imagined man, and the client says he feels inadequate. “How do you feel about the fact that you feel that inferiority, weakness?” Nicolosi Jr. asks.

“Sadness,” the client says.

“Feel your sadness as you continue looking at that guy,” Nicolosi Jr. urges. “And as you hold them together right now, zero to 10, how strong is your sexual attraction toward him?”

As my colleague Henry Carnell and I reported in that investigation last year, conversion therapists have seized on disputes over the treatment of trans youth—a controversy fomented by religious-right organizations and anti-LGBTQ fringe groups and exploited by Republican politicians—to argue that they should be allowed to encourage kids to not be trans. Accordingly, in recent years, conversion therapists’ lawsuits have increasingly focused on trans people and gender identity, rather than gay people and sexual orientation.

That’s the argument made by Kaley Chiles, the licensed counselor in Colorado who filed Chiles v. Salazar, the case the US Supreme Court has now agreed to hear. Conversion therapy bans “silence counselors’ ability to express views their clients seek on a topic of ‘fierce public debate’—’how best to help minors with gender dysphoria,”‘ Chiles’ petition to the court argues.

Chiles is represented by the Alliance Defending Freedom, the powerful religious-right law firm behind the most significant anti-LBGTQ Supreme Court cases of recent years. Targeting Colorado in particular, ADF has found great success using the First Amendment to chip away at the state’s strong anti-discrimination protections for queer and trans people in the name of “religious freedom.” The court’s conservative supermajority has repeatedly sided with ADF, deciding that First Amendment allows Christian cake-bakers and wedding–website designers to refuse service to LGBTQ people planning same-sex weddings.

ADF’s argument on behalf of Chiles likewise centers on her religious beliefs—in this instance, her feelings about trans people. “A practicing Christian, Chiles believes that people flourish when they live consistently with God’s design, including their biological sex,” her petition argues. “Many of her clients seek her counsel precisely because they believe that their faith and their relationship with God establishes the foundation upon which to understand their identity and desires. But Colorado bans these consensual conversations based on the viewpoints [Chiles and her clients] express.”

Like all other conversion therapy bans, Colorado’s ban applies only to licensed therapists, not to religious advisers like priests and pastors. (Of course, church-based conversion therapy can also cause immense harm, as Carnell reported.)

At least two Supreme Court justices are known to be friendly to the argument that conversion therapy for minors is protected by the First Amendment. Last year, when the court declined to take up a nearly identical case challenging a conversion therapy ban in Washington state, Justice Clarence Thomas issued a dissent, joined by Justice Samuel Alito, that described bans on conversion therapy for minors as “viewpoint-based and content-based discrimination in its purest form.”

“Although the Court declines to take this particular case, I have no doubt that the issue it presents will come before the Court again,” Thomas wrote at the time. “When it does, the Court should do what it should have done here . . . consider what the First Amendment requires.” With arguments in Chiles v. Salazar expected to be scheduled for next fall, Thomas will soon get the chance he’s been waiting for.