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The Supreme Court Just Condemned Countless Kids to Psychiatric Abuse

The court’s 8–1 ruling overturning Colorado’s ban on conversion therapy is a disaster for LGBTQ kids—and also for the healthcare profession.

The façade of the Supreme Court Building.

In an 8–1 ruling on Tuesday, the Supreme Court overturned Colorado’s ban on conversion therapy. In so doing, it not only condemned countless children to a form of psychiatric abuse but also likely consigned the nation to a future of substandard medical care.

I’m not the only one who thinks this. In her solo dissent, Justice Ketanji Brown Jackson summarized the court’s opinion this way: “[T]o put it bluntly, the Court could be ushering in an era of unprofessional and unsafe medical care administered by effectively unsupervised healthcare providers.”

The case at the heart of the ruling is called Chiles v. Salazar, and it involves Colorado’s Minor Conversion Therapy Law (MCTL), which bans conversion therapy for young people. Conversion therapy is the practice of telling gay or transgender children that they’re not really gay or transgender and they can choose to be cis-hetero normative if they just really, really try. The “therapy” has been debunked as a medical practice: It is not only ineffective (turns out, you cannot “pray the gay away”) but it has also been consistently shown to be harmful to children. Colorado is one of more than 20 states that ban conversion therapy from being practiced on children. The ban applies only to state-licensed medical professionals, and leaves religious groups free to shame and abuse children as their gods allow.

Kaley Chiles is a licensed therapist. She is also an evangelical Christian who brought the challenge against Colorado’s MCTL because, notwithstanding the medical evidence, she still wants to practice conversion therapy. She claims that she doesn’t want to “change” or “convert” children but rather “help” them achieve “their own goals.” I cannot speak to Chiles’s intent, because she filed the lawsuit before Colorado even attempted to enforce the law against her. It would have been reasonable to wait for Chiles to practice something banned by the state before hearing this lawsuit. Then we’d be able to look at the facts of her practice rather than rely on mere conjecture about what she’d like to say but allegedly can’t. But the Republicans on the Supreme Court no longer wait for facts when there is a culture war to be won.

Chiles challenged the law on First Amendment grounds. She is a “talk therapist” and argued that the First Amendment protects her right to talk about whatever the hell she wants, including, apparently, debunked, unsound, unscientific, and harmful medical practices.

From a certain point of view, you can see Chiles’s point. The First Amendment protects “speech,” and telling children wrong and horrible things about themselves is, technically, speech. I do not know why people would want to use their speech to abuse children, but the First Amendment does and arguably should protect your right to tell little kids that they suck.

But Chiles is not using her First Amendment rights to menace children as an ordinary citizen out in the wild. She’s not shouting “Hey, stop being gay!” at little kids unfortunate enough to hit a baseball into her yard. She’s doing it from her position as a medical professional with a license from the state of Colorado. That means that when she tells kids to stop being gay in a therapy session, she’s not merely expressing her personal views or those of her god; she’s speaking as an expert recognized by the state of Colorado.

Colorado, like other0000 states, has a right to regulate what licensed professionals can say to make sure that the treatments they’re providing represent the best and safest ideas the medical and scientific community has come up with. That is the point of requiring medical professionals to get a license in the first place.

Or rather, states had a right to regulate the speech of licensed professionals until the court’s ruling in Chiles v. Salazar. In his majority opinion, Justice Neil Gorsuch ruled that medical professionals have an absolute free speech right, just like everybody else, even when they are speaking as a medical professional. Gorsuch, the originalist-when-convenient, essentially ignored the centuries of history and tradition regarding medical licenses, and instead came up with a brand new formulation of the First Amendment that cannot be saddled by things as petty as “scientific facts” and “best practices” when it comes to medical care. Gorsuch basically erased the distinction between Dr. Sanjay Gupta and........

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