The U.S. Supreme Court Likely Green Lights "Conversion Therapy" for Minors

This week the Supreme Court of the United States heard oral arguments in the Chiles vs. Salazar case that seeks to legalize conversion therapy practices for minors by overturning Colorado's existing legal protections against these practices.

"Conversion therapy," is known under many pseudonyms such as reparative therapy, sexual orientation and gender identity change efforts (SOGICE), ex-gay therapy, re-integrative therapy, pastoral/spiritual counseling or coaching, etc.

Despite the ever changing name of these practices, every major respectable and reputable worldwide professional medical and psychological association disavows these practices as pseudoscientific, pseudo-psychological, and pseudo-spiritual practices that seek to "change" the gender identity or sexual orientation of both minors and adults; most often under the guise that LGBTQIA+ identities are an aberration of nature and are incompatible with conservative religious beliefs/ideologies.

Kaley Chiles, the lead plaintiff, a so-called licensed psychotherapist based in Colorado, "Helps clients who want to reduce unwanted same sex attraction, change unwanted same-sex behavior, and to resolve dysphoria that they are experiencing within their body."

This was an exact quote used to describe Chiles "therapy" work during oral arguments.

Nearly the entirety of debate prompting these oral arguments is the belief that Colorado's existing laws that ban conversion therapy practices in turn censor professional speech between a licensed professional and a minor further arguing that, "States should not manipulate private conversations between licensed professionals and clients."

Despite the seemingly innocuous nature of this first amendment debate; scientific research presents a different picture of the harms caused by these practices; this was conveniently lacking from the initial arguments aired last week.

Make no mistake, I am not a constitutional legal scholar or attorney; however, I am a Christian pastor's kid that grew-up hearing a lot of the narratives pro-conversion therapy advocates promoted. I often spent time in my teenage years actively attempting to "pray away" my own queerness; of which grew-out of an environment that whole-heartedly believed that queerness could indeed be prayed away if one prayed ardently enough.

Later on in college, because of these experiences, I suffered from pervasive and ongoing panic attacks. Those years were hell and I do not wish them upon anyone. Fortunately, I was not directly put through "conversion therapy" proper; however, what I did experience was something that I now acknowledge as a form of "self-conversion therapy" promoted by my upbringing and all of the anti-queer narratives heard during my formative years.

I did not have awareness of this until I met my dear friend Matt Ashcroft, a black gay man who is a Canadian survivor of conversion therapy. Matt single handedly prompted the federal passage of bill C4 in Canada that bans conversion practices nationwide. What Matt experienced was performed in both group and private settings primarily within an organization named "Journey Into Manhood" involving the likes of prominent conversion "therapists," Christopher Doyle, Rich Wyler, David Matheson, and Jayson Graves, among others.

The stories Matt shares about his journey are horrific and things that no human being should ever have to endure. What Matt experienced is nothing short of abuse and lifelong psychological damage. This is what is at stake by green lighting conversion therapy practices here within the United States.

You can hear more about Matt's journey in his own words on the first episode of Queer Story Time The Podcast entitled, "Conversion Therapy Exposed: Matt Ashcroft's Brave Testimony".

Given my own life experiences, as a soon to be Naturopathic Doctor and as an existing therapist, I'm deeply concerned about the long-term health consequences, both physical and psychological, of conversion practices. Prior to medical school in my role as a therapist, I've personally worked with survivors of these egregious practices; most of whom, just like my friend Matt, experience paralyzing complex-post-traumatic stress due to undergoing these "therapies".

Conversion practices extend a wide range of "therapies" from what may be perceived as innocuous, such as talk therapy or "praying away the gay;" to the absolute bizarre and outright dehumanizing practice of smelling a jar of your own feces when you have same-sex sexual desires; or the homoerotic practice of "cuddling" with your conversion therapist; or masturbating in front of them. Conversion therapies also involve things like electroshock therapy, taking emetic herbs to encourage vomiting while staring at videos of gay pornography; there's even a history of queer and trans people suffering a surgical lobotomy which is when the frontal lobe of the brain is severed from the rest of the brain.

Kaley Chiles and her legal team are actively painting the picture that her gender & sexuality change efforts via talk therapy are safer and more acceptable than the other more extreme forms of conversion therapy mentioned above; this is why her entire argument centers free speech among licensed mental health professionals.

What conversion therapists advocates don't acknowledge is, the "talk therapy" of which they seek to legalize has no basis in evidence-informed therapy as established by organizations like the American Psychological Association and the American Counseling Association.

Their version of "talk therapy" often integrates conservative Christian religious dogma that subtly overtime indoctrinates and manipulates people into believing that gender identity and sexual orientation is changeable and that they have the psychological tools to help them achieve that. These antics and behaviors are exactly what happen in religious cults.

Furthermore, conversion therapists often repurpose the language of faith by using terms like 'healing,' 'redemption,' and 'purity' all to pathologize natural human diversity by eroding their sense of self and equating their struggles with sexual orientation or gender identity to a spiritual or moral failing that must be changed to be in better alignment with their faith.

