By: The Editorial Board – wsj.com – October 6, 2025

A Christian counselor, gender dysphoria, and the First Amendment.

Colorado responds that she’s “overreading” the law, claiming that none of what Ms. Chiles says she wants to do is banned. Rather, the state prohibits a range of treatments—“from electric shocks, to hypnosis, to role-playing, to cognitive behavioral therapies”—if they’re done in an effort to alter a minor’s gender identity or sexual orientation. The state argues such “conversion therapy” is harmful, substandard healthcare, even if it involves only talking.

But the plain text of the law appears broader than Colorado now prefers to admit. “A therapist treating a minor who seeks to understand whether they identify as a girl or boy should help that patient explore that question,” the state says. Explore how? Ms. Chiles believes that most children with gender dysphoria before puberty eventually resolve those feelings. In that case, she’s in a bind.

Imagine a family coming to counseling with a little boy who has dysphoria and likes trying on his sister’s dresses. If a therapist discourages this for now, how is that not an illegal effort to change “behaviors or gender expressions”? Yet Colorado’s legislators made sure to add a line making clear that giving “assistance” for a gender transition is acceptable.

Ms. Chiles also says some of her clients are referred by local churches, and some want to discuss issues that “implicate Christian values about human sexuality,” including if they’re living inconsistently with their beliefs. She no longer feels she can get near such conversations with clients under 18. Colorado says it has so far never enforced its law against any counselor, but forgive Ms. Chiles for not wanting to take it on faith. How many years has the Colorado cake baker Jack Phillips been under siege?

The lower courts ruled against Ms. Chiles, and the Tenth Circuit Court of Appeals held 2-1 that Colorado’s law only “incidentally” involves speech, since it merely regulates “professional conduct” and bans “a type of prohibited treatment.” The state argues that this is a “routine” regulation of healthcare, not a free speech question, akin to oversight of “a surgeon who incompetently closes a suture.”

The comparison is hardly apt. Ms. Chiles argues strict judicial scrutiny should apply, since Colorado is prescribing orthodoxy in the counseling room. She says the law can’t pass that test, since it’s a restriction that “cuts off distressed kids and their families from the counseling they seek.” The state predicts, with what reads like unwarranted confidence, that its law can survive any level of scrutiny.

But the idea that talk therapy is conduct, not speech? That could get a chilly reception from the Justices, who are always wary of claimed exceptions to the First Amendment.

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Source: ‘Conversion Therapy’ at the Supreme Court – WSJ