Two years ago, a Colorado therapist named Kaley Chiles sat with clients who came to her wanting help. Some wanted to feel more at peace with being gay. Others, she claimed, wanted her help suppressing that attraction, or bringing their gender identity in line with the sex they were born... the practice every major U.S. medical association calls "conversion therapy" and warns can cause lasting harm.
Colorado had banned counselors from practicing conversion therapy on minors. Chiles filed a lawsuit, arguing that the restriction curtailed her right to free speech. The case eventually reached the US Supreme Court, who ruled that the ban went too far and sent it back to the state for revision. That decision didn't end in Colorado, though. The ripple from Chiles has already reached Missouri, Michigan, and an Oregon case that isn't about conversion therapy at all.
What Is Conversion Therapy, Exactly?
The term covers any effort to change someone's sexual orientation or gender identity. Decades ago that included some extreme methods: electric shocks, nausea-inducing drugs, even institutionalization. Those techniques have been abandoned almost everywhere, including by today's challengers.
What remains contested is talk conversion therapy alone: steering a client toward suppressing an attraction or aligning gender identity with sex at birth using only words. Every major medical and mental health body still calls it ineffective and harmful. More than 20 states have banned it for minors specifically, since kids can't meaningfully consent to a debunked treatment their parents request for them.
That word, minors, is important here. Colorado's law never touched what counselors could say to adult clients, only what they could say to kids... but the SCOTUS decision in that case appears to have opened the door much wider.
What Just Happened in Missouri?
On July 2, the 8th U.S. Circuit Court of Appeals revived a similar lawsuit to the one in Colorado from two Kansas City counselors, Wyatt Bury and Pamela Eisenreich, who sued after Kansas City and Jackson County banned conversion therapy for minors. A district judge had thrown the case out; the panel sent it back, citing the Supreme Court's March ruling in Chiles, which ULC covered when it came down.
That 8-1 decision found Colorado's law banning conversion therapy for minors regulated speech, which gets the First Amendment's strictest protection. Justice Neil Gorsuch, writing for the majority, said the law "censors speech based on viewpoint." Justice Ketanji Brown Jackson dissented alone, warning the ruling risks putting almost any talk-based therapy practices beyond the reach of state regulation.
Where Else Is This Playing Out?
Missouri isn't alone. In Michigan a Sixth Circuit ruling issued just before Chiles blocked the state's own minors-only conversion therapy ban. That case now hangs in limbo, depending on how lower courts apply the new SCOTUS standard.
Colorado has already rewritten its own law in hopes that a ban could survive the stricter review. Kansas City repealed its ordinance outright under state pressure. Jackson County's ban still stands.
Then there's Oregon, where the Chiles decision just did something none of the conversion therapy cases predicted.
The Oregon Case That Isn't About Conversion Therapy
Frank Canepa is a Catholic counselor in Beaverton who saw one adult client weekly for two-and-a-half years without ever volunteering his views on same-sex relationships. When she pressed him for twenty minutes to personally bless her own same-sex relationship, he told her he couldn't, citing his faith. As a result, Oregon's counseling board fined him nearly $90,000 for violating its ethics code against imposing personal values on clients.
Canepa claims he never tried to change anyone's orientation, and no one alleges engaged directly in conversion therapy with his adult client. But once the Supreme Court ruled that the First Amendment protects what counselors say in session, Oregon's board withdrew Canepa's fine within weeks, citing Chiles directly.
The Chiles ruling, it appears, could be used to allow therapists to practice in ways they never could before.
What Do Supporters of These Rulings Say?
The group Alliance Defending Freedom, representing counselors in both Missouri and Oregon, frames all of it as one free speech question, whether the client is a teenager or an adult. Senior Counsel Bryan Neihart says the Kansas City and Jackson County ordinances "push kids down the dangerous path of gender transition" while forbidding the opposite conversation, even at a client's own request.
Eisenreich says in court filings she's felt compelled by the ban to refer away teenagers whose parents specifically sought conversion therapy services in line with their religious beliefs, calling it a barrier between families and the counseling they want.
What Do Survivors and Clinicians Say?
Every major medical and mental health association still classifies conversion therapy as ineffective and harmful, a position that the majority opinion in Chiles didn't touch.
Justice Jackson's dissent leaned on testimony from the Conversion Therapy Survivor Network, which told the Court that even nonaversive, talk-based versions of this conversion therapy teach gay and transgender children shame and self-hatred, and that survivors can carry PTSD, anxiety, and suicidal thoughts for years afterward.
Clinical researcher Dr. Luis Alvarez Hernandez told Colorado Public Radio that loosening these bans risks a return to coercion, isolation, and in extreme documented cases, physical abuse. A recent Trevor Project survey found the share of LGBTQ+ youth who'd undergone conversion therapy fell by half since 2020, to 5 percent, as more states passed bans. That rate could soon increase again.
What's Really at Stake?
Counselors on both sides describe their work in nearly identical language: helping people become who they're meant to be. That's the paradox underneath every case ULC has covered, from Idaho's law letting religious therapists opt out of LGBTQ+ clients altogether to the web designer the Supreme Court let turn away same-sex couples.
Courts keep deciding whose faith gets protected: the adult holding the credential, not the person who came seeking help, whether a teenager in Missouri or an adult in Oregon. Increasingly, the law seems to suggest that a counselor's right to speak their conscience matters. It appears to be less interested in protecting a client's right to leave a session without new shame to carry home.
What Do You Think?
Where should the line sit between a counselor's freedom of speech and a client's protection from a practice every major medical body calls harmful? If Oregon's case is any indication, how far could this ruling stretch beyond conversion therapy itself?
No child should be subjected to gender ID confusion, they have enough to worry about no need to put extra burden on their developing minds. Any school partaking in this behavior should be closed and those adults should be fired and never allowed in a classroom with children again.