AMHCA is disappointed by the recent Supreme Court ruling in Chiles v. Salazar. On March 31, 2026, the Supreme Court ruled that a stricter legal standard must be applied when evaluating laws banning conversion therapy—raising concerns about future protections for vulnerable youth. AMHCA continues to oppose conversion therapy, citing clear evidence of harm and lack of effectiveness, and remains committed to protecting the health and well-being of LGBTQ+ individuals. For additional research on the harms of conversion therapy, please refer to The Trevor Project’s analysis of the Supreme Court decision.
In 2019 Colorado passed the Minor Conversion Therapy Law which banned mental health professionals from engaging in any practice or treatment, including talk therapy, that attempts to change an individual's sexual orientation or gender identity. This is one of more than 20 states that have bans on conversion therapy practices. Lower courts, including the 10th Circuit Court of Appeals, ruled that the ban was constitutional as it regulated professional conduct, and only incidentally impacted speech. The Supreme Court, however, overturned these lower court decisions, and stated that the ban “censors speech based on viewpoint.” While the ruling does not outright overturn Colorado’s ban on conversion therapy, it orders lower courts to apply “strict scrutiny” to these laws, raising the bar considerably for states who want to pass similar bans.
In his majority opinion, Justice Neil Gorsuch wrote “The Supreme Court has long held that laws regulating speech based on its subject matter are ‘presumptively unconstitutional’” and therefore trigger strict scrutiny, which requires the government to show that a restriction on speech is narrowly tailored to serve a compelling government interest. “Under that test,” Gorsuch added, “it is rare that a regulation . . . will ever be permissible.”
The majority opinion, written by Justice Neil Gorsuch, emphasized the First Amendment and the right to free speech, saying “the even greater dangers associated with regulations that discriminate based on the speaker’s point of view. When the government seeks not just to restrict speech based on its subject matter, but also seeks to dictate what particular ‘opinion or perspective’ individuals may express on that subject, ‘the violation of the First Amendment is all the more blatant,’” Gorsuch stressed. “’Viewpoint discrimination,’” Gorsuch said, “represents ‘an egregious form’ of content regulation, and governments in this country must nearly always ‘abstain’ from it.”
The lone dissenting opinion was from Justice Ketanji Brown Jackson, who read her dissent from the bench. She wrote, “based on the medical profession’s broad consensus that this medical treatment … is ineffective and harmful.” She insisted, “there is zero evidence that Colorado has engaged in the corrosive and illicit suppression of ideas that the First Amendment valiantly repels.” Instead, she argued, Chiles “is simply being held to the same standard of care that all other licensed medical professionals in that State must follow.”
“Ultimately,” Jackson said, “because the majority plays with fire in this case, I fear that the people of this country will get burned. Before now, licensed medical professionals had to adhere to standards when treating patients: They could neither do nor say whatever they want.” But the court “turns its back on that tradition,” Jackson said. “And, to be completely frank, no one knows what will happen now.”
AMHCA will continue to support initiatives that will curb harmful practices that have documented iatrogenic effects, and will thus help ensure the overall health and safety of LGBTQ youth. AMHCA stands in solidarity with our LGBTQ+ clients and counselors, and will continue to fight for you.
AMHCA’s Code of Ethics (2020) Applied:
The AMHCA Code of Ethics provides clear ethical guidance relevant to this issue. The Code emphasizes client autonomy, dignity, and self-determination as foundational to ethical practice. Specifically, CMHCs are required to support clients’ rights to make informed choices and avoid any interventions that impede autonomy (I.A.1.a). This includes rejecting practices that impose counselor values or attempt to direct clients toward predetermined identity outcomes.
The Code further affirms that clients must be treated with dignity and respect at all times (I.A.7) and explicitly prohibits discrimination based on sexual orientation, gender identity, or other identities (I.C.2.a) . In alignment with these standards, clinical mental health counselors recognize diverse sexual orientations and gender identities as part of human diversity and do not engage in practices that pathologize or attempt to change these identities.
Client Autonomy and Self-Determination:
CMHCs have a primary ethical responsibility to ensure client autonomy and self-determination (I.A.1.a). Any therapeutic approach that seeks to alter a client’s identity or restrict their ability to make informed, self-directed decisions is inconsistent with this ethical obligation.
Protection from Harm (Nonmaleficence):
CMHCs are required to avoid actions that cause harm and to protect clients from physical, emotional, and psychological risk (I.A.7.j). Practices that have been shown to contribute to harm violate this responsibility and are therefore inconsistent with ethical care.
Informed Consent:
Ethical counseling requires that clients receive clear, accurate, and sufficient information to make informed decisions about treatment (I.B.2.a–c) . This includes transparency about the nature, risks, benefits, and evidence base of any intervention. When an approach lacks scientific support or carries known risks, meaningful informed consent cannot be obtained.
Counselor Responsibility, Competence, and Cultural Awareness:
CMHCs are expected to maintain current knowledge of scientific and professional information (I.C.1.c), engage in ongoing education, and practice within the boundaries of competence. They are also required to demonstrate cultural competence, including sensitivity to diverse identities and evolving cultural understandings (I.C.1.g, I.C.1.m) . This includes awareness of how personal values may impact clinical work and a commitment to not imposing those values on clients.
Non-Discrimination and Bias Awareness:
The Code explicitly prohibits discrimination based on sexual orientation, gender identity, and other protected characteristics (I.C.2.a) and requires counselors to actively examine and address their own biases to prevent interference in the counseling process (I.C.2.c) .
Ethical Decision-Making:
When ethical concerns arise, CMHCs are expected to utilize a structured ethical decision-making process grounded in the Code (Preamble), prioritizing client welfare, autonomy, and best interests. Read more about the AMHCA ethical decision-making model on our website.
AMHCA Statement on Conversion Therapy: AMHCA Publications - American Mental Health Counselors Association
Supreme Court Ruling: 24-539 Chiles v. Salazar (03/31/2026)
Thank you to the AMHCA Public Policy and Legislative Committee for their contributions to this post.
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