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Twenty-four states and the District of Columbia have enacted similar bans on licensed mental health providers, subjecting minors to practices aimed at changing their sexual orientation or gender identity.
Here's what to know about the case as oral arguments tee off the high court's next term.
When the U.S. Supreme Court begins its new term in October, all eyes will be on the blockbuster cases waiting in the wings. On October 7, the justices will hear Chiles v. Salazar, a case that could decide whether states can continue protecting LGBTQ+ youth from so-called “conversion therapy” or whether those protections collapse nationwide.
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At stake is more than the future of a single Colorado law. Twenty-four states and the District of Columbia have enacted similar bans on licensed mental health providers, subjecting minors to practices aimed at changing their sexual orientation or gender identity. If the justices strike Colorado’s law, those protections could unravel.
“This case is a real test of whether there will always be a double standard for our community,” Shannon Minter, legal director of the National Center for LGBTQ Rights, told The Advocate in an interview. “These laws are ordinary regulations of mental-health treatments that protect kids from ineffective and harmful practices. It would be tragic if they were struck down just because, in this case, they happen to protect LGBT young people.”
The petitioner is Kaley Chiles, a licensed counselor in Colorado who wants to continue offering conversion therapy to minors. She argues that the state’s 2019 ban violates her First Amendment rights, framing therapy as a form of speech that the government cannot regulate.
Related: Fighting for LGBTQ+ youth: The cases challenging conversion therapy bans
The respondent is Patty Salazar, executive director of the Colorado Department of Regulatory Agencies. Her department oversees professional licensing, and she is defending the law on behalf of the state.
Colorado’s statute is narrow: it prohibits licensed professionals from claiming to change or attempting to change a minor’s sexual orientation or gender identity. It does not apply to clergy or religious counselors, and it does not restrict supportive therapy that helps young people explore their identities.
Lower courts upheld Colorado’s law, joining a chorus of rulings across the country that recognized conversion therapy bans as constitutional regulations of professional conduct. But in 2023, the U.S. Court of Appeals for the 11th Circuit created a split, striking down local bans in Florida. That divergence set the stage for Supreme Court review.
For survivors, the case is personal. A 2023 report by The Trevor Project, It’s Still Happening, documented how conversion therapy persists despite professional condemnation. More than 80 percent of LGBTQ+ adults surveyed who experienced conversion efforts said it caused lasting harm, from depression and anxiety to estrangement from family and faith.
Former participants described trauma, shame, and suicidality.
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The Trevor Project and the American Foundation for Suicide Prevention submitted their own amicus brief, citing research showing LGBTQ+ youth subjected to conversion efforts are more than twice as likely to attempt suicide as their peers. The groups warned the court that striking down Colorado’s law would greenlight a practice every primary medical and mental health association has deemed fraudulent and dangerous.
If the Court strikes Colorado’s law, the impact would be immediate. States from California to New York could see their bans fall. Parents desperate for answers might once again be funneled to providers offering false promises of “cures.” Survivors worry it would also send a cultural message that the nation’s highest court has blessed a practice they know to be abuse.
On the other hand, if the Court affirms Colorado’s authority, it could solidify the legality of conversion therapy bans nationwide and shore up states’ ability to regulate professional treatment even in a polarized political climate.
For LGBTQ+ advocates, the case is not an abstract clash over free speech but a life-and-death struggle. “It’s vitally important to keep these laws banning this dangerous, discredited practice because there’s a direct association with LGBTQ+ youth being exposed to conversion [therapy] more than doubling the risk of attempting suicide,” Mark Henson, vice president at The Trevor Project, told The Advocate in an interview. “Further, those who have experienced conversion therapy are two and a half times as likely to report multiple suicide attempts in the prior year.”
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Henson stressed that the practice “drives a wedge between youth and their families. It drives a wedge between young people and their faith communities. There are long-lasting, devastating effects.”
Colorado’s ban, he said, was “very well crafted” and reflects the consensus of medical and mental health organizations that “condemn this so-called therapy.” The law, he added, is part of states’ longstanding authority to ensure professional licensing standards. “It’s enabling states to ban snake oil salesmen effectively, since states do have this license requirement. Professional organizations should be doing things that help people instead of hurt people,” Henson said.
