By: Dr. Panicha McGuire, LMFT, RPT™
The Supreme Court recently weighed in on conversion therapy, and while the ruling is being framed as narrow, the implications are not. On March 31, 2026, the U.S. Supreme Court ruled 8-1 against a Colorado ban on conversion therapy for minors. The decision in Chiles v. Salazar sided with a Christian counselor, arguing the law restricted her First Amendment rights, which could invalidate similar bans in other states. So while nothing has been outright overturned yet, the direction is clear.
The Court is moving toward framing what happens in therapy as protected speech rather than regulated healthcare. That distinction might sound technical, but it fundamentally changes how we think about harm, responsibility, and ethics in clinical spaces. Because therapy is not just speech.
When people hear “conversion therapy,” they often picture something extreme or outdated. Electroshock. Institutional settings. Practices that feel obviously abusive by today’s standards. And while those forms have existed, that framing misses what conversion therapy actually looks like now. It is often subtle, relational, and it is often framed as care. At its core, conversion therapy refers to attempts to change, suppress, or redirect someone’s sexual orientation or gender identity. It does not require a specific technique or overt coercion. The defining feature is the goal itself: that a person’s identity is something to be altered.
The reason conversion therapy has been restricted or banned for licensed professionals in many states is not political but clinical. There is overwhelming consensus across the medical and mental health field that conversion therapy is ineffective and harmful. It does not reliably change sexual orientation or gender identity. What it does reliably produce is harm.
Research consistently links conversion practices with increased depression, anxiety, trauma symptoms, and suicidality. They are tied to the core message embedded in the intervention. It is not simply, “Let’s explore who you are.” It is, “Who you are is a problem”. And when that message comes from a therapist, or other healthcare professional, it carries weight. It is not just an idea in a political debate. It is delivered within a relationship built on trust, authority, and vulnerability. Especially when the client is a minor, the power imbalance is significant. To call that “just speech” ignores how therapy actually works.
This is where the Supreme Court’s reasoning becomes concerning from a clinical standpoint. The majority opinion focuses on the idea that Colorado’s law restricts speech based on viewpoint. In simple terms, the law allows therapists to affirm a client’s identity but prohibits them from trying to change it, and that asymmetry is being treated as a constitutional issue.
From a clinical perspective, it collapses a critical distinction because not all therapeutic interventions are ethically equivalent simply because they are verbal. We already accept this in other areas of healthcare. There are limits on what providers can do, even if a client/patient requests it. Those limits exist because care is not just about choice but it is about safety, evidence, and responsibility. Conversion therapy has been evaluated within that framework and found to be harmful.
The dissenting opinion highlights this clearly, noting that bans were based on a broad medical consensus that the practice is ineffective and dangerous. So the question is not whether therapists have the right to speak. It is whether the state has the right to set boundaries around practices that have been shown to harm patients, even when those practices are delivered through conversation.
Even without this ruling, conversion therapy has never fully disappeared.
It has adapted. It has moved out of obvious, easily regulated spaces and into ones that are harder to track and harder to challenge. It rarely calls itself “conversion therapy” anymore. Instead, it shows up as coaching, faith-based counseling, discipleship, or values-based work. The language softened and the branding shifted. But the goal remains the same.That matters, because some people use this reality to argue that bans do not work.But that misses the point.We did not ban conversion therapy for licensed professionals because we thought it would disappear overnight. We banned it to establish a baseline. A line in the sand. A shared understanding of what is considered harmful within healthcare.Because healthcare, at minimum, is supposed to offer some common protections.There are things you do not get to do to people under the guise of care, even if you can justify it, even if it aligns with your personal beliefs, even if someone asks for it.
That is why licensing exists. That is why ethical codes exist. That is why standards of care exist. Without those boundaries, therapy becomes whatever the provider wants it to be. And that is exactly what these bans were trying to prevent. They were not about controlling speech. They were about maintaining a floor of safety. About saying that regardless of personal, cultural, or religious beliefs, licensed professionals do not get to provide interventions that have already been shown to increase harm. So yes, conversion therapy still exists. But removing protections for what licensed professionals can do does not limit it. It legitimizes it.
