Kaley Chiles, a licensed mental health counselor in Colorado, challenged the state's 2019 conversion therapy ban as it applies to her talk therapy practice. Chiles provides counseling to clients with diverse goals regarding sexuality and gender identity—some seek affirmation while others hope to change unwanted attractions or behaviors. The Colorado law permits counselors to provide 'acceptance, support, and understanding' for identity exploration but prohibits any practice attempting to 'change an individual's sexual orientation or gender identity.'
Justice Gorsuch, writing for the majority, determined that Colorado's law 'regulates speech based on viewpoint' and constitutes an 'egregious form of content regulation' requiring strict scrutiny. The Court rejected Colorado's argument that the law merely regulates professional conduct, noting that 'her speech does not become conduct just because the State may call it that.' Gorsuch emphasized that the First Amendment protects licensed professionals' speech rights equally to all others, warning against government efforts to 'manipulate professional speech' to 'increase state power' and 'suppress minorities.'
Both the federal district court and Tenth Circuit had previously denied Chiles's preliminary injunction request, finding she had standing to challenge the law but concluding it warranted only rational-basis review as a regulation of professional conduct rather than speech. The courts determined the law regulated 'therapeutic modalities' and affected speech only 'incidentally,' but Judge Hartz dissented, calling the majority's approach 'a labeling game.'
The decision creates a circuit split on conversion therapy bans, with implications for similar laws in 25 other states. Justice Kagan filed a concurrence suggesting viewpoint-neutral healthcare speech regulations might face different analysis, while Justice Jackson dissented alone, arguing the majority failed to appreciate that medical professionals' treatment-related speech deserves less First Amendment protection when regulated as part of healthcare practice.