High Court Limits Bans on Youth Conversion Therapy

The U.S. Supreme Court on Tuesday, March 11, 2026, narrowed how far states can go in restricting professional counseling aimed at changing a minor’s sexual orientation or gender identity. In an 8-1 decision in Chiles v. Salazar , the Court said that bans applied to “talk therapy” are “presumptively unconstitutional” under the First Amendment, a ruling that limits the reach of existing state measures.

Justice Neil Gorsuch wrote the majority opinion, describing the decision as protecting Americans’ rights to free thought and speech. Justices Sonia Sotomayor and Elena Kagan joined the majority. Justice Ketanji Brown Jackson filed the lone dissent, warning that the Court’s approach could have “potential long-term and disastrous implications” for medical regulation.

The ruling affects more than half of U.S. states that have enacted laws designed to shield LGBTQ+ minors from conversion therapy. Those statutes generally prohibit licensed professionals from attempting to change a young person’s sexual orientation or gender identity, and the Court’s decision now constrains how such prohibitions can be applied when the activity at issue is speech-based counseling.

The case arose from a challenge backed by the Alliance Defending Freedom, which represented Colorado counselor Kaley Chiles. Chiles argued she had a First Amendment right to provide conversion therapy despite Colorado’s ban. Colorado defended its statute by saying it regulated professional conduct and only incidentally burdened speech, a view that had been accepted by a federal appeals court before the Supreme Court intervened.

Major American medical associations oppose conversion therapy for youth, citing a lack of effectiveness, ethical concerns, and a heightened risk of suicide among survivors. The Court’s decision does not change those medical groups’ stated positions, but it does reshape the legal landscape for how states can enforce restrictions when the counseling is characterized as “talk therapy.”

Justice Jackson’s dissent argued that the majority effectively entered a cultural dispute by strengthening the position of anti-LGBTQ+ therapists while potentially weakening the government’s ability to regulate other medical professionals. Her warning focused on the broader regulatory consequences she said could follow if speech protections are applied in ways that limit professional oversight.

For policymakers and regulated professions, the decision sets a new constitutional boundary that states must navigate when drafting or enforcing protections for minors. The immediate uncertainty is how lower courts will apply the Court’s “presumptively unconstitutional” standard to existing statutes and to future efforts to regulate counseling practices involving minors.