There is also a deeper layer to this conversation that often gets overlooked. Conversion therapy is frequently defended as a matter of client choice. But choice does not exist in a vacuum. Many individuals enter these practices due to family pressure, religious expectations, or fear of rejection. For minors, autonomy is even more limited. And therapy, at its best, is supposed to expand a person’s capacity to exist as they are, not narrow it.
At Living Lotus Therapy, we have seen this firsthand. We work with clients who have been through these experiences sometimes explicitly labeled as conversion therapy, but often not. Many come to us after spending years in spaces that told them, directly or indirectly, that they needed to change who they are to be acceptable.We see how long it takes to rebuild something that should never have been broken in the first place. And it is why we are committed not just to affirming care in the therapy room, but to systemic change outside of it.
At the center of all of this is a simple question. What is therapy for? If therapy is about reducing harm, supporting identity development, and helping people live more fully as themselves, then conversion therapy does not meet that standard. It reinforces shame, teaches that acceptance is conditional and it creates an environment where authenticity feels unsafe.
Living Lotus Therapy’s Stance
At Living Lotus Therapy, we stand alongside the major medical and mental health organizations that have unequivocally rejected conversion therapy as harmful, ineffective, and unethical. We do not view LGBTQ+ identities as problems to be treated, reduced, or changed. We view them as valid expressions of human experience that deserve respect, protection, and affirmation.
We believe that therapy must be grounded in evidence-based practice, ethical responsibility, and a commitment to do no harm. This includes recognizing that not all interventions are neutral, and that attempts to change a person’s sexual orientation or gender identity fall outside the bounds of ethical care.
We are committed to advocating for standards, policies, and protections that uphold the dignity and safety of LGBTQ+ individuals, especially youth. We believe healthcare must maintain clear boundaries around what constitutes harm, regardless of personal, cultural, or religious beliefs.
And we will continue to stand for that, both in the therapy room and beyond it.
Resources, Research, and Reporting Conversion Therapy
Research on the Harms of Conversion Therapy
Conversion therapy is not evidence-based and has been consistently linked to harm.
- It is associated with increased depression, anxiety, and suicidal ideation among LGBTQ+ individuals.
- Reviews of scientific evidence have found it to be ineffective and connected to suicide attempts and significant psychological distress.
- Research from the Williams Institute (UCLA) shows significantly higher rates of suicide attempts among individuals exposed to conversion therapy.
- Peer-reviewed studies consistently identify conversion therapy as a harmful, discredited practice with no reliable evidence of efficacy.
Davison, G. C., & Walden, K.-R. (2024). History and Iatrogenic Effects of Conversion Therapy. Annual Review of Clinical Psychology, 20(1). https://doi.org/10.1146/annurev-clinpsy-080822-052144
Forsythe, A., Pick, C., Tremblay, G., Malaviya, S., Green, A., & Sandman, K. (2022). Humanistic and Economic Burden of Conversion Therapy Among LGBTQ Youths in the United States. JAMA Pediatrics, 176(5). https://doi.org/10.1001/jamapediatrics.2022.0042
Olson-Kennedy, J. (2022). When the Human Toll of Conversion Therapy Is Not Enough. JAMA Pediatrics, 176(5), 450–451. https://doi.org/10.1001/jamapediatrics.2022.0049
Major Organizations Opposed to Conversion Therapy
Conversion therapy is rejected across the healthcare field.
Major organizations opposing it include:
- American Psychological Association (APA)
- American Psychiatric Association
- American Medical Association (AMA)
- American Academy of Pediatrics (AAP)
- American Association of Marriage and Family Therapy (AAMFT)
- National Association of Social Workers (NASW)
- American Counseling Association (ACA)
- World Psychiatric Association
These organizations cite a consistent conclusion: conversion therapy is ineffective, unethical, and harmful.
California Law on Conversion Therapy
California prohibits licensed mental health providers from engaging in conversion therapy with minors.
- SB 1172 (2012) bans these practices for licensed professionals
- The law defines conversion therapy as attempts to change sexual orientation or gender identity
- Violations can result in disciplinary action, including loss of licensure
Where to Report Conversion Therapy
If a licensed provider is engaging in conversion therapy, you can file a complaint.
California licensing boards:
Support and advocacy organizations:
- The Trevor Project (24/7 crisis support): 1-866-488-7386
- National Center for LGBTQ Rights
- ACLU
Even in states with bans, these practices may continue in unregulated spaces. Reporting licensed professionals helps maintain accountability.