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The Supreme Court’s Conversion Therapy Decision Gets It Wrong

This blog was adapted from remarks delivered by Legal Director Josh Rovenger at the Freedom Forum Debate on June 29, 2026, addressing the Supreme Court’s ruling in Chiles v. Salazar.

Garrard’s Story: “The Light Went Out of His Eyes”

Before diving into the merits of the opinion, I want to start with a brief story about our client, Garrard. 

Garrard grew up in rural Arkansas in a deeply Baptist family. Church was the center of his world – his family went at least three times a week. He was close to both his parents. His mother nurtured his love of reading and writing. His father took him hunting and fishing and showed him, as Garrard put it, “God’s beauty through nature.” His childhood was idyllic. 

Garrard is also gay. And when his parents discovered he was gay, they sent him to a conversion therapist on the advice of church leaders. Garrard went willingly. He was terrified of losing his family, his church, and his relationship with God. 

Without any evidence, his counselors told him that child abuse caused homosexuality – in 99% of cases, they said. They planted the notion that his mother had shown him “excessive affection” and “inappropriate touch.” The conversion therapists also instructed him to yell at an empty chair representing his father – to say that he hated him for being emotionally absent. But Garrard refused to do the exercise, telling his counselors, “I don’t hate my father. I love my father.” 

Now, he knew what they were saying about his mom wasn’t true. But he grew uneasy around her and began to pull away. His mother later told him that when he entered conversion therapy, the light went out of his eyes, and she felt like she was watching her baby die in front of her. His father, ashamed the treatment hadn’t worked, pulled away. For years, Garrard could barely speak to either parent. He lost his faith, lost his ability to pray, and identified for a time as an atheist. 

We told the story about Garrard – and many others like him – in our amicus brief to the Supreme Court in this case. And in that brief, we closed the story with a quote from him, saying, “Conversion therapy breaks young people down until they can no longer feel love from God or family. Religious families and communities are helped, not harmed, by laws prohibiting this harmful practice.” 

That’s the voice I want to hold in mind as I address what I believe are serious errors in the Court’s decision. Because stories like his – which are not unique – can get lost in the legal nuance, even though they are at the core of what we’re discussing. 

Therapy Is Not Ordinary Speech

On the merits, there are four interrelated points I want to make about the decision. 

The first is that it completely misapprehends what talk therapy is – which is the main way that conversion therapy occurs today. 

The Court treated what Ms. Chiles does as if it were ordinary conversation – the kind of speech two people might have on a park bench. Justice Gorsuch described the issue in simple terms: she offers “talk therapy,” and talk is speech, and speech is presumptively protected. 

But that framing collapses a distinction that medicine and law have long recognized. A diagnosis is words. A prescription is words. The particular method a therapist uses to guide a patient toward a conclusion is words. None of that makes those acts equivalent to a person’s protected right to speak her mind. 

Talk therapy operates through a specific clinical mechanism. It leverages the authority the therapist holds, the vulnerability the patient brings, and the trust the therapeutic relationship depends on. The American Psychological Association, the American Psychiatric Association, the American Medical Association – every major professional body that has studied this – agrees: therapeutic speech is not merely speech. It is a professional intervention, like getting a vaccine or having a surgery. It works precisely because the provider is exercising professional judgment, and the patient is seeking help. 

This is why Justice Jackson was right that a century of precedent supported Colorado. States have always regulated what health care professionals may do with their patients – including how they speak to them, what goals they may set, and what outcomes they may promise. Before Chiles, a therapist who told a sexually abused survivor that the abuse was their fault could face professional discipline. Or, a therapist who recommends that a depressed patient try bloodletting could similarly face consequences for advocating for a discredited practice. None of that has ever been understood as a First Amendment problem – because the state is regulating professional conduct, not suppressing ideas. But now, by treating the form – talk – as dispositive and ignoring the function of that medical modality, the decision opens the door to questioning that entire paradigm.

The Evidence Matters

The second piece of the decision that I want to highlight is how the Court’s decision to narrow its focus to the applicable standard of review allowed it to make sweeping constitutional conclusions, without any meaningful engagement with the state’s justification for the law. 

Colorado did not pass this law on a whim or out of ideological preference or because it was seeking to promote an “ideology.” It passed the law after legislative hearings at which it reviewed a substantial body of evidence showing that conversion therapy is associated with increased depression, anxiety, suicidal ideation, and suicide attempts. 

Indeed, every major medical association has reached this exact same conclusion. So too has other research, including a report from offices in the UK Government aimed at examining the international evidence on conversion therapy practices. One study cited in our brief found that LGBTQ+ people who underwent conversion therapy were nearly twice as likely to report suicidal ideation or attempts as their peers who did not. Another documented severed family ties as a near-universal outcome. 

The stories in GLAD Law’s brief are, similarly, human illustrations of what the clinical literature documents repeatedly and consistently: elevated rates of suicidality, fractured family bonds, loss of faith, and estrangement from religious community. 