Their "talk therapy" often frames LGBTQIA+ identity as inherently sinful or as a sickness. Rather than using purely clinical language, conversion therapists often use spiritual terms that promise wholeness and salvation through conformity to the therapists beliefs. Circular logic also abounds in these "therapy" sessions by combining not only the authority of the therapist but immeshing that with the authority of religious texts all to create an unchallengeable environment where doubt is reframed as a lack of faith or conviction. In turn, this creates conditions where failure to change one's identity is not seen as a problem of the "therapy" itself but as a failing of the queer or trans person's insufficient engagement with the "therapeutic process" or with their faith/prayer.

The difference between conversion therapists and evidence-informed therapists are that conversion therapists first start out with an ideological goal that is doggedly focused on changing or eliminating one's LGBTQIA+ identity using harmful, debunked, and pseudoscientific practices that are well-documented within the scientific literature to cause significant harm.

Evidence-informed therapists on the other hand, start with the client's goals all while providing a neutral and affirming space to explore gender identity and sexual orientation without a predetermined outcome which in turn supports the client's autonomy and self-determination.

This difference is substantial and clear. Evidence-informed therapy is focused on empowerment and embodiment while conversion therapy is focused on weaponizing peoples' true identity and sense of self against them.

What the scientific literature lays bare is that conversion therapy contributes to an increase in both physical and psychological disease burden within gender and sexually expansive (GSE) communities.

A 2022 JAMA Pediatrics article assessed 28 conversion therapy related articles with a total combined population of nearly 200,000 LGBTQIA+ people across these 28 studies; researchers found that among this population, 47% of those who had undergone conversion therapy experienced serious psychological distress, 65% experienced depression, 67% experienced substance use, and 58% attempted suicide (Reference #2).

Within this same study, they also performed an economic analysis of which determined that the total economic cost of gender & sexuality change efforts totals $650 million dollars with calculated harms totaling over $9 billion dollars (Reference #2).

$9 billion dollars in damages all to change something that is an immutable aspect of human existence.

Additionally, a 2020 JAMA Psychiatry article found that exposure to conversion therapy before age 10 is associated with higher odds of lifetime suicidal attempts and persistent feelings of shame; this study occurred among 27,000+ participants (Reference #5).

All of this suggesting that both lifetime and childhood exposure to gender & sexuality change efforts are indeed associated with adverse mental health outcomes throughout one's lifespan.

Not only does conversion therapy have a substantial impact on one's mental health but receiving such therapy produces a litany of associated physical pathologies including an elevated risk of heart disease and systemic inflammation caused by persistent and ongoing chronic stress exacerbated by marginalized stressors; along with gastrointestinal distress, sexual dysfunction, increased risk of eating disorders, and post-traumatic stress disorder (References #1-5).

All of this in an environment where LGBTQIA+ people often struggle to receive appropriate access to medical and psychological care which in turn causes delays in receiving culturally informed care by healthcare professionals adequately trained in the unique needs of gender & sexually expansive communities. This lack of access to appropriate care often exacerbates many if not all of the physical and mental health concerns mentioned above.

If the U.S. Supreme Court green lights conversion therapy; we will have legalized a practice that is nothing short of state-sanctioned abuse. There is nothing moral, just, or ethical about this. It will allow for unfettered profits to be made off the suffering of a community that is less than 8% of the U.S. population as a whole; of which transgender people make-up less than 1%.

Queer & transgender people are not the threat.

If you think we are, you've mistaken us for Conservative Evangelical Christians aligning themselves with technocratic authoritarian billionaires.

The real threat in this country comes from fundamentalist "Christian" ideologues seeking to turn the U.S. into a White Christian nation; these are the same forces that seek to strip LGBTQIA+ people of our dignity, rights, and humanity through well-funded and coordinated legal assaults, judicial appointments, non-legally binding executive orders, and an administration using queer and transgender people as their political pawns.

We will not comply with their attempts to change our gender or sexuality; nor will be accept fitting within their white supremacist mold of compulsory cisgender-heterosexuality.

With the disastrous history of conversion therapy here within the United States and a lifetimes worth of health disparities it contributes to, I strongly and fervently dissent.

References:

1. American Psychological Association. [APA]. (2021, July). Guidelines for psychological practice with sexual minority persons.https://www.apa.org/about/policy/psychological-sexual-minority-persons.pdf
2. Forsythe A, Pick C, Tremblay G, Malaviya S, Green A, Sandman K. Humanistic and Economic Burden of Conversion Therapy Among LGBTQ Youths in the United States. JAMA Pediatr. 2022;176(5):493–501. doi:10.1001/jamapediatrics.2022.0042
3. Gibb JK, Schrock JM, Smith MS, D’Aquila RT, McDade TW, Mustanski B. Conversion Therapy Exposure and Elevated Cardiovascular Disease Risk. JAMA Netw Open. 2025;8(5):e258745. doi:10.1001/jamanetworkopen.2025.8745
4. Kinitz DJ, Goodyear T, Dromer E, et al. "Conversion Therapy" Experiences in Their Social Contexts: A Qualitative Study of Sexual Orientation and Gender Identity and Expression Change Efforts in Canada. Can J Psychiatry. 2022;67(6):441-451. doi:10.1177/07067437211030498
5. Turban JL, Beckwith N, Reisner SL, Keuroghlian AS. Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults. JAMA Psychiatry. 2020;77(1):68–76. doi:10.1001/jamapsychiatry.2019.2285