The Supreme Court’s conservative majority on Tuesday seemed poised to rule for a Christian therapist who says her free speech rights have been violated by a Colorado law barring mental health professionals from seeking to change a minor’s sexual orientation or gender identity.
The court’s decision, expected by June, will have implications for the more than 20 other states that have similar laws.
In a lively argument lasting about 90 minutes, the justices debated whether the so-called conversion therapy covered by Colorado’s law causes harm to minors. Lawyers for the therapist and the Trump administration said there were no reliable studies indicating such therapy causes harm. The state’s lawyer countered that there is a “mountain of evidence” that conversion therapy is ineffective and potentially dangerous for young people.
Medical organizations began to speak out against the practice in the late 1990s, citing a growing body of research that it was ineffective and potentially harmful.
A central question for the justices is whether Colorado’s law impermissibly interferes with free speech or is a legal regulation on professional conduct.
If the Supreme Court rules that Colorado’s law infringes on free speech and is subject to a demanding form of judicial review, the justices could send the case back to the lower court for further consideration — or declare the law unconstitutional and strike it down.
Colorado’s statute prohibits “any practice or treatment” that tries to change a minor’s “gender expressions or to eliminate or reduce sexual or romantic attraction or feelings toward individuals of the same sex.”
In an exchange with Colorado’s solicitor general, Justice Samuel A. Alito Jr. said the voluntary talk therapy the law bans “looks like blatant viewpoint discrimination” by government officials, which the First Amendment prohibits. He asked whether medical consensus can be wrong or colored by ideology.
Justice Amy Coney Barrett, who is often in the majority, pressed Colorado’s lawyers about whether the banned therapy truly causes harm.
The state’s solicitor general, Shannon Stevenson, told the justices that the harm comes “from telling someone there is something innate about yourself you can change — and then you spend all kinds of time and effort trying to do that, and you fail.”
Colorado officials have never enforced the measure, which includes fines up to $5,000 for each violation and possible suspension or revocation of a counselor’s license. The law includes a religious exemption for those “engaged in the practice of religious ministry.”
The liberal justices Sonia Sotomayor and Ketanji Brown Jackson had the toughest questions for the lawyer representing the therapist, Kaley Chiles, who filed a lawsuit in 2022. Mrs. Chiles, an evangelical Christian, says the state is preventing her from working with patients who want to live a life “consistent with their faith.”
Justice Sotomayor compared conversion therapy to a dietitian or counselor telling a client to do something that would harm their body.
“I don’t think the state has to provide a study to show that the advice is not sound,” she said.
James Campbell, representing Mrs. Chiles, said the difference is his client is trying to help children and instead “is being silenced, and the kids and families who want her help are unable to access it.”
He urged the justices to declare the law unconstitutional, rather than return it to the lower court.
Justice Sotomayor also asked whether Mrs. Chiles faced a realistic threat of punishment, that is, whether she had standing to sue, an initial legal hurdle required to move forward with a lawsuit.
Mr. Campbell, a lawyer with the conservative Christian legal organization Alliance Defending Freedom, told the justices that “anonymous complaints” have been filed against Mrs. Chiles and that those complaints were being investigated by the state of Colorado. The assertions were not included in court filings.
Katie O’Donnell, the communications director for the Colorado Department of Regulatory Agencies, said Tuesday she could not comment on active litigation. In a response to a request for public records about the case, the department said complaints or investigations are not subject to disclosure under Colorado law.
The Supreme Court has in recent years issued a series of decisions in favor of religious people, notably conservative Christians. In 2023, the court sided with a web designer in Colorado who said she had a First Amendment right to refuse to design wedding websites for same-sex couples. In 2022, the court said a high school football coach had a constitutional right to pray at the 50-yard line after his team’s games.
The conversion therapy case is being heard a few months after the court’s conservative majority upheld a Tennessee law barring certain medical treatments for transgender youth that the state deemed unsafe. Later this term, the justices will also hear challenges to state laws prohibiting transgender athletes from participating in girls and women’s sports.
On Tuesday, Justice Jackson noted that states have a long history of regulating medical treatment. Referring to the court’s decision in the Tennessee matter, she asked why the Colorado regulation at issue “isn’t just the functional equivalent” with state lawmakers similarly prohibiting a medical treatment for minors that major medical associations say can lead to an increased risk of depression and suicidal thoughts.
“The regulations work in basically the same way,” she said. “So it just seems odd to me that we might have a different result here.”
Hashim Mooppan, a principal deputy solicitor general representing the Trump administration, said the key difference is that Tennessee’s law dealt with drugs, whereas Colorado’s law governs what is said in therapy sessions, raising First Amendment concerns.
The Trump administration and Mrs. Chiles’s legal team say the law should be subject to a demanding standard of judicial scrutiny that would require the state to show that its law advances a compelling government interest and is narrowly designed to do so. The challengers say that if the law were subject to that higher standard, known as strict scrutiny, courts would find that it surely violates the Constitution.
Colorado officials argue that the law should not be subject to the standard, but say it should survive even if the justices disagree.
In general, the First Amendment prevents the government from restricting speech because it dislikes the content or message. But the Supreme Court has said certain restrictions aimed at governing a person’s conduct are permissible even if they incidentally burden speech.
The issue has split the lower courts. A divided panel of the U.S. Court of Appeals for the 10th Circuit upheld Colorado’s law. Several times on Tuesday, the justices discussed a 2018 case in which Justice Clarence Thomas, writing for the majority, invalidated a California law that required pregnancy crisis centers to post notices that free or low-cost abortions were available to low-income women through public programs.
“Speech is not unprotected merely because it is uttered by ‘professionals,’” Justice Thomas wrote in National Institute of Family and Life Advocates v. Becerra.Chief Justice John G. Roberts Jr., who is almost always in the majority, made a similar point on Tuesday, as he explored Colorado’s claim that it can regulate a licensed therapist’s communications with clients to prevent substandard care.
“Just because they’re engaged in conduct doesn’t mean that their words aren’t protected,” he said.
Abbie VanSickle, Julie Tate and Amy Harmon contributed reporting.
Ann Marimow covers the Supreme Court for The Times from Washington.
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