Public debates about “conversion therapy” often focus on horror stories. We picture coercive programs aimed at “fixing” LGBTQ youth or parents pushing a doctrinal agenda on a vulnerable child.
But the reality inside many therapy rooms is far more complicated than this binary suggests. A quiet tension has emerged among diverse religious therapists who work with religiously observant clients. They worry that the laws banning conversion therapy, though designed to stop harmful practices, have sometimes been interpreted so broadly that even voluntary discussions about faith and identity feel legally risky.
These therapists are not trying to cure anyone. Instead, they want to help clients who come to them in pain, unsure how to reconcile sexuality or gender identity with religious commitments that are central to their sense of self. They fear that if a client wants to talk about moving away from certain desires or exploring how to live more comfortably in their body, the law might mistakenly classify that conversation as prohibited “change” therapy. The result is a chilling effect that was never part of the original legislative intent.
Kaley Chiles, the Colorado-based counselor at the center of Chiles v. Salazar, fits within this understudied terrain. She is not claiming a religious duty to redirect minors toward heterosexuality or traditional gender roles. Her clients, she says, seek her out because they want to sort through unwanted attractions or discomfort around gender in light of their faith. She wants room to offer that support.
Yet unlike previous challengers, Chiles has not filed a religious liberty claim. She has brought a free speech claim. That shift is precisely why her case now before the Supreme Court matters.
Colorado’s law prohibits therapists from engaging in any practice that attempts or purports to change a minor’s sexual orientation or gender identity, including efforts to alter behavior, attraction, or gender expression.
Under the Supreme Court’s Free Exercise doctrine, this kind of neutral, generally applicable law would almost certainly be upheld. But Chiles argues that therapy is fundamentally conversation and that the state cannot criminalize the expression of a viewpoint simply because it disapproves of it.
Her claim draws on cases like NIFLA v. Becerra, which held that the government cannot force medical professionals to deliver state-mandated messages. If the government cannot compel speech, she argues, it should not be able to forbid speech either.
This move reflects a broader judicial trend. The Court increasingly resolves disputes rooted in religious motivations through free speech principles rather than religious liberty.
For example, in 303 Creative v. Elenis, the Court sidestepped Free Exercise altogether and focused solely on compelled expression. The same reframing is at work in Chiles.
And when a claim is cast as censorship rather than burden on religion, the constitutional stakes shift dramatically.
The tension was especially clear during oral argument for this recent case. Several justices pressed Colorado on whether it had ever enforced the law. The state acknowledged that it had not and said it would not go after the kind of “consensual talk therapy” Chiles describes.
Justice Sotomayor captured the puzzle. If Colorado insists it will not apply the statute to her work, then who exactly is being regulated? Chiles’s attorney countered that the statute’s plain text does cover what she does and that the state’s assurances cannot cure that overbreadth.
The result is a strange posture in which the challenger says the law is broad and the state says it is narrow. Colorado defends the statute by downplaying its reach, yet the legislature wrote it to prevent a wide range of practices deemed harmful by every major medical association.
If therapy is treated as speech rather than professional conduct, the Court’s precedents leave states with little room to draw distinctions, even when the purpose is to protect minors.
This doctrinal pivot may have far-reaching consequences. Much of mental health care is delivered through conversation. Suicidality counseling, eating disorder treatment, addiction recovery, gender-affirming care, grief therapy, and end-of-life support all depend on spoken guidance.
If courts treat the content of that guidance as protected expression, even when provided to children, a wide swath of health regulations could become vulnerable to constitutional challenge.
It is important to name what is at stake on both sides. The medical consensus on conversion therapy for minors is unequivocal. It is not effective, and it carries serious risks including depression and suicidality.
But the lived experience of many faith-aligned therapists is also real. They are trying to meet clients who are navigating conflicts between identity and belief, and they fear that broad statutory language may prevent them from doing ethically appropriate work.
In a healthier political environment, legislatures and licensing boards might draw careful distinctions between coercive interventions and voluntary, client-initiated conversations. But First Amendment doctrine leaves little space for nuance.
Once a law is treated as regulating ideas rather than practices, courts look skeptically at almost any restriction. And once a therapist’s work is conceptualized as speech, the needs of minors can quickly recede from view.
Chiles v. Salazar is not simply about LGBTQ youth or parental authority. It is a window into a deeper struggle over how we draw boundaries around professional expertise in an era of expansive free speech protections.
The Court must decide not only how far states can go in protecting children but also how far therapists may go in responding to the needs of clients whose identities, beliefs, and vulnerabilities do not fit neatly into polarized cultural narratives.