Conversion Therapy Is Still Happening. Now, It's Protected.

The ruling in Chiles v. Salazar threatens decades of hard-won progress.

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KEY POINTS

• The Supreme Court's ruling puts conversion therapy bans at risk in more than 20 states.

• Conversion therapy can be self-directed, not only imposed by others.

• Every major medical and mental health organization in the U.S. has condemned conversion therapy.

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On March 31, 2026, the Supreme Court ruled 8-1 in Chiles v. Salazarthat Colorado's ban on conversion therapy for minors likely violates the First Amendment rights of licensed therapists. The ruling effectively puts conversion therapy bans in more than 20 states at risk and sends a devastating message to LGBTQ communities across the country.

Conversion therapy is the harmful and discredited practice aimed at changing an individual's sexual orientation or gender identity. It is still legal in more than 20 states.

As of 2026, 23 states and Washington, D.C., entirely prohibit, and four states and Puerto Rico restrict, licensed healthcare providers from subjecting LGBTQ youth to conversion therapy. The Supreme Court's decision could well invalidate laws in some two dozen of those states.

What's still concerning is that the laws don't restrict the practice among religious providers, many of whom are our neighbors, pastors, and people who are part of our daily lives.

Conversion therapy doesn't only happen in a therapist's office. It can come from within as well.

I used to jokingly tell people I could have won an Oscar for the role I played as a straight person. Because of my hypervigilance as a gay child growing up, I had a heightened sense of awareness for how straight men were supposed to dress, walk, and talk. I trained myself to act like the guys I knew.

For my entire adolescence, I gender-policed myself to ensure my sexuality remained hidden. I felt that the more I could blend in, the better my chances were at being accepted, staying safe, and avoiding hell. I even curated my room in the fraternity house, which I had joined specifically to hide that I was gay, with posters of Heidi Klum on the walls and Playboy magazines where visitors could readily see them.

What I understand now, looking back, is that I was practicing a version of conversion therapy on myself.

One of my clients, a man in his fifties, still lives with the consequences of the conversion therapy he underwent decades ago. Raised religious, he attended a religious school where he was outed and subsequently expelled. His parents then sent him to conversion therapy. To this day, he gets anxious when he's aroused and feels shame about his sexuality. For most of his life, he relied on substances to be intimate with another man.

One of the things conversion therapy does that is particularly soul-killing is rob a person of ever considering their identity is something sacred and to be revered. It leaves an indelible mark on their self-concept.

In August 2025, the American Psychological Association (APA) filed an amicus brief in Chiles v. Salazar, joined by the American Psychiatric Association and 12 other major medical and mental health organizations, presenting the Court with scientific evidence that conversion therapy is ineffective and associated with long-lasting psychological harm.

Following the March 31st ruling, the American Psychiatric Association released a formal statement declaring that conversion therapy "is not a legitimate therapeutic treatment" and that leading health care entities have concluded these are "potentially harmful, discredited practices not supported by scientific evidence." APA President Arthur C. Evans Jr., PhD, cautioned that the decision threatens not only conversion therapy bans but the broader authority of state licensing boards to enforce best practices enacted for the safety and protection of consumers. Research from The Trevor Project and The Williams Institute found that LGBTQ youth exposed to conversion therapy are more than twice as likely to report attempting suicide.

When LGBTQ people grow up without affirming homes, affirming classrooms, or affirming communities, the absence sends a message that who they are needs to be hidden or changed—which, at its core, is what conversion therapy tries to do.

A fellow therapist friend who creates content specifically for gay men made a video in response to the Supreme Court's ruling and emphasized that just because something is legal doesn't mean it's good, especially when it comes to medicine and mental health. We've seen time and again that treatments once considered good or acceptable turned out to be harmful.

There are many laws throughout the United States today that aren't good. I was born and raised in Tucson, Arizona, and spent my high school years in the closet while ARS 15-716 was in effect, a law that prohibited Arizona schools from "portraying homosexuality in a positive light" or providing any LGBTQ-affirming education. I often wonder whether having LGBTQ-affirming education while I was in school would have made it easier to accept something I was contending with on my own. The Arizona law was repealed only in 2019 and is an example of a law that was neither good nor just.

The same will be said of the Supreme Court ruling one day. The question is how many more people will be harmed before we get there.

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Chris Tompkins is a gay male therapist in West Hollywood (Los Angeles) who specializes in working with adult gay men, individuals and couples. He supports clients navigating identity, relationships, religious trauma, addiction, and self-esteem. To learn more, explore therapeutic services or schedule a free consultation.