WASHINGTON −Growing up in a conservative and religious family in Arizona, Matt R. Salmon was desperate not to be gay.
He prayed, fasted, read scripture and pleaded with God to change him.
“Even at other kids’ birthday parties, when they were blowing out their birthday candles, I would try to make my wish before they could, to try and steal it,” Salmon, now 37, recounted.
When that didn’t work, he agreed at age 18 to see a counselor he was told could help.
Not only did his attraction to men not go away, but Salmon said he absorbed the therapist’s message that something was deeply wrong with him. Although he’s worked hard to undo those two years of what he called “psychological abuse,” Salmon said he still feels “so hurt and, to this day, broken by the experience.”
So he was stunned when the Supreme Court said it would decide whether Colorado’s ban on “conversion therapy” for LGBTQ+ minors violates a counselor’s free speech rights.
“Licensed professionals don’t have free speech,” said Salmon, now a psychiatrist and counselor himself in Washington, DC. “You don’t just get to say whatever you want.”
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People hold rainbow-colored umbrellas and flags at a demonstration on Dec. 4, 2024, as the U.S. Supreme Court hears arguments over a challenge to Tennessee’s ban on gender-affirming medical care for transgender minors.
In one of their biggest cases of the term, the justices will debate Oct. 7 whether the First Amendment allows states to regulate treatments like talk therapy.
Kaley Chiles, the licensed counselor challenging Colorado’s ban, said the law is preventing her from communicating messages that some people – including those who believe they were born in the wrong body − are interested in.
The law, she said, allows her to support adolescents who wants to transition to another gender but not to help them accept their assigned sex at birth.
“Clients would like to hear a message of hope that you can have struggles with your body in a variety of ways and you can actually grow in peace and comfort with the body that you’re in,” Chiles said. She views her work as an outgrowth of her Christian faith.
Colorado licensed counselor Kaley Chiles is challenging the state’s ban on “conversion therapy” for minors.
Trump administration backs Christian counselor
Chiles has the backing of the Trump administration.
The Justice Department has told the Supreme Court that Colorado is “muzzling one side of an ongoing debate in the mental-health community about how to discuss questions of gender and sexuality with children.”
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Colorado argues that states have long had the ability to protect patients by regulating healthcare, and the evidence is clear that trying to change someone’s sexual orientation or gender identity doesn’t work and can lead to depression, anxiety, loss of faith, and suicidality.
“So-called conversion therapy is an inhumane and abusive practice overwhelmingly shown to harm young people,” Colorado Attorney General Phil Weiser said in a statement. “We have a compelling interest in protecting children from this dangerous pseudoscience.”
Chiles can use a variety of therapeutic techniques to help minors, including those who don’t want to act on same-sex attractions, the state says. But counselors can’t seek “the predetermined outcome of changing a minor’s sexual orientation or gender identity.”
Colorado Attorney General Phil Weiser speaks to reporters outside the U.S. Supreme Court on Dec. 05, 2022.
Myth that conversion therapy is an `artifact of history’
The American Psychiatric Association, in 1793, stopped classifying homosexuality as a mental illness.
“Having same- or multi-gender attractions, behaviors, and desires, as well as transgender, nonbinary, and gender diverse identities and expressions, is a healthy feature found in every society and culture,” a coalition of major medical and psychological professional associations told the Supreme Court in a brief supporting Colorado’s law.
Still, in 2023, The Trevor Project – an advocacy group for LGBTQ+ people – said it found more than 600 professional counselors who say they can help alter someone’s sexual orientation or gender identity. (The group identified hundreds more unlicensed counselors who operate through a religious capacity and are not covered by laws like Colorado’s.)
“There is a myth out there that conversion therapy is an artifact of history,” said Casey Pick, senior director of law and policy at The Trevor Project.
What has changed over time is the approach.
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Talk therapy most common form of conversion practices
Historically, there were a wide range of inventions. Those included “averse techniques,” such as using bad smells, electric shocks or other negative feedback to try to train the patient to not have homosexual thoughts.
