National Coalition for LGBTQ Health Statement on Chiles vs. Salazar: Colorado Conversion Therapy Ban for Minors

WASHINGTON, DC, March 31, 2026 – In an 8–1 decision in Chiles v. Salazar, the U.S. Supreme Court backed a challenge to Colorado’s conversion therapy ban for minors, marking a significant shift in how the boundary between speech and medical practice is understood.

By treating what licensed providers say—and, in practice, how treatment is delivered—as protected speech rather than regulated care, the Court shifts away from what leading medical and mental health organizations have long recognized as evidence of harm. Conversion therapy is not simply clinical conversation—it is a discredited practice linked to increased risks of depression, anxiety, and suicidality among LGBTQ+ individuals.

As Justice Ketanji Brown Jackson makes clear in her dissent, this case is not about policing ideas, but about whether states can set reasonable limits on licensed professionals when there is documented risk to patients, particularly minors.

Beyond this single law, the decision raises broader questions about how healthcare is regulated and delivered. It begins to blur what has been a stable line between professional conduct and expression, opening the door to challenges across core areas of care.

This dynamic is not limited to this case. We are seeing similar pressures in other areas of healthcare, where evidence-based standards are being weighed against more individualized, less uniform approaches to care. For example, federal health officials, including the U.S. Department of Health and Human Services and the Advisory Committee on Immunization Practices (ACIP), help guide vaccine use and safeguard public health. They are also leaning into shared clinical decision-making, placing greater emphasis on provider–patient conversations, much like what is now being treated as protected speech in the Colorado case.

In practice, that can mean less clear guidance and more decisions left to individuals—even when there are established standards. As a result, how consistently those standards are applied can begin to vary.

The Supreme Court’s decision leaves patients less protected by clinical standards and more exposed to claims framed as protected speech—raising new questions about how those standards can be enforced at all. This has real implications for patient safety, provider accountability, and the integrity of the clinical relationship.

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