The Supreme Court on Tuesday struck down part of Colorado’s ban on “conversion therapy” as applied to a licensed counselor’s talk therapy, finding the law violates the First Amendment.
In a decision released March 31, 2026, the Court in Chiles v. Salazar held that Colorado’s statute, as applied to counselor Kaley Chiles, regulates speech based on viewpoint and must face the Constitution’s most demanding level of review.
Writing for an 8–1 majority, Neil Gorsuch said the law does not merely regulate professional conduct but instead targets “what she may say” in counseling sessions. The opinion emphasized that Chiles provides only talk therapy—“no medicines, no physical treatments”—and that the state’s law permits speech affirming a client’s “gender identity” while prohibiting speech aimed at changing it.
“Viewpoint discrimination,” the Court reiterated, is “an egregious form” of content regulation that governments must nearly always avoid. The justices concluded that the lower courts erred by applying only rational-basis review and should instead have subjected the law to strict scrutiny.
The ruling reverses a decision from the U.S. Court of Appeals for the Tenth Circuit and sends the case back for further proceedings.
The majority opinion drew support from across the Court’s ideological spectrum, including John Roberts and justices Clarence Thomas, Samuel Alito, Sonia Sotomayor, Elena Kagan, Brett Kavanaugh, and Amy Coney Barrett.
Separate opinions revealed fractures among the Court’s Democratic-appointed justices, particularly over how far First Amendment protections should extend in regulating medical and mental health professionals.
In a concurrence joined by Sotomayor, Kagan agreed the Colorado law was unconstitutional because it “distinguishes between two opposed sets of ideas” and permits “speech on only one side.” She described the statute as “textbook” viewpoint discrimination because it allows therapists to affirm a minor’s “gender identity” but bars them from helping a client seek change.
At the same time, Kagan cautioned that the Court was not resolving a broader and more difficult question: whether a similar content-based but viewpoint-neutral law would survive constitutional scrutiny. She suggested that regulations of speech in medical settings may not always raise the same censorship concerns, noting that “medical care typically involves speech” and is already heavily regulated.
That narrower framing contrasted sharply with the dissent from Ketanji Brown Jackson, who argued the majority had improperly constitutionalized routine state regulation of medical practice.
Jackson wrote that Colorado’s law is a valid exercise of the state’s authority to regulate licensed professionals and protect minors from what it considers harmful treatment. She emphasized that “talk therapy is a medical treatment” and that states have long imposed standards of care that necessarily affect what providers can say.
“The Constitution does not pose a barrier to reasonable regulation of harmful medical treatments just because substandard care comes via speech instead of scalpel,” Jackson wrote, warning the decision could make “speech-only therapies and other medical treatments involving practitioner speech effectively unregulatable.”
The divide highlights a deeper disagreement over whether speech within a professional-client relationship should be treated like ordinary public discourse or as part of regulated conduct. While the majority rejected the idea of a “First Amendment Free Zone” for licensed professionals, Jackson argued that longstanding precedent allows states to impose limits when speech is part of the delivery of care.
The case arose from a 2019 Colorado law banning licensed counselors from engaging in efforts to change a minor’s “sexual orientation” or “gender identity,” while allowing counseling that affirms or supports those identities. Chiles challenged the law as applied to her practice, arguing it censors private conversations with clients who may seek different therapeutic goals.
The Court stressed that its ruling is limited, addressing only how the law applies to Chiles’s talk therapy, not the statute as a whole.
