Whether a law that censors certain conversations between counselors and their clients based on the viewpoints expressed regulates conduct or violates the Free Speech Clause.
Chiles v. Salazar, Docket No. 24-539, is a pending United States Supreme Court case regarding the constitutionality of Colorado's Minor Conversion Therapy Law (MCTL), which bans conversion therapy for minors by licensed mental health professionals. The ban was challenged as an alleged violation of the First Amendment of the United States Constitution, though the state had constrained the ban to licensed professionals and only as with respect to their professional duties. The ban was upheld in lower courts.
Colorado's Minor Conversion Therapy Law (MCTL), passed in 2019, prohibits licensed mental health professionals from engaging in conversion therapy with clients under 18 with an exemption for therapists "engaged in the practice of religious ministry". Conversion therapy refers to practices aiming to change an individual's sexual orientation or gender identity. Over 20 states have similar laws which are supported by major medical organizations.[1][2] The Supreme Court has turned down earlier cases challenging state bans on conversion therapy.[1]
The plaintiff, Kaley Chiles, is a licensed professional counselor in Colorado. In her petition to the Court, she stated that as "a practicing Christian, Chiles believes that people flourish when they live consistently with God's design, including their biological sex." Her lawsuit says she wants to help patients with the goal of "seeking to reduce or eliminate unwanted sexual attractions, change sexual behaviors or grow in the experience of harmony with one's physical body". She contends that the law violates the Free Speech and Free Exercise Clauses of the First Amendment. However, the law already makes exceptions for therapists "engaged in the practice of religious ministry."[1][2]
Chiles filed a pre-enforcement challenge against the MCTL, asserting violations of the Free Speech and Free Exercise Clauses of the First Amendment. She sought a preliminary injunction to prevent the law's enforcement. The U.S. District Court for the District of Colorado denied her motion, finding that, while she had standing, she failed to demonstrate a likelihood of success on the merits. The Court concluded that the MCTL regulates health-care professional conduct rather than therapists’ speech.[3][4]
Chiles appealed the district court's decision to the U.S. Court of Appeals for the Tenth Circuit. A 3-judge panel of the Tenth Circuit affirmed the lower court's ruling, agreeing that Colorado was entitled to regulate professional conduct and citing evidence of the harms conversion therapy can cause minors. Judge Harris Hartz dissented, arguing "courts must be particularly wary that in a contentious and evolving field, the government and its supporters would like to bypass the marketplace of ideas and declare victory for their preferred ideas by fiat".[1][3]
Supreme Court
Following the Tenth Circuit's decision, Chiles petitioned the U.S. Supreme Court for certiorari, arguing that the MCTL violates her First Amendment rights by censoring certain conversations between counselors and their clients based on the viewpoints expressed. She contended that governments do not have greater authority to regulate speech simply because the speaker is licensed or providing specialized advice.[5]
On March 10, 2025, the Supreme Court granted certiorari to review the case, signaling intent to address the constitutional questions surrounding the regulation of professional speech and the balance between state regulatory power and free speech rights within professional contexts.[6]
According to experts interviewed by The Guardian, the ADF's petition to the Supreme Court "profoundly misrepresented" their research cited in the ADF report on the possible psychological damage of conversion therapy.[7]
Oral arguments were held on October 7, 2025. Journalists covering the Court believed from the questions asked that the conservative majority would likely find the ban unconstitutional, having given more weight to the First Amendment issues than the state's concern on the practice.[8][9]
Analysis
The case highlights the tension between First Amendment free-speech rights and the state’s authority to regulate medical practice. The Supreme Court must determine whether a therapist’s talk-based treatment of minors qualifies as protected speech or regulable professional conduct.[10]
A ruling for Chiles could sharply limit states’ ability to oversee speech-based therapies. If such therapy is treated as free speech rather than medical treatment, it becomes harder for states to define and enforce what counts as accepted professional practice. Without a clear “standard of care” definition, therapists might not know whether certain interventions are legally allowed.[11]
"If the Supreme Court rules that the law violates a clinician’s right to free speech, it could create confusion for medical professionals about what the standard of care is. And some worry that the case could serve as a legal precedent for clinicians who say something that ultimately harms a patient and want to claim free speech as their defense."[11]
Other arguments frame the case as a fundamental debate over medical expertise as a whole. Vox suggested that the Court may undermine medical authority in its questioning of expert consensus: "It would arguably be inconsistent for the Court to allow some states to prohibit specific forms of gender-affirming healthcare [as ruled in United States v. Skrmetti in 2025] because they believe it’s harmful, while stopping other states from prohibiting conversion therapy because they believe it’s harmful [in Chiles v. Salazar]."[12]
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