Written by: Emily Den Haese
May a state regulate what licensed professionals say to their clients, or does such regulation unconstitutionally regulate speech?
In Chiles v. Salazar, the Supreme Court confronted this question in the context of a Colorado law banning “conversion therapy” for minors, ultimately holding that the law likely violates the First Amendment when applied to certain forms of talk therapy.
The decision, issued in an 8-1 ruling, has significant implications for the relationship between free speech protections and the government’s authority to regulate licensed professionals.
Background
In 2019, Colorado enacted the Minor Conversion Therapy Law, prohibiting licensed counselors from engaging in “conversion therapy” with minors, defined broadly as practices aimed at changing a person’s sexual orientation or gender identity. The statute also barred efforts to change behaviors, gender expressions, or romantic attractions toward individuals of the same sex. At the same time, the statute permitted counselors to provide support, acceptance, and assistance for identity exploration and gender transition.
Kaley Chiles, a licensed counselor in Colorado, challenged the law as it applies to her, arguing it restricted her ability to engage in talk therapy tailored to her client’s goals. Chiles emphasized that her counseling only involved speech; she did not prescribe medication or use physical interventions.
Both the District Court of Colorado and Court of Appeals of the Tenth Circuit upheld the statute, reasoning that it regulated professional conduct, regulating speech only incidentally, and was therefore subject to minimal constitutional scrutiny.
The Decision
On March 31, 2026, the Supreme Court reversed, concluding that Colorado’s law, as applied to Chiles’ talk therapy, regulates speech based on viewpoint and is therefore subject to more rigorous scrutiny.
In an opinion written by Justice Gorsuch, the Court explained that statutes targeting speech on content grounds are presumptively unconstitutional and typically require strict scrutiny. For the Court, the Colorado statute allowed counselors to express certain viewpoints, such as affirming the client’s identity, but prohibits others, including efforts to change that identity. Because the statute permitted some perspectives but not others, the Court determined that it engaged in “viewpoint discrimination.” The Court also rejected the argument that the statute regulated only professional conduct, emphasizing that speech does not lose constitutional protection simply because it occurs in a professional setting.
The Court held that the lower courts should have applied a more rigorous First Amendment analysis. The Court did not definitively strike down the law but instead remanded the case for further review under the more demanding First Amendment standard. On remand, the government must show that the Colorado statute serves a compelling interest and is narrowly tailored to achieve that interest.
Competing Perspectives
The decision in Chiles reflects a broader tension between two important legal principles: the protection of free speech and the state’s authority to regulate professional practices.
Chiles framed her challenge in terms of client autonomy, arguing that some individuals affirmatively seek counseling that is aligned with their personal or religious goals. The law prevents them from receiving it, and counselors are prevented from assisting clients who are voluntarily pursuing these goals.
The Colorado Solicitor General argued that states have long been able to regulate licensed professionals to prevent harmful treatments. To Colorado, the statute “represents nothing more than a traditional law licensing the practice of medicine.”
Major medical groups, such as the American Medical Association, oppose conversion therapy, citing research linked to depression, anxiety, and suicide risk among LGBTQ+ individuals. From this perspective, the statute was designed to protect vulnerable minors from practices considered unsafe.
The Supreme Court emphasized that the First Amendment protects an individual’s right to express ideas, even in professional contexts. The majority warned that allowing the government to restrict speech based on viewpoint could lead to broader forms of censorship.
Justice Jackson, in dissent, expressed concern that the Court’s decision could undermine the states’ ability to regulate medical care and protect public health. She cautioned that extending free speech protections in this context may create uncertainty for other forms of professional regulation.
Looking Forward
The Court’s ruling in Chiles casts doubt on similar laws in more than two dozen states that restrict or prohibit conversion therapy for minors. It also raises broader questions about how far First Amendment protections extend into professional settings, as the reasoning provided by the Court could affect regulations affecting other professionals, including doctors and lawyers. At the same time, the Court did not foreclose all regulation, leaving open the possibility that certain forms of conduct, especially non-speech-based practices, may still be subject to state control.
As lower courts revisit the case and similar challenges arise, they will likely continue to grapple with how to distinguish between protected speech and regulable professional conduct. Courts may be asked to extend First Amendment protections to a broader range of professional communication, particularly when they consist solely of speech. However, Chiles may complicate the states’ ability to regulate licensed professionals, especially where treatment is defined primarily through conversation. Courts will need to balance constitutional protections for speech with longstanding state authority to set the standards of care in the interest of public health and safety.
Sources:
Chiles v. Salazar, 607 U.S. __ (2026).
Colo. Rev. Stat. § 12-245-224(1)(t)(V) (2025).
Justin Jouvenal, Supreme Court rules against ban on ‘conversion therapy’ for LGBTQ+ minors, The Washington Post(Mar. 31, 2026), www.washingtonpost.com/politics/2026/03/31/supre me-court-conversion-therapy-colorado-ban/.
John Kruzel, US Supreme Court rejects Colorado’s ban on LGBT ‘conversion’ talk therapy, Reuters (Mar. 31, 2026, 10:10 AM EDT), www.reuters.com/world/us-supreme-court-backs-challenge-colorados-ban-lgbt-conversion-therapy-2026-03-31/.