The Court was presented with all of this, and its majority opinion essentially set it aside – indeed, nothing in the opinion casts doubt on these conclusions, or suggests that conversion therapy practices are safe and effective. Justice Gorsuch’s response to the evidence of harm was to say that if Colorado had a compelling interest in protecting minors, it could try to prove it on remand under strict scrutiny. But by focusing solely on the level of scrutiny, the Court was essentially able to cast a constitutional shadow over Colorado’s law, without ever seriously engaging in the underlying testimony and research that democratically-elected representatives relied upon to enact in.

This Case Was Never About Silencing Religion

The third point I want to make is that the case was litigated on the premise that Colorado was censoring religious voices. It was not. 

Let’s be precise about what the law said. It applied only to licensed mental health professionals – therapists, psychologists, licensed counselors – acting in their clinical capacity. It explicitly excluded anyone “engaged in the practice of religious ministry.” A pastor could say whatever they believed. A priest could counsel a parishioner however they saw fit. A faith leader could refer a family to a religious program not governed by the mental health licensing regime. 

Ms. Chiles herself – a licensed counselor – remained free under the law to express her own beliefs. She could tell a client she personally believed that living according to birth sex is God’s design. She could discuss the theological tradition she comes from. She could try to find research inconsistent with the unanimous view on conversion therapy and then try to advocate for a different standard of care. What she could not do is pursue the elimination of her client’s sexual orientation or gender identity as the goal of licensed therapeutic treatment. That is not censorship of religion. That is a standard of care. 

Moreover, the law explicitly permitted what the Colorado legislature called “identity exploration and development.” A therapist could work with a client whose same-sex attractions and religious convictions were in tension. She could help that client explore, sit with the conflict, develop coping strategies, strengthen family relationships. She could provide “support and understanding” for the client’s choice to prioritize one identity or another – like, if a Christian gay man said he wanted to abstain from sexual intercourse because of his religion, the law did not prohibit her from supporting that choice. What she could not do was attempt or promise to change who the client fundamentally is through licensed therapeutic intervention – because that promise is false, and the law correctly treated it as such. 

Here is what troubles me most about the Court’s decision from a religious perspective. The eight survivors in GLAD Law’s brief did not just struggle with their mental health. Most of them lost their religion. These were deeply religious young people who entered conversion therapy willingly because they loved God and wanted to stay close to their religious communities. They came out estranged from their families, severed from their churches, unable to pray, identifying as atheists. Conversion therapy – done in the name of religion – destroyed their relationship with religion.

The Court has now protected the practice that does this. It has done so in the name of the First Amendment. But the communities most harmed by this decision are the religious families who were promised something that could not be delivered, and who lost their children to the wreckage of that false promise.

The Scientific Consensus Is Clear

Finally, I want to be direct about where the Court – and those of us focused solely on the legal analysis – have simply lost the plot. Underlying conversion therapy practices is an assumption that sexual orientation and one’s transgender status can, in fact, be changed. But this is not subject to serious debate. That premise is contradicted by the scientific evidence and clinical consensus. The APA says that one’s sexual orientation and gender identity cannot be changed in this way. The AMA agrees. The American Psychiatric Association agrees. The American Academy of Pediatrics agrees. The independent forensic experts who advise the United Nations have classified conversion therapy as a form of cruel, inhuman, and degrading treatment. 

The reason homosexuality was eventually removed from the DSM was not because advocates won a rhetorical debate in the marketplace of ideas. It was because the scientific and clinical community reviewed the evidence and reached a consensus. That consensus is now fifty years old. It is not tentative. It is not contested among credentialed researchers. And this effort to preserve conversion therapy practices is a poorly veiled effort to try to attack that medical consensus, all as part of a well-funded, coordinated effort to bring this country back 50 years.

And so, on this, I’m ultimately left wondering – if the science tells us that sexual orientation and gender identity cannot be changed; and if the data tell us that trying to change either causes profound harm on kids – including, those like Garrard, who may want the conversion therapy practice – and if survivors tell us, time and time again, that they wanted the practice but that the practice destroyed aspects of their lives, then, frankly, who cares if it is a constitutional right or not to engage in the practice? Morally, and ethically, don’t we have an obligation to avoid causing known harms to kids, even if we have a right to do so? We cannot allow the court’s legal analysis to blind ourselves to that reality.

Why This Decision Matters

I began with Garrard’s story, so I’ll also end there. 

He is not someone who now opposes religion. In fact, he returned to Christianity. He prays again. He has reconnected with his family. He is driven, in his own words, by the conviction that his life’s purpose is to bring more love and compassion into the world. He asked the Court, through our brief, to hear this: religious families and communities are helped, not harmed, by laws that prohibit this practice. 

Twenty-three states and the District of Columbia had enacted laws like Colorado’s. They passed those laws after careful deliberation. They relied on clinical consensus and individual testimony from conversion therapy survivors about the harms of this baseless and ineffective practice. They took action to protect families. 

The decision in Chiles v. Salazar puts those laws at serious risk. It does so on a legal theory that misunderstands what therapy is, brushes past the evidence of harm, misreads the threat to religion, and furthers the effort to push an assumption that the medical community has conclusively rejected. It is a dangerous opinion that undermines – rather than uplifts – the First Amendment. Garrard and others like him deserved better.