Babe, wake up! The Supreme Court of the United States of America has just dropped a new judgment and it fucking SUCKS!
I know, it’s not exactly breaking news, but this one IS unique in a few unfortunate ways, so I’m gonna talk about it. On Tuesday, the Trans Day of Visibility, The Supreme Court ruled that a Colorado law banning conversion therapy was unconstitutional. And the worst part? Only one justice dissented.
If you aren’t aware, “conversion therapy” is not, in fact, therapy. It is the pseudoscientific and abusive practice of attempting to force a person to be heterosexual against their actual sexual desires, and to force a person to be cis gender against their actual gender identity. It only exists because of anti-LGBTQ bigotry, usually amplified and supported by regressive religious belief systems. While there are, of course, consenting adults who hold these views and volunteer to undergo this sort of treatment, it’s often forced upon nonconforming children and teenagers by their bigoted parents. In “therapists’” offices, camps, or church basements, these kids are often literally tortured in the hope that their same sex attraction or gender dysphoria will go away if they associate it with painful outcomes like electric shocks, ice baths, or burns.
Study after study has shown that this form of “aversion therapy” does not work. In fact, researchers knew it didn’t work as early as 1961, when Czech researchers gave up trying to convert people and just finally decriminalized homosexuality. Since then, every serious study has supported the fact that it doesn’t work, and that it also leads to extremely poor outcomes for its victims. For instance, a 2024 paper published in Lancet Psychiatry found that “Recalling both forms of conversion practice (sexual orientation and gender identity) was most strongly associated with greater post-traumatic stress disorder and suicidality symptoms. Recall of only sexual orientation-related conversion practice was associated with greater symptoms of PTSD. Recall of gender identity-related conversion practice alone was most strongly associated with greater depressive symptoms.”
A 2020 paper in Gerontologist suggests that these negative effects can persist well into middle age and beyond, finding that men with a mean age of 62.6 years who had previously undergone conversion therapy “were more likely to have depressive symptoms and above-average internalized homophobia. Men exposed to conversion therapy had 2–2.5 times the odds of reporting 1 and ?2 psychosocial conditions, respectively, compared with those who reported 0 conditions.”
And as recently as February of 2026, a study from the Trevor Project found that “LGBTQ+ young people whose most recent exposure occurred within the past year reported the highest rates of both past-year suicidal ideation (61%) and attempts (35%), compared to those whose exposure occurred more than a year prior.
“One in twenty (5%) LGBTQ+ young people reported ever having been subjected to conversion therapy.
And “Transgender and nonbinary young people reported higher rates of lifetime exposure to conversion therapy (6%) than their cisgender peers (4%).”
Despite 65 years of confirmation that conversion therapy is nothing but abuse, it continues to be practiced around the world today. That’s why here in the United States, 23 states have laws banning the use of conversion therapy on minors: because it has no basis in science, only bigotry, and it is blatantly abusive.
One of those states is Colorado, where a Christian “counselor” argued that the law violated freedom of speech, and thus was unconstitutional. All of the Supreme Court justices agreed EXCEPT for Ketanji Brown Jackson. Now, we’ve become accustomed to seeing the conservative majority overrule the liberal justices to quickly whittle away Americans’ rights and freedoms, but it’s a real slap in the face to see people like Elena Kagan and Sonya Sotomayor join them.
I am not, as you may have noticed, a constitutional lawyer, but I think I get what has happened here: the specific argument the Christian counselor made was that the Colorado law was broad enough that it didn’t just outlaw those abusive tactics used in conversion therapy, but also “talk therapy.” Talk is, well, speech, and so technically the law impinges upon a counselor’s freedom to say a specific thing. Kagan argued that Colorado can’t restrict biased speech from one side of talk therapists (who wish to convert LGBTQ+ patients) and not that of the other side of talk therapists (who accept that there’s nothing inherently wrong with LGBTQ+ patients).
But the fact of the matter is that the 1st Amendment does not offer blanket protections to literally anything anyone ever wants to speak out loud. No, don’t worry actual lawyers, I’m not going to say that you can’t yell “fire” in a crowded theater. Instead, I will just quote from Justice Jackson’s excellent, fiery 26-page dissent:
Ultimately, because the majority plays with fire in this
case, I fear that the people of this country will get burned.
Before now, licensed medical professionals had to adhere to
standards when treating patients: They could neither do
nor say whatever they want. Largely due to such State reg-
ulation, Americans have been privileged to enjoy a long and
successful tradition of high-quality medical care.
Today, the Court turns its back on that tradition. And,
to be completely frank, no one knows what will happen now.
This decision might make speech-only therapies and other
medical treatments involving practitioner speech effectively unregulatable—not to be reached via licensing standards, medical-malpractice liability, or any other means of
state control. Who knows? Certainly not the majority. It appears to have made this momentous decision without adequately grappling with the potential long-term and disastrous implications of this ruling.
The fallout could be catastrophic. Many regulations impact the speech of medical professionals in the context of their provision of healthcare to patients; the possibilities go far beyond talk therapy and informed consent. For example, many States require that medical professionals “make every reasonable effort to promote the welfare, autonomy and best interests of ” the client.
Some States further prohibit medical professionals from treating a patient “in a cruel manner.”
Similarly, some licensing boards can discipline a provider who “is incompe-
tent.” On the majority’s view, these kinds of regulations become
unenforceable if the healthcare provider risks harming patients with their speech rather than an operation. Providers who offer “cruel” speech-only therapies or who use
speech to (intentionally or incompetently) harm the welfare of patients, for example, can now assert a First Amendment right to carry on, regardless of these standards.”
The SCOTUS majority is essentially codifying a “sticks and stones” legal defense for medical practitioners who can say whatever they want to their patients: “You shouldn’t bother to continue your cancer treatment.” “Your dick looks like a microwaved rubber ducky.” “If you get this abortion, you’d be murdering a child and you might die so you probably shouldn’t do it.”
Oh, hold on, hold on, whoops, that’s actually an example of biased speech from a medical professional that actually IS coded into law in several states and will remain so after this decision. Georgia, Pennsylvania, Iowa, and Nebraska are just a few of the states in which misogynists have mandated that patients seeking abortions undergo biased counseling prior to getting the procedure, in which they are actively discouraged from getting it by biased medical professionals using blatant fear-mongering and sometimes straight up lies. So SCOTUS has just decided that it’s unconstitutional for states to prevent unscientific speech by medical professionals while it remains perfectly fine for other states to MANDATE unscientific speech by medical professionals. Huh.
Kagan suggested ways for Colorado to change their law to make sure it still allows these conversion therapy ghouls to “say” whatever they want while still preventing physical abuse, but fuck that, Jackson is right: if we do not have any standards for how a medical professional can speak to a patient, particularly a scared, underage patient facing an entire system that wants to see them dead, then we don’t have any standards at all.
