The Supreme Court, with only one justice dissenting, ruled in favor of a therapist who challenged a Colorado law banning “conversion therapy” for minors. The therapist argued that the law violated the First Amendment. The justices sent the case back to the district court for further consideration under a stricter legal standard that makes it very likely the law will be struck down. 

What is this case about? 

• “Conversion therapy” refers to any therapy program or methodology that attempts to change an LGBTQ+ person’s sexual orientation or gender identity to match heterosexual or cisgender norms. This includes, among other things, talk therapy, faith-based counseling, or physical exercises such as aversive conditioning (attempting to create a negative association with an individual’s LGBTQ+ identity by exposing them to distressing stimuli like an electric shock or other painful sensations). Major medical and psychological organizations have condemned these practices as ineffective and harmful.
• 23 states and the District of Columbia have banned “conversion therapy.” 
• In 2019, Colorado enacted the Minor Conversion Therapy Law, which prohibits “any practice or treatment … that attempts … to change an individual’s sexual orientation or gender identity.” The legislature cited high rates of depression, anxiety, suicidal thoughts, and suicide attempts among participants in “conversion therapy” as part of its justification for enacting the ban. A violation of this law carries a fine of up to $5,000.
• Kaley Chiles, a licensed therapist and evangelical Christian, filed a lawsuit challenging the Colorado law, arguing it infringes her First Amendment rights.

What happened in the courts?

• A federal judge in Colorado rejected Chiles’s request to freeze implementation of the law, writing that it “neutrally regulates professional conduct and professional practices” and does not unconstitutionally target religious beliefs or the viewpoint of speech.
• The U.S. Court of Appeals for the Tenth Circuit upheld the lower court’s ruling, concluding that the Colorado law “is a regulation of professional conduct incidentally involving speech.” 
• The U.S. Supreme Court heard oral arguments in the case in October 2025.

What did the Supreme Court decide?

• By a vote of 8-1, the justices ruled that the lower courts had applied the wrong legal standard when determining whether Colorado’s law infringed on the therapist’s First Amendment rights. They sent the case back to the district court for further proceedings. Justice Neil Gorsuch wrote the majority opinion. 
• Justice Ketanji Brown Jackson was the sole dissenter. Justice Elena Kagan wrote a short concurring opinion, which was joined by Justice Sonia Sotomayor. 
• The Court held that because Colorado’s law regulates the content of therapists’ speech, it must be evaluated under the heightened standard of “strict scrutiny” rather than the more deferential “rational basis” test used by the lower courts.
  • “Rational basis”: “[R]equiring the State to show merely that its law is rationally related to a legitimate governmental interest.”
  • “Strict scrutiny”: “[R]equires the government to prove its restriction on speech is ‘narrowly tailored to serve compelling state interests.’”
• Gorsuch rejected Colorado’s argument that the law should be assessed under the rational basis test on the ground that it regulates conduct or medical treatment rather than speech: “Chiles seeks to engage only in speech, and as applied to her the law regulates what she may say. Her speech does not become conduct just because the State may call it that. Nor does her speech become conduct just because it can also be described as a ‘treatment,’ a ‘therapeutic modality,’ or anything else. The First Amendment is no word game.”
• According to the majority, the law goes beyond regulating the content of speech to regulate the speaker’s viewpoint. Gorsuch wrote, “Colorado’s law … goes a step further, prescribing what views she may and may not express.” Quoting a 1995 Supreme Court decision, Gorsuch emphasized that “When the government seeks not just to restrict speech based on its subject matter, but also seeks to dictate what particular ‘opinion or perspective’ individuals may express on that subject, ‘the violation of the First Amendment is all the more blatant.’”
• Gorsuch concluded, “Colorado may regard its policy as essential to public health and safety … But the First Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech in this country. It reflects instead a judgment that every American possesses an inalienable right to think and speak freely, and a faith in the free marketplace of ideas as the best means for discovering truth. However well-intentioned, any law that suppresses speech based on viewpoint represents an ‘egregious’ assault on both of those commitments.”
• In her concurring opinion, Justice Kagan suggested the outcome could have been different if “Colorado had instead enacted a content-based but viewpoint-neutral law.” In that scenario, strict scrutiny might not apply to a law that does not “enable[] ‘speech on only one side’—the State’s preferred side—of an ideologically charged issue.” Kagan pointed to the Court’s ruling in a 2024 trademark case as an example of this.

Why did Justice Jackson dissent?

• Justice Jackson argued that Colorado’s law regulates medical care, not speech, and that any impact on speech is merely incidental to the state’s authority to set healthcare standards.
• Jackson wrote, “Stated simply, the majority has failed to appreciate the crucial context in which Chiles’s constitutional claims have arisen. Chiles is not speaking in the ether; she is providing therapy to minors as a licensed healthcare professional … bedrock First Amendment principles have far less salience when the speakers are medical professionals and their treatment-related speech is being restricted incidentally to the State’s regulation of the provision of medical care.” 
• She also warned that the Court’s ruling risks undermining states’ ability to regulate medical professionals and could lead to lower standards of care. Jackson: “This decision might make speech-only therapies and other medical treatments involving practitioner speech effectively unregulatable—not to be reached via licensing standards, medical-malpractice liability, or any other means of state control. Who knows? Certainly not the majority. It appears to have made this momentous decision without adequately grappling with the potential long-term and disastrous implications of this ruling.” 

What happens next?

• The case will return to the district court, which must now evaluate Colorado’s law under strict scrutiny.
• Given the Supreme Court’s conclusion that the law is viewpoint-based, Colorado will have a tough time meeting the strict scrutiny standard. As a result, the Colorado ban on “conversion therapy” will likely be struck down.
• Although the Court limited its holding to this case, its reasoning is likely to invite challenges to similar laws nationwide, as many states, including California, New York, and Illinois, have adopted bans phrased in a similar manner.