The U.S. Supreme Court ruled on March 31 in Chiles v. Salazar that a Colorado law restricting certain counseling conversations between counselors and minor clients violates the First Amendment. The 6-3 decision found that the state's attempt to regulate speech in the counseling room constitutes viewpoint-based discrimination.
The case centered on Kaley Chiles, a licensed Colorado counselor who challenged the state's ban on what it termed 'conversion therapy' for minors. The law prohibited counselors from engaging in voluntary conversations with clients under 18 that help them 'change' their sexual orientation or gender identity, while allowing conversations that encourage clients to explore different gender identities.
In the majority opinion, Justice Samuel Alito wrote that Colorado's law 'censors speech based on viewpoint,' calling the state's action an 'egregious' assault on First Amendment principles. The Court emphasized that while the debate over how to help minors with gender identity issues is fierce, the government cannot use public health justifications to suppress one side of that debate.
What the Left Is Saying
Progressive advocacy groups and Democratic lawmakers have defended similar laws across the country as necessary protections for LGBTQ+ youth. The American Academy of Pediatrics and other medical organizations have argued that so-called conversion therapy practices can cause serious harm to minors, including increased rates of depression and suicide.
Democratic state legislators who have passed these laws argue they are exercising their authority to protect children from potentially dangerous practices. They note that the Supreme Court's decision in Chiles v. Salazar conflicts with established precedent allowing states to regulate professional conduct, including in healthcare settings.
Several progressive lawmakers have indicated they will continue pursuing legislation to protect LGBTQ+ youth despite the ruling, arguing that the Court got this one wrong and that states retain authority to regulate licensed professionals. They point out that the decision could undermine other professional speech regulations, from medical malpractice standards to informed consent requirements.
What the Right Is Saying
Conservative groups and Republican lawmakers praised the ruling as a victory for free speech and parental rights. Alliance Defending Freedom, which represented Chiles, called it a 'monumental decision' that protects the ability of counselors to have voluntary conversations with clients who want to discuss their feelings about gender and body image.
Republican legislators in states with similar laws expressed concern that the ruling will force them to reconsider their approaches. However, many conservative legal scholars argue the decision correctly applies First Amendment principles, noting that the government cannot compel or prohibit certain viewpoints even when acting to protect public health.
The decision gives counselors in more than 20 states with similar laws a pathway to challenge those restrictions. Conservative legal advocates say the ruling reinforces fundamental American values about free expression and the right of individuals to seek the counseling they believe will help them.
What the Numbers Show
According to data from the Williams Institute at UCLA, as of 2024, 20 states and the District of Columbia have laws or regulations restricting conversion therapy for minors. An additional 100 localities have enacted similar restrictions.
Research published in the journal JAMA Pediatrics estimates that approximately 90% of children who experience gender dysphoria before puberty will no longer meet diagnostic criteria for the condition by adolescence if not affirmatively encouraged to identify with a gender different from their sex. This statistic, cited in arguments before the Court, has been contested by some medical professionals who say the research methodology is flawed.
The Trevor Project's 2023 National Survey on LGBTQ+ Youth Mental Health found that LGBTQ+ youth who had access to conversion therapy reported higher rates of suicide attempts. However, the same survey found that affirming environments and access to supportive adults correlate with better mental health outcomes.
The Williams Institute estimates there are approximately 1,800 licensed counselors in Colorado who would have been affected by the state's law. Similar laws in other states affect thousands of licensed mental health professionals.
The Bottom Line
The Supreme Court's decision in Chiles v. Salazar represents a significant expansion of First Amendment protections into the realm of professional counseling. The ruling establishes that states cannot ban certain viewpoints in therapy sessions, even when acting under the guise of protecting public health.
The practical impact remains uncertain. While the decision strikes down Colorado's specific law, legal experts say it will likely prompt challenges to similar statutes in other states. The Court's majority emphasized that while the debate over youth gender issues is contentious, 'the First Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech.'
Counselors and clients in Colorado can now engage in voluntary conversations about gender identity without state interference. What happens next will likely depend on how other states choose to respond — whether they amend their laws, await further litigation, or attempt new regulatory approaches that survive constitutional scrutiny.