Docket 24-539
Chiles v. Salazar
DecidedMar 31, 2026
8-1decision
Source: CourtListener.
Court strikes down Colorado ban on talk therapy aimed at changing minors' sexual orientation or gender identity
What it does
The Court held that Colorado's conversion therapy ban, as applied to talk-only therapy, regulates speech based on viewpoint and must be subjected to the most demanding First Amendment review — not the lenient "rational basis" standard the lower courts used. The ruling reverses the Tenth Circuit and sends the case back for further proceedings under that stricter standard. The decision resolves a split among federal appeals courts over how the First Amendment applies to laws like Colorado's when those laws reach talk therapy.
Who benefits
Licensed counselors and talk therapists who wish to offer clients — including minors — therapy aimed at changing sexual orientation, gender identity, or related behaviors. Clients who seek out such therapy and wish to pursue those goals with a licensed professional also benefit from the ruling.
Who is affected
State governments that have enacted laws banning conversion therapy for minors, including the roughly 26 states with such laws, which now face a higher legal bar to enforce those bans against talk-only therapists. Minors and their families who rely on state licensing standards to ensure that counselors provide only treatments the medical community considers safe and effective are also affected.
Practical impact
Colorado's conversion therapy ban cannot be enforced against talk-only therapists like Ms. Chiles unless the state can satisfy strict scrutiny — meaning it must show the law is narrowly tailored to serve a compelling government interest, a very high bar that few speech restrictions survive. Other states with similar bans on conversion therapy face the same constitutional challenge when those bans are applied to counselors who use only talk therapy. Licensed counselors who previously stopped offering such therapy out of fear of losing their licenses may now resume doing so while legal proceedings continue.
Majority reasoning
The majority held that Colorado's law, as applied to Ms. Chiles, regulates speech based on viewpoint — the most serious form of First Amendment violation — because it allows counselors to express acceptance and support for a client's gender transition or identity exploration, while forbidding them from saying anything that attempts to change a client's sexual orientation or gender identity. The Court reasoned that speech does not become "conduct" simply because the government labels it a "treatment" or "therapeutic modality"; what matters under the First Amendment is whether the law regulates speech in the specific case at hand, and here Ms. Chiles does nothing but speak. The majority rejected the argument that licensed professionals enjoy lesser First Amendment protection, reaffirming that the Constitution protects the right of all people — including doctors and counselors — to speak freely, and that history shows governments have often tried to manipulate professional speech to suppress disfavored ideas. The Court also rejected Colorado's attempt to fit its law within recognized exceptions to strict scrutiny — such as informed-consent rules or malpractice law — finding that those traditions are meaningfully different and cannot be combined to create a broad new zone where states may silence speech they consider "substandard care." Finally, the majority warned that allowing states to suppress professional speech whenever it deviates from current medical consensus would give governments unchecked power to silence dissenting views in medicine, a result the First Amendment was designed to prevent.
Dissent reasoning
In dissent, Justice Jackson argued that the majority failed to appreciate the crucial context: Ms. Chiles is not speaking freely in public, but providing medical treatment to minors as a state-licensed healthcare professional, and states have regulated the content of medical treatments — including those delivered through speech — for centuries without constitutional problem. The dissent read the Court's 2018 NIFLA decision as establishing that when a state restricts a healthcare provider's speech as part of regulating the provision of medical care, that restriction is merely "incidental" to the regulation of professional conduct and does not trigger the highest level of First Amendment scrutiny. Justice Jackson argued that all medical standards are inherently viewpoint-based — a state that tells doctors not to encourage suicide or not to advise an anorexic patient to eat less is taking sides — and that this kind of standard-setting is the entire point of licensing and malpractice law, not a constitutional violation. The dissent warned that the majority's ruling could make speech-based medical treatments effectively unregulatable, threatening the ability of states to enforce any professional standard of care that is delivered through words rather than physical procedures, and potentially opening the door to unsafe or harmful care by talk therapists, psychiatrists, and others who treat patients primarily through speech.
Constitutional question
Does Colorado's law banning "conversion therapy" for minors violate the First Amendment when applied to a licensed counselor who uses only talk therapy — no physical techniques or medications — to help clients pursue goals they themselves have chosen, including changing their sexual orientation or gender identity?
Precedent changed
The ruling does not explicitly overrule any prior case, but it narrows the practical reach of the "speech incident to conduct" doctrine as applied to professional medical speech, and rejects lower-court readings of NIFLA v. Becerra (2018) that had allowed rational-basis review of talk therapy bans.