In Chiles v. Salazar, (Sup.Ct., March 31, 2026), the U.S. Supreme Court in an 8-1 decision struck down most applications of Colorado's law that prohibits licensed counselors from engaging in conversion therapy for minors, defined as therapy that attempts to change an individual’s sexual orientation or gender identity. Justice Gorsuch, joined by all but Justice Jackson, wrote the majority opinion which says in part:
The State insists, and the Tenth Circuit agreed, that its law does not “regulate expression” at all, only “conduct,” “treatment,” or a “therapeutic modality.”... As a result, Colorado reasons, its law triggers no more than rational-basis or intermediate scrutiny review.... But the State’s premise is simply mistaken. In many applications, the State’s law banning “conversion therapy” may address conduct—such as aversive physical interventions. But here, Ms. 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. And the rights it protects cannot be renamed away or their protections nullified by “mere labels.”...
As applied here, Colorado’s law does not just regulate the content of Ms. Chiles’s speech. It goes a step further, prescribing what views she may and may not express. For a gay client, Ms. Chiles may express “[a]cceptance, support, and understanding for the facilitation of . . . identity exploration.” §12–245–202(3.5)(b)(I). For a client “undergoing gender transition,” Ms. Chiles may likewise offer words of “[a]ssistance.” §12–245–202(3.5)(b)(II). But if a gay or transgender client seeks her counsel in the hope of changing his sexual orientation or gender identity, Ms. Chiles cannot provide it....
At bottom, Colorado and the dissent fundamentally misconceive this Court’s speech-incident-to-conduct precedents. In these cases, the question is not whether a law mostly addresses conduct and only sometimes sweeps in speech. Instead, the focus lies on two entirely different questions: whether the law in question restricts speech only because it is integrally related to unlawful conduct— or ... only for reasons unrelated to its content....
Colorado’s law does not regulate speech incident to conduct under either test....
... Colorado emphasizes, [prior precedent] left open the possibility that a future party might present “persuasive evidence . . . of a long (if heretofore unrecognized) tradition” of content regulation regarding additional categories of professional (or other) speech that might likewise warrant only “diminished” First Amendment protection....
... Colorado and the dissent ask us to recognize a cavernous “First Amendment Free Zone,”... one in which States may censor almost any speech they consider “substandard care.” It is, once more, an approach our precedents already foreclose.
Justice Kagan, joined by Justice Sotomayor, filed a concurring opinion stating that the result might be different if a law regulating speech in doctors' and counselors' offices were content-based but viewpoint-neutral.
Justice Jackson filed a 35-page dissenting opinion saying in part:
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. The Tenth Circuit was correct to observe that “[t]here is a long-established history of states regulating the healthcare professions.” ... And, until today, the First Amendment has not blocked their way. For good reason: Under our precedents, 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....
Over the past few decades, however, the premise of conversion therapy (in whatever form) has been widely discredited within the medical and scientific community. Conversion therapy is, at bottom, “based on a view of gender diversity that runs counter to scientific consensus.”...
A state license used to mean something to the patients who entrust their care to licensed professionals—i.e., that the person is certified to be one who provides treatments that are consistent with the standard of care.
That stops today....
The Guardian reports on the decision. ADF, which represented petitioner, issued a press release commenting on the decision.
