April 8, 2026

The Supreme Court decision in the case of Chiles v. Salazar appears to some therapists to be a major blow to LGBTQ rights, mainly to children and adolescents who are gay, lesbian, queer, transgender or a different gender from the one assigned at birth. These minors, specifically transgender minors, have been a major target of the current administration. This decision allows a “talk therapist” in Colorado to practice conversion “therapy” to attempt to change the sexual gender of minor patients, viewing the case as a matter of free speech, not the harmful nature of conversion “therapy”. There have been many concerns about the way this decision will affect the 23 states that prohibit conversion “therapy”. The fact that the therapist involved in this case is a Licensed Professional Counselor, whose Code of Ethics parallels the CSWA Code of Ethics, makes this case even more troubling.

This decision highlights a major conflict that has long concerned CSWA: the way that the legal system and the mental health system do not see data the same way. The right of anyone who claims to be practicing some kind of psychotherapy can be harmful if the person is not ethically-trained and licensed. Additionally, religious beliefs, often the main driver of conversion “therapy”, are not always based on helping people understand and accept themselves as psychotherapy does in an evidence-based way.

This decision has been seen as a step in eliminating the right of minors to identify and accept their sexual orientation or gender identity. Much suffering has occurred as some families, friends, and wider communities have demeaned the experience of queer and trans youth. Understanding the nature of Chiles v. Salazar, and the way it may contribute to the suffering that has occurred because of an individual’s effort to be authentically themselves, including the way they experience their gender and sexual orientation, is crucial.

CSWA strongly supports the rights of trans youth (“At Risk: Trans Children and Adolescents”, 2023, CSWA website) and opposes any efforts to deny youth their right to experience their gender identity and sexual orientation. The high rates of suicidal ideation and self-harm in this group demonstrate the ways that denying their reality has caused serious psychological damage.

This decision was based on the Court’s view of Chiles v. Salazar as a free speech issue, not on helping queer and trans youth accept their emotional reality. CSWA believes that ethical psychotherapists do not direct anyone to change their self-image or personal beliefs; rather LCSWs do their best to help minors and their parents understand the challenges that queer and trans youth face and how to navigate them. The belief that queer and trans youth are making a choice that can be reversed is similar to the long-discredited belief that the same should be done for adults with a gay, lesbian, or queer identity. The Colorado practitioner rejects trans identity, as all conversion “therapy” intends to do, and rejects the trans experience as authentic and valid. This is the opposite of how licensed LCSWs have been trained to help others through psychotherapy. The parents or guardians of minors with a self-image that is not consistent with their assigned sex can help minors find a licensed therapist who can help the minor accept their experience, or find a therapist who attacks their identity, as conversion “therapy” does.

Chiles v. Salazar has been misunderstood by some to be a blanket rejection of the laws that prohibit the use of conversion “therapy”. It simply allows the plaintiff who brought the case to practice conversion “therapy” as an individual. This may certainly lead to a broader expansion of allowing conversion “therapy”, without considering the harm that can be done to youth by denying their gender experience. This damage is why 23 states have prohibited conversion “therapy” and six other states have partial prohibition (https://www.lgbtmap.org/equality-maps/conversion_therapy) .

In summary, Chiles v. Salazar has the potential to undermine ethical psychotherapy practice and cause emotional harm to queer and trans youth. For this reason, CSWA opposes this decision and will work to have it overturned legislatively in Colorado.

References

Austin, L., Craig, S., D’Souza, S., McInroy, L. (2022) “Suicidality Among Transgender Youth: Elucidating the Role of Interpersonal Risk Factors”, Interpersonal Violence, 2022,DOI: 10.1177/0886260520915554

CNN, 2022. “This record-breaking year for anti-transgender legislation would affect minors the most.” (https://www.cnn.com/2021/04/15/politics/anti-transgender-legislation-2021/index.html)

NIMH (2022). “Understanding the Characteristics of Suicide in Young Children.”

https://www.nimh.nih.gov/news/science-news/2021/understanding-the-characteristics-of-suicide-in-young-children

Stern, M. “How in the World Was the Supreme Court’s Awful Conversion Therapy Ruling 8–1?”, Slate, https://slate.com/news-and-politics/2026/03/supreme-court-awful-conversion-therapy-kagan-sotomayor-why.html (Slate)

https://www.lgbtmap.org/equality-maps/conversion_therapy

Contact: Laura Groshong, LICSW, CSWA Director of Policy and Practice, lwgroshong@clinicalsocialworkassociation.org