He also noted that the issue crosses partisan lines. “Since 2012, there have been over a thousand times when Republicans have voted for or helped enact conversion therapy bans,” he said. “Republicans are on the record banning this and standing up for LGBTQ+ youth and standing up for medical professions and the standards to eliminate this dangerous, discredited practice.”
What sets Chiles v. Salazar apart from past battles is the unusual range of amici weighing in to support Colorado. Alongside LGBTQ+ advocacy groups are unexpected allies: conservative Catholic therapists, evangelical educators, and even former leaders of the “ex-gay” movement.
One brief, authored by Colorado therapist Julia Sadusky, a devout Catholic whose practice focuses on youth from conservative religious families, could prove especially influential.
Catholic educators warned the Court that conversion therapy fractures families and drives young people away from their faith. Another brief came from conservative gay Christians, some of whom endured conversion programs themselves, testifying that the practice increases despair rather than fostering belonging.
Related: Supreme Court rules states can ban gender-affirming care for youth in U.S. v. Skrmetti
Even leaders of the former “ex-gay” movement told the justices that their own ministries had done profound harm.
Minter called these filings “so powerful” in his interview with The Advocate. “It’s intellectually honest and deeply moving to see conservative voices saying, ‘This isn’t therapy. This isn’t faith. This is abuse.’ I hope the Court listens.”
At the heart of the case is whether Colorado’s ban regulates professional conduct or suppresses speech. Chiles’s lawyers, backed by the Alliance Defending Freedom, a right-wing group opposed to LGBTQ+ rights, argue that therapy is speech, and any restriction is viewpoint discrimination.
Colorado counters that conversion therapy is a treatment, not a protected opinion. States, it says, have broad authority to regulate medicine and mental health to protect the public. In fact, in the last term, the U.S. Supreme Court in Skrmetti upheld a Tennessee law banning gender-affirming care for minors using this logic.
The Constitutional Accountability Center, a progressive law firm and think tank, filed an amicus brief highlighting that distinction. “Advice and treatment provided by professionals have long been treated differently than private speech,” CAC wrote. “The First Amendment does not allow courts to override the judgment of the Colorado legislature that the treatment Chiles wishes to provide is outside the bounds of professional norms and threatens to harm Colorado’s children.”
For advocates, Chiles v. Salazar cannot be separated from the broader political moment aimed at erasing gains the LGBTQ+ community has made in recent years. The Trump administration has backed anti-LGBTQ+ litigation, and the Department of Health and Human Services even rebranded “conversion therapy” as “exploratory therapy.” Simultaneously, Trump has pressed cases seeking to exclude transgender students from sports and restrict gender-affirming care.
“The very fact that Alliance Defending Freedom is behind this case should tell us it is intimately connected to the broader attacks,” Minter said. “They want to turn back the clock to a time when being gay or transgender was morally condemned and legally unprotected.”
The fear is that a ruling against Colorado would not only invalidate bans in nearly half the country but also embolden new efforts to recast anti-LGBTQ+ discrimination as constitutionally protected “speech.”
Mardi Moore, the CEO of Rocky Mountain Equality, told The Advocate that Colorado’s political climate makes it a testing ground for national conservative attacks. She said Colorado has become a magnet for litigation. “The alliance defending freedom and others have taken Colorado to the Supreme Court, again, to be heard next year on our conversion therapy law,” she explained. Once-sleeping giants like Focus on the Family have “reactivated in areas like Colorado Springs,” making the state “a breeding ground” for measures that target LGBTQ rights, from sports bans to restrictions on gender-affirming care, she said.
Oral arguments on October 7 are likely to highlight whether the justices view therapy as speech or conduct.
Minter, who has litigated LGBTQ+ cases for decades, admitted the stakes are “nerve-wracking.” “If the Court misunderstands these laws and strikes them down, it would be devastating,” he said. “But after seeing the breadth of amicus briefs, especially from unexpected allies, I feel encouraged. If the Court does its job and reads them carefully, we have a very significant chance of winning.”
The Court’s decision is expected by June 2026.
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