The recent Supreme Court decision in Chiles v. Salazar has been widely discussed as a ruling about conversion therapy. But focusing only on that frame risks missing the deeper issue emerging beneath it.
This case is not only about conversion therapy.
It is about whether what we do in the therapy room is considered professional conduct—or protected speech.
And that distinction has significant implications for how our work is understood, regulated, and ethically guided moving forward.
The Legal Shift: Therapy as Speech
In its decision, the Court did not strike down Colorado’s Minor Conversion Therapy Law. Instead, it ruled that the law—when applied to talk therapy—regulates speech based on viewpoint and must
therefore be evaluated under strict scrutiny.
At the center of this reasoning is a critical question:
Can the state regulate what a therapist says in session?
The argument advanced in this case is that the law permits certain therapeutic conversations—those that affirm identity—while prohibiting others—those that aim to change it. Under this framing, the issue becomes one of viewpoint discrimination, not simply professional regulation.
Whether one agrees with that argument or not, it is now part of the legal landscape shaping how these laws are evaluated.
The Deeper Tension: Speech vs. Care
For those of us in clinical practice, this introduces a tension that is not easily resolved.
If therapy is treated primarily as speech, then the boundaries of our work may be increasingly defined by constitutional protections. If it is treated as professional conduct, then it remains subject to regulation based on standards of care and client protection.
But in reality, therapy has always existed in both spaces.
We use words.
But we are not engaged in casual conversation.
We are delivering care.
And that distinction matters.
Because the question is not only what we have a right to say.
It is what we are responsible for doing.
Conversion Therapy and the Question of Harm
This is where the conversation returns—necessarily—to conversion therapy.
Major medical and mental health organizations have consistently found that efforts to change sexual orientation or gender identity are ineffective and associated with harm, including increased depression, anxiety, and suicidality.
That evidence has informed ethical standards across disciplines.
But the current legal framing shifts the focus. Instead of asking “Is this practice harmful?”, the question becomes “Can the state prohibit this form of speech?”
Those are not the same question.
And the gap between them is where ethical responsibility becomes even more important.
Ethics in a Changing Legal Landscape
For counselors, this is where clarity matters.
Because, regardless of how courts ultimately rule on the scope of state regulation, our ethical obligations do not shift in response.
The ACA Code of Ethics remains clear:
- Nonmaleficence — do no harm
- Beneficence — promote client wellbeing
- Justice — provide equitable, affirming care
Section C.7.c. offers especially direct guidance: counselors do not use interventions when substantial evidence suggests harm—even if those services are requested.
That standard does not depend on whether a practice is legally permitted.
It depends on whether it is ethically and clinically sound.
In other words:
The expansion of free speech protections does not redefine what constitutes ethical care.
The Risk of Oversimplification
It would be easy to reduce this moment to a binary:
- free speech vs. regulation
- therapist autonomy vs. state control
But the reality is more complex.
Therapists hold both:
- rights, as individuals
- responsibilities, as licensed professionals
And those do not always align neatly.
The risk in this moment is not only that harmful practices could become more difficult to regulate. It is also that the identity of therapy itself becomes blurred—reframed as speech alone, rather than as a form of care grounded in evidence, ethics, and accountability.
Staying Awake to Our Work
So what does this mean for us, right now?
Practically, very little has changed. Colorado’s law remains in effect as the case returns to the 10th Circuit for further review.
But conceptually, something important is shifting.
We are being asked—implicitly or explicitly—to consider:
What defines our work?
Who determines its boundaries?
And what do we do when legal and ethical frameworks begin to diverge?
This is not a moment for panic.
But it is not a moment for complacency either.
It is a moment to stay awake to our work.
To remain grounded in the ethical standards that define our profession.
To engage thoughtfully with the broader forces shaping it.
And to continue providing care that is not only permissible—but responsible.
Because in the end, the most important question is not what we are allowed to say.
It is whether what we do, and how we do it, serves the wellbeing of those who trust us with their care.
For Further Reading:
For the full text of the ruling in the Chiles vs. Salazar case to date: Click Here
View the ACA & SAIGE joint statement: Click Here
Read the full article by the APA: Click Here
For an article from Kaley Chiles’ and the ADF’s point of view: Click Here
The information referenced from CCA was provided in a direct email from CCA to Counselor members. To read the full text, members can reach out to CCA for a copy.
For more from Wholehearted Counseling: Click Here
