Chiles v. Salazar FAQ

The United States Supreme Court issued a ruling in a case, Chiles v. Salazar, pertaining to the constitutionality of a state law that prohibits licensed healthcare professionals from providing reparative/conversion therapy to minors.  AAMFT has drafted the following frequently asked questions to answer questions about the case, the Supreme Court’s decision, and its impact.  

1. What is the Chiles v. Salazar case and what issues did it address? 

The case arose from a challenge to a Colorado statute that restricted licensed mental health professionals from engaging in conversion therapy. At its core, the case asked whether such regulations constitute permissible oversight of professional conduct or instead represent an unconstitutional restriction on speech.  

2. What did the Supreme Court decide?

In an 8–1 ruling issued on March 31, 2026, the Supreme Court of the United States held that talk therapy constitutes protected speech under the First Amendment of the U.S. Constitution. The Court explained that when a law targets the content or viewpoint of what a therapist says in a clinical setting, it implicates core free speech protections rather than merely regulating professional conduct.  

As a result, such laws must be evaluated under strict scrutiny, the most demanding level of constitutional review. Applying this framework, the Court indicated that the Colorado law at issue may ultimately be found unconstitutional if it cannot satisfy that high standard.  

3. What legal question was at the heart of the case?

The central legal question in Chiles v. Salazar was whether state restrictions on certain therapeutic practices should be understood as regulation of professional conduct or as regulation of speech. Historically, states have exercised broad authority to regulate licensed professions in order to protect public health and safety. However, the Court drew a critical distinction in this case, emphasizing that when regulations specifically target what professionals say, particularly in the context of individualized conversations, they may cross the line into unconstitutional speech regulation.  

4. What is “strict scrutiny,” and why is it significant here?

Strict scrutiny is the highest level of judicial review applied to laws that burden fundamental constitutional rights, including freedom of speech. Under this standard, a law will be upheld only if the government can demonstrate that it serves a compelling state interest and is narrowly tailored to achieve that interest using the least restrictive means available. In Chiles v. Salazar, the Court determined that the Colorado law appeared to regulate speech based on viewpoint, which is particularly disfavored under First Amendment doctrine. This designation is significant because very few laws survive strict scrutiny in practice. By requiring this level of review, the Court substantially increases the burden on states seeking to defend similar laws and signals that regulations targeting therapeutic dialogue may face serious constitutional challenges going forward.  

5. Does this decision impact laws in other states that restrict licensed mental health professionals from engaging in conversion therapy? 

Although the specific decision was on the constitutionality of a Colorado law restricting licensed mental health professionals from engaging in conversion therapy, this decision would impact laws in other states banning conversion therapy for minors. Like the Colorado law, the laws in other states restricting licensed mental health professionals from providing conversion therapy for minors must also be evaluated under strict scrutiny.    

6. How does this affect licensed marriage and family therapists in practice? 

For licensed marriage and family therapists, the decision reinforces that their clinical speech is entitled to constitutional protection, particularly even when it involves “talk therapy” with clients. However, this does not mean that therapists are free from regulation. Licensing boards, malpractice standards, and professional oversight mechanisms remain fully in effect. Therapists must continue to operate within the bounds of their training, competence, and ethical obligations.  

7. How might states respond to this decision?

In response to the ruling, states may seek to revise their laws to better withstand constitutional scrutiny. This could include shifting the focus from regulating speech to regulating conduct, crafting more narrowly tailored statutes, or adopting viewpoint-neutral approaches. Some states may also strengthen informed consent requirements, impose malpractice liability for causing harm or injury to clients, or rely more heavily on professional licensing boards to enforce standards of care. The decision is likely to generate ongoing legal and legislative activity as policymakers attempt to balance free speech protections with health objectives.  

8. What is AAMFT’s position on the decision?

AAMFT strongly opposes the decision by the Supreme Court regarding state restrictions on conversion therapy for minors.  

The scientific and clinical consensus is clear and longstanding from the medical and mental health communities: efforts to change a person’s sexual orientation or gender identity are not supported by clinical evidence and may cause significant harm, particularly for children and adolescents.  

AAMFT joined an amicus brief with 13 other organizations in this case to underscore the importance of protecting clients from practices that are not evidence-based and that pose potential risks to their well-being. This decision raises important questions about how states can ensure client safety and well­being when professional services are delivered through speech.  

Chris Michaels, AAMFT CEO, states: “AAMFT stands firmly with the LGBTQIA+ community. We affirm the dignity, worth, and lived experiences of LGBTQIA+ individuals and families, and we recognize the real and lasting harm caused by practices that seek to invalidate or change who they are. We remain committed to supporting affirming care, advancing inclusive practices, and ensuring that all individuals have access to safe, competent, and respectful therapeutic support. AAMFT will continue to advocate for safe, affirming, and clinically sound therapeutic practices, and for policies that protect vulnerable populations while supporting the integrity of the profession.”  

AAMFT remains committed to supporting its members and advancing policies and practices that uphold ethical, evidence-based care and protect the well-being of all individuals and families. 

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Unsure of how to navigate this new legal development? Join our webinar May 13th, as we discuss the ethical and legal effects of the decision to the profession.

Please contact AAMFT at ethics@aamft.org if you have any questions.