On March 31, 2026, the Supreme Court of the United States issued an 8–1 decision in favor of Kaley Chiles—a case asking whether the speech of therapy is, in fact, speech protected by the First Amendment, or conduct that falls outside its protections.

In short, the question before the Court was whether therapy is speech, and as such, constitutionally protected, or whether it is conduct and therefore unprotected. This question has become muddled in the national conversation, largely due to the conflation of traditional therapy with conversion therapy bans, particularly those addressing conversion from a homosexual lifestyle to a heterosexual one.

Further confusing the question is the role of voluntarily seeking therapy to align one’s sexual orientation with one’s religious beliefs, and informed consent. It is not accurate to suggest that the aversion techniques of conversion therapies were forced onto non-consenting patients; voluntary treatments should not be conflated with involuntary ones, whereas where the informed consent was breached and/or harm was done, the case enters the tort area of law through malpractice suits and ethics complaints against the therapist.

Also complicating the speech-versus-conduct question is gender identity and gender-affirming care, an area in which the academy has aggressively worked to silence dissenting views.

The majority opinion was authored by Justice Gorsuch and joined by all eight of his colleagues in the majority, with Justices Kagan and Sotomayor also filing a concurring opinion. Justice Jackson was the lone dissenter. The Court held that therapy speech is speech, and therefore protected by the First Amendment. It held that:

Colorado’s law regulates the content of [Kaley Chiles’s] speech and goes further to prescribe what views she may and may not express, discriminating on the basis of viewpoint. The law permits her to express acceptance and support for clients exploring their identity or undergoing gender transition, but forbids her from saying anything that attempts to change a client’s ‘sexual orientation or gender identity,’ including efforts to change ‘behaviors,’ ‘gender expressions,’ or ‘romantic attraction[s].’ Her speech does not become ‘conduct’ just because a government says so or because it may be described as a ‘treatment’ or ‘therapeutic modality.’ The First Amendment is no word game, and ‘the exercise of constitutional rights’ cannot be circumscribed ‘by mere labels.’

This is the victory those of us who filed amici curiae briefs on behalf of Kaley Chiles argued for, hoped for, and now celebrate.

The majority opinion also clearly addressed the question of informed consent, and found it wanting:

Colorado’s analogy to informed-consent laws fails because such laws regulate speech only incident to separate physical conduct and usually require disclosure of only factual and uncontroversial information, whereas Colorado’s law as applied to Ms. Chiles seeks to silence a viewpoint she wishes to express.

The Respondent and the dissent’s claim that therapists harm patients unless they are properly “policed” by the state is also dismantled:

Colorado’s invocation of traditional tort claims for malpractice fails because malpractice actions require exacting proof of injury caused by breach of duty, ‘provid[ing] breathing room for protected speech,’ whereas Colorado’s law threatens fines, probation, and loss of license simply for expressing a particular view, and does not allow clients to consent to practices that depart from the prevailing standard of care. The First Amendment stands as a bulwark against any effort to prescribe an orthodoxy of views, reflecting a belief that each American enjoys an inalienable right to speak his mind and a faith in the free marketplace of ideas as the best means for finding truth. Laws like Colorado’s, which suppress speech based on viewpoint, represent an egregious assault on both commitments (internal citations omitted).

And finally, the confusing argument permeating the national conversation on the outdated aversion techniques is directly addressed and properly recognized: “Ms. Chiles did not take issue with Colorado’s effort to ban what she herself calls ‘long-abandoned, aversive’ physical interventions.”

This leads to the following, articulated in Justice Jackson’s dissent:

In the worst-case scenario, our medical system unravels as various licensed healthcare professionals — talk therapists, psychiatrists, and presumably anyone else who claims to utilize speech when administering treatments to patients — start broadly wielding their new-found constitutional right to provide substandard medical care. It is baffling that we could now be standing on the edge of a precipitous drop in the quality of healthcare services in America. But the Court sees fit to bring us one step closer to that fate today.

I strongly disagree with her formulation. At first blush, it is offensive to scores of us who practice conscientiously and to the best of our abilities, and not, like she says, “provide substandard care.” Freedom of speech, indeed, the entire Bill of Rights, pre-exists our profession. It is not, as she would have it, “new-found.”

Secondly, she conflates therapy with medicine (i.e., talk vs. medical interventions). By insisting on equating medical treatments with the speech of therapy, she further confuses her own argument. The Constitution recognizes that speech can be unpleasant and even downright offensive, and unless it is for the purpose of defamation, fraud, or “fighting words,” it is still protected. And to add more emphasis to the speech therapy, it is still safer than surgery and medications.

Finally, and most disturbingly, she conflates education and credentialing with First Amendment protections. Counselors can indeed be harmful and say silly, unfounded things. Sometimes they make mistakes, some of them egregious. But the remedy is not the overturning of the First Amendment.

Rather, we should look at two sets of groups: the universities that educate therapists and the accrediting bodies that regulate them—often by stifling them—such as the American Psychological Association, the Council for Accreditation of Counseling and Related Educational Programs, and the Council on Social Work Education. Both academic and accrediting bodies have succumbed to ideological activism, and their regulations reflect it. The progression is natural: accreditation, education, and regulatory “police powers.”

As a result, universities and accrediting bodies should be reformed to educate the future therapists within the proper confines of each discipline. If they recover from their ideological quagmires, the dissent’s worries about the “police powers” of the state and holding bad therapists responsible for their harmful practices would not run afoul of the First Amendment protections for the entire profession.

Universities should be more selective in their admissions, clearer-eyed in their role as educators, and unwilling to behave like diploma mills—articulating more stringent academic standards that serve their students’ professional interests, and their future patients. Academic standards loosened during the pandemic and were further loosened by the “diversity, equity, and inclusion” overreach. These are the areas that we should focus on, not messing with the rights enshrined in our First Amendment.

Justice Jackson’s dissent amounts to throwing the baby out with the bathwater, by undermining the profession, making it suspect to the eyes of the public if not policed through and through, and rendering useless the scores of state and federal laws that already exist and that all license-holders abide by.

Happily, her opinion was dismantled by the majority, and our most cherished freedoms are still protected. This is a good decision!