Today, talk therapy is most common, according to the Williams Institute at the UCLA School of Law, a think tank that researches sexual orientation and gender identity issues.
Salmon said his counselor suggested his attraction to men was his father’s fault because his job kept him away from home a lot, causing Salmon to identify more with his mother.
“He convinced me that my parents were part of the problem,” Salmon said. “He put a wedge between us.”
A transgender male who testified before the Colorado state legislature said his therapist encouraged him to wear skirts, hose, heels and cosmetics “to develop my femininity.”
“My parents were blamed for not instilling this in my upbringing,” Francis Lyon told a legislative committee in 2019.
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Arizona Gov. Katie Hobbs, on June 27, 2023, signs executive orders expanding protections for LGBTQ Arizonans by allowing state employees to access gender-affirming surgery and severing any official involvement with so-called conversion therapy.
About half the states restrict `conversion therapy’
Starting in 2013, California and New Jersey led the way in trying to prevent conversion therapy.
More than 20 states have restricted the practice through laws – including some that were backed by Republican governors. A handful of other states have used executive orders or regulatory agencies to attack the issue.
In 2015, a division of the U.S. Department of Health and Human Services made a case for eliminating the use of conversion therapy among youth.
“There is limited research on conversion therapy efforts among children and adolescents; however, none of the existing research supports the premise that mental or behavioral health interventions can alter gender identity or sexual orientation,” the Substance Abuse and Mental Health Services Administration said in its report.
The Trump administration has since added a disclaimer to the federal website referencing that report, saying a court order required the page be maintained by the Health Department but, “This page does not reflect reality and therefore the Administration and this Department reject it.”
President Donald Trump gestures, as he signs an executive order banning transgender girls and women from participating in women’s sports, in the East Room at the White House in Washington, U.S., Feb. 5, 2025.
`Simply practicing speech-only counseling’
Chiles, likewise, argues that issues related to sex and sexuality are not as settled as Colorado claims.
Her attorney, Jim Campbell, said Colorado is pointing to studies that lump together the kind of counseling Chiles wants to do with shock therapy and other aversive treatments that have been used in the past.
Chiles “is simply practicing speech-only counseling,” said Cambell, chief legal counsel with Alliance Defending Freedom, a conservative legal organization that has appeared frequently at the court in recent years in cases involving high-profile social issues.
“If you go through the seminal (American Psychological Association) report that they have included, it says over and over again that there is no evidence that this kind of counseling causes harm,” he said.
Protestors and supporters gather in front of the U.S. Supreme Court on Oct. 8, 2019 in Washington as the justices hear three challenges from New York, Michigan and Georgia involving workers who claim they were fired because they were gay or transgender.
Pyschological association says report being mischaracterized
The American Psychological Association says Chiles is mischaracterizing key aspects of the association’s 2009 report on conversion therapy that found it’s ineffective and can be harmful.
While the report noted a lack of published research about the effects on minors, that’s because of the difficulty of doing clinical studies without harming children by subjecting them to the change efforts, the group told the Supreme Court in a brief supporting Colorado’s law.
“Our finding in 2009, and subsequently in 2021, is that these sexual orientation and gender identity change efforts have no track record of being effective,” said Deanne Ottaviano, the APA’s general counsel. “But they do have a good record, based on self-reported evidence, of causing harm – depression, and suicidality and loneliness and other adverse psychological concerns.”
Justices could be swayed by debate over evidence
That may not be persuasive to a majority of the justices.
When the Supreme Court in June allowed Tennessee to ban gender affirming care for minors, the conservative majority seemed swayed by what Chief Justice John Roberts called the “open questions” about the benefits and harms of puberty blockers and hormone therapy for transgender youth.
And some legal experts say the court might again worry that a medical issue is being driven by politics, rather than science.
“There could well be a concern among a majority of the justices that what’s really going on here is a desire to kind of pick a side,” said veteran Supreme Court attorney Roman Martinez, “and to pick a side in a way that’s at odds with First Amendment principles.”
This article originally appeared on USA TODAY: Supreme Court weighing if states can ban ‘conversion therapy’ for kids
