When parents discover their child is questioning their identity, the fear can be overwhelming. In that vulnerable moment, some may encounter practitioners who promise they can help through something they call therapy. But what if that promised help actually causes harm? And what if a Supreme Court case could make it legal for anyone to offer these unproven treatments?

The case currently before the Supreme Court, Chiles v. Salazar, will determine whether states can continue to protect children from conversion therapy practices that major medical organizations have condemned for decades. The outcome will affect millions of families across America.

Understanding Chiles vs Salazar: the case that matters

In 2019, Colorado passed a straightforward law protecting minors from conversion therapy by licensed mental health professionals. This law, known as the Minor Conversion Therapy Law, does not prevent pastors or religious counsellors from offering guidance. It only regulates state-licensed therapists who must follow professional standards to keep their licenses.

Kaley Chiles, a licensed counsellor in Colorado, represented by Alliance Defending Freedom, challenged this law. She argues that because therapy involves talking, and talking is protected speech under the First Amendment, Colorado cannot regulate what she says to clients. On 7th October 2025, the Supreme Court heard oral arguments in this case, and during those arguments, a majority of justices appeared sceptical of Colorado’s ban, signalling they may rule in favour of expanded therapist speech protections.

If the Court rules against Colorado, the implications extend far beyond conversion therapy. As legal experts have noted, this decision could affect how states regulate all forms of medical and mental health care, potentially limiting their ability to protect patients from harmful practices.

The deceptive marketing of conversion therapy

One of the most troubling aspects of conversion therapy is how practitioners market their services to frightened parents. They rarely use the term “conversion therapy.” Instead, they describe their work as “faith-informed counseling” or helping clients “become comfortable and at peace” with their bodies. This language sounds benign, even compassionate.

But underneath these reassuring phrases lies a practice that every major medical and mental health organisation has condemned, including the American Psychological Association, the American Medical Association, and the American Academy of Pediatrics. These organisations reject conversion therapy not because of ideology, but because of evidence.

Practitioners often target parents at their most vulnerable moments. They may suggest that a child’s struggles stem from family dynamics or parenting choices, implying that expensive therapy programs can “fix” what they frame as the real problem. In one notable case, a mother described how a practitioner convinced her to spend thousands of dollars on multiple programs for her son, only to watch their relationship deteriorate with each attempt.

The 2015 landmark case Ferguson v. JONAH exposed the consumer fraud at the heart of conversion therapy. A New Jersey jury found that conversion therapy organization guilty of unconscionable fraud after “success story” witnesses admitted they still experienced same-sex attraction despite completing the program. The judge in that case stated plainly that “the theory that homosexuality is a disorder is not novel but, like the notion that the earth is flat and the sun revolves around it, instead is outdated and refuted.”

The research on conversion therapy harms

The scientific evidence on conversion therapy’s harmful effects is substantial and growing. Parents considering any treatment for their children deserve to know what research shows:

Research from the Williams Institute found that people who experienced conversion therapy were nearly twice as likely to report having attempted suicide compared to those who did not undergo such practices. Among youth, the statistics are even more alarming.

A 2020 study published in the American Journal of Public Health examined over 34,000 LGBTQ youth and found that those who underwent conversion therapy were more than twice as likely to report having attempted suicide and more than 2.5 times as likely to report multiple suicide attempts in the past year.

A 2021 research estimated that conversion therapy and its associated harms cost the US $9.23 billion annually. This includes direct costs of the therapy itself ($650 million) and the much larger costs associated with mental health treatment for depression, anxiety, substance abuse, and suicide attempts that often follow exposure to these practices.

The long-term psychological effects are severe. A Stanford Medicine study of more than 4,000 participants found that conversion practices were linked to greater symptoms of depression, post-traumatic stress disorder, and suicidality. Participants reported 77% experiencing significant long-term harm, including feelings of alienation, loneliness, social isolation, and damaged relationships with family members.

For transgender youth specifically, research published in Health Economics found that conversion therapy increased the risk of suicide attempts by 55% and more than doubled the risk of running away from home.

Perhaps most telling, these negative outcomes persist even when researchers control for other risk factors like adverse childhood experiences, family rejection, or religious upbringing. The evidence consistently points to conversion therapy itself as a source of harm.

What this means for families of faith

For parents who want to raise their children according to their faith values, the stakes in Chiles v. Salazar are high, but perhaps not in the way some advocacy groups suggest.

Colorado’s law does not prevent therapists from helping young people explore their feelings and identity in ways consistent with their family’s religious values. It does not prohibit discussions about celibacy or living according to faith teachings. What it prohibits is making promises that cannot be kept: promising to change fundamental aspects of who a person is.

The law recognizes what research has shown for decades. You cannot “talk someone out” of being gay or transgender any more than you can talk someone into being gay or transgender. When therapists promise otherwise, they are engaging in fraud, taking money from desperate families for outcomes they cannot deliver.

Moving forward: questions parents can ask

When considering any mental health support for a child, parents can protect their family by asking direct questions:

• What specific outcomes does this treatment promise?
• What peer-reviewed research supports these methods?
• Is this approach endorsed by major medical organizations?
• What happens if the treatment does not produce the promised results?
• Will you be working with us as parents, or will sessions be confidential in ways that exclude parental involvement?

Legitimate therapists will welcome these questions. They will explain their methods, cite evidence for their effectiveness, and work collaboratively with families. They will not promise to change fundamental aspects of a child’s identity because ethical practitioners know such promises cannot be kept.

The path forward

The Supreme Court will issue its decision in Chiles vs Salazar by summer 2026. Regardless of the outcome, parents need to understand what conversion therapy is, how it is marketed, and what research shows about its effects.

Children who are questioning their identity need support, not promises of transformation. They need adults who will walk alongside them with honesty, not practitioners who will take advantage of family vulnerability for profit.

Understanding what is truly at stake in this case empowers families to make informed decisions based on evidence rather than fear. It protects children from practices that could cause lasting harm. And it ensures that when families seek professional help, they find practitioners who are accountable to medical standards, not protected by speech rights that put profits over patient welfare.

The choice facing our nation is clear: Do we want a system where therapists can promise anything without accountability, or do we want protections that ensure children receive care that is safe, effective, and grounded in evidence? For families of faith who believe children are precious gifts deserving protection, the answer should be obvious.

Adam Mulligan, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.