April 2, 2026 

Chiles v. Salazar

WASHINGTON, D.C. – Doctors for America is dismayed by the Supreme Court ruling in the case of Chiles v. Salazar. In an 8-1 ruling, the Supreme Court stated that bans on conversion therapy of LGBTQ+ people “likely violates free speech” and impairs the expression of religion, thus implying that future bans will likely not survive legal challenge. The case was brought by a licensed Christian counselor in Colorado to challenge Colorado's Minor Conversion Therapy Law which prohibits physicians and licensed mental health professionals from engaging in any practice that attempts to change a minor’s sexual orientation or gender identity. 

Conversion “therapy” has historically used techniques including talk, religious exhortation, hypnosis, electric shocks, and chemically induced nausea to try to change sexual orientation, gender identity, or behavior. The Williams Institute at UCLA estimates that as of 2019, about 700,000 LGBTQ+ people had been subjected to  conversion therapy. About 1,300 practitioners nationwide sell the putative “therapy” in states where it remains legal. The Trevor Project's research has found that LGBTQ+ youth subjected to conversion pressures are more than twice as likely to attempt suicide and more than 2.5 times as likely to report multiple suicide attempts. Survivors describe lasting psychological damage including depression, PTSD, anxiety, self-hatred, and suicidal ideation. 

Currently, conversion therapy is illegal in Colorado and 30 other US jurisdictions, as many major medical and mental health organizations across the country have condemned it as not only ineffective, but as demonstrably harmful. The American Psychological Association, the American Medical Association, the American Academy of Child and Adolescent Psychiatry, and more than a dozen other professional organizations have formally opposed conversion therapy. Additionally, the United Nations has deemed conversion therapy as a form of torture and recommended it to be banned worldwide. 

Writing for the majority, Justice Neil Gorsuch stated that the Colorado law violated the counselor’s First Amendment right to free speech, stating, “the First Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech in this country.” Justice Ketanji Brown Jackson, the sole dissenter of the case, emphasized the detrimental impact such a ruling could have on a state’s ability to regulate the health professions, writing, “The Constitution does not pose a barrier to reasonable regulation of harmful medical treatments just because substandard care comes via speech instead of scalpel.”

The Supreme Court decision in Chiles v. Salazar first will cause significant physical, mental, and emotional harm to LGBTQ+ children by allowing the practice of talk conversion therapy under the guise of free speech. DFA asserts that conversion therapy in any form is against the medical standard of care and pathologizes a person’s gender identity and/or sexual orientation as something that must be fixed. Second, such a decision is a foundational challenge to all professions and threatens the beneficial and safe application of empirical and scientific knowledge to human needs under the guise of protecting First Amendment rights, while blindly ignoring the real world effects, vulnerabilities, and disparities. States should be allowed to regulate medical and therapeutic interventions to ensure they comply with the standard of care and do not cause undue harm to the patient. Infringing upon this regulatory ability in the name of free speech will risk harm to the patient (particularly those of minoritized identities) and the patient/physician relationship. DFA strongly disagrees with this Supreme Court decision and affirms both the harms of conversion therapy and the need for state regulation of harmful medical/therapeutic practices. 

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About Doctors for America:

Doctors for America (DFA) is a national nonprofit that mobilizes over 40,000 physicians and medical trainees to advocate for policies that improve the health of patients and communities. Through advocacy training and action at the state and federal levels, DFA works to expand access to affordable care, strengthen community health and prevention, and advance health justice and equity. We do not accept funding from pharmaceutical, insurance, or for-profit health care entities, ensuring our work remains fiercely independent and patient-centered. DFA puts patients over politics–and over profits. Find out more at doctorsforamerica.org and on X @drsforamerica or Bluesky drsforamerica.bsky.social.