Talk Therapy at Stake in Chiles v. Salazar

Does the First Amendment Allow States to Regulate Talk Therapy?

The Crux of the Matter

What constitutes free speech?  The largely Conservative justices backed by the Trump Administration have started to determine if Kaley Chiles, an Evangelical Christian mental health counselor has the right to counsel her trans patients but not to help them accept their assigned sex at birth.  How far can she influence her patients in Colorado?  Will she tackle controversial topics such as bathrooms, sports teams, and pronouns, not popular with the current administration?

The Supreme Court this week has heard debates, an “amicus” or “friend of the court” submitted by major medical and psychological organizations, including the National Alliance on Mental Illness, stating that conversion therapy, a form of indoctrination and practice to convert LGBTQ+ minors is harmful and doesn’t work.  Those who have witnessed the practice report abuse, brainwashing, and testify that it did not make them straight.

A brief History of Conversion Therapy

This court case Chiles V. Salazar will not be settled over night and could affect similar bans in over twenty states. The lower courts have upheld Colorado’s state law.  Conversion therapy has been around a long time.  The American Psychiatric Association and the American Medical Association has opposed conversion or so-called reparative therapy.

Homosexuality has not been regarded as a disease since 1973 when the American Psychiatric Association took gender dysphoria out of their diagnostic tool, the DSM manual.  In 2012, Robert Spitzer, M.D. denounced his well-known study on gay culture and reparative therapy; the study didn’t conclude that conversion therapy actually worked.  Not only was it ineffective, it can cause depression, guilt, substance abuse, damaged familial relationships, shame, and even suicide!

Many religious groups are opposed to conversion therapy.  In a 2025 poll in America, a majority of adults in the United States (56%) think conversion therapy should be illegal to use on minors, those under eighteen. You cannot be “cured.”

While mental health professional Ms. Chiles will not use medicine in her practice such as puberty blockers, she is represented by the Alliance Defending Freedom.  The plaintiff has filed a lawsuit against the state of Colorado, saying that the ban on conversion therapy infringes on her freedom of speech.

Patty Salazar, the Respondent

Patty Salazar, is the Executive Director of the Colorado Department of Regulatory Agencies.  She is representing the state of Colorado.  The defendant argues that the law is a regulation of a specific health care treatment and protects minors from harmful and ineffective practices.  She wants the status quo.  Since 2012, Republican legislators have supported bans more than 1,000 times on conversion therapy introduced into U.S. legislatures.

How far will Ms. Chiles go in her talk therapy?  Will it just be exploratory?  Says Ms. Chiles, “the state is preventing me from working with patients who want to live a life consistent with their faith.”  Her lawyer James Campbell said “Kaley is trying to help children and instead “is being silenced, and the kids and families who want her help are unable to access it.”

On the other side of the coin,  Matt R. Salmon, now a psychiatrist in Washington, D.C.  who was damaged by talk therapy. He relayed that he prayed, fasted, read scriptures and pleaded with God to change him and make him “straight.” Growing up in a religious family in Arizona,  he agreed at age eighteen to see a counselor he was told could help, but didn’t.  “Licensed professionals don’t have free speech,” he says.  “You don’t just get to say whatever you want.”  Salmon to this day said he still feels “so hurt and broken by the experience”of talk therapy aimed at changing him.

Sources:  The New York Times,  “Conversion Therapy, Once Widely Condemned, Is Back Up for Debate,” 10/8/25 and Treasure Coast Newspapers,”Court to weigh LGBTQ+ conversion, ” 10/7/25.