Blog 4/3/26

Equitas Health CEO Responds: SCOTUS Conversation Therapy Decision

By David Ernesto Munar

In an 8-1 opinion issued on March 31, the Supreme Court of the United States (SCOTUS) found that the practice of speech-only conversion therapy is protected by the First Amendment’s right to free speech. Accordingly, SCOTUS ordered a lower court to take another look at Colorado’s ban against conversion therapy.

Like 23 other states, Colorado prohibits the harmful, pseudo-scientific practice of conversion therapy on minors. But now, SCOTUS has ordered the lower court to apply the highest level of scrutiny reserved for First Amendment rights. This mandate to the lower court will most likely result in the eventual invalidation of Colorado’s ban, because American courts have generally shown extreme reluctance to restrict protected speech. Consequently, SCOTUS’s ruling significantly impedes states from being able to protect minors from the harmful and shame-based practice of conversion therapy.

LGBTQ+ advocates across the country expressed grave concern. SCOTUS refused to recognize that the speech in question occurs within the profound context of state-licensed medical care for minors. The state bears a mantle of responsibility to ensure minors in the care of licensed professionals are afforded safe and scientifically valid medical care. Without guardrails, therapists are free to guide young people down a path of self-hate, suppression, and long-lasting psychological harm. Other foreboding observations about the ruling:

1. SCOTUS will go to extreme lengths to argue against the rights of transgender, non-binary, and gender expansive people and others outside the cis/hetero paradigm. SCOTUS dramatically and irresponsibly reinterpreted well-established legal convention, allowing states to regulate healthcare practice. Just last year, SCOTUS ruled against the rights of trans and non-binary minors in Tennessee, who were seeking equal protection under the law to receive gender-affirming care. SCOTUS affirmed Tennessee’s ban on gender affirming care for minors and restricted access to these medications, and they argued that the state is well within its rights to regulate medical practices. Unsurprisingly, the medications at the center of this case remain readily available to cisgender youth.
2. Under the guise of protecting free speech, SCOTUS allows therapists to disregard medical standards driven by science. According to them, free speech can protect quack beliefs, pseudo-science, harmful practices, and their related impacts. But we, the public who bear the brunt of harmful practices, like conversion therapy, retain the right to denounce harmful practitioners and their practices with our protected free speech. Furthermore, states, courts, and professional associations may continue to regulate professional standards, remedy malpractice, and seek relief for civil and criminal damages incurred by licensed professionals.
3. Announced the day after historic No Kings rallies nationwide, SCOTUS’ latest interpretation of the right to free speech could have far-reaching implications. As the Trump administration increasingly targets protesters, this decision could actually protect people and press outlets who criticize their government, exercise their right to assembly, and denounce surveillance and other tactics of intimidation. The ruling could also help invalidate certain restrictions against transition-related behavioral health services for the LGBTQ+ community.
4. Justice Ketanji Brown Jackson continues to be a much-appreciated voice of reason. In her sole dissent, Justice Jackson articulates the long-established precedent that states can regulate scientifically sound and safe medical practices, even when such regulations restrict what a therapist can say. She also details how the Colorado ban against conversion therapy continues this tradition, aiming to protect minors under the care of state-licensed therapists. The law does not unnecessarily curb the speech of therapists. Rather, the law binds therapists to widely accepted and scientifically based care standards for the welfare of children who shame-based tactics might otherwise harm.

There are no gender identity and sexual orientation exceptions to life, liberty, and the pursuit of happiness in the Constitution, and there must be no exceptions to the welfare of children. SCOTUS’s failure to understand the real, pervasive, and irrevocable harm caused by conversion therapy to LGBTQ+ lives must be met with visible, vocal, and persistent advocacy. For every therapist who will use this ruling to project their hatred and bigotry onto the lives of young LGBTQ+ people, tens of thousands of us must use our voices – and our votes – to protect them.