During a hearing this week, the court’s theocrats made it clear that they’ll vote to end a ban on conversion therapy for minors.
A man stands outside the US Supreme Court as the court hears oral arguments in Chiles v. Salazar on October 7, 2025.(Andrew Caballero-Reynolds / AFP via Getty Images)
On Tuesday, the Supreme Court heard oral arguments in Chiles v. Salazar, a case about the legality of “conversion therapy.” As ever with this Supreme Court, the forces of bigotry disguised as Christianity held a 6–3 advantage over law and science. The six Republicans on the court are likely to endorse this form of child abuse as an extension of “free speech.” The only open question is whether they go full RFK Jr. in their war against medical expertise.
Conservatives and Republicans would like you to think of this case as a free speech issue. In 2019, Colorado became one of the more than 20 states to ban the practice of conversion therapy by licensed medical professionals seeing patients under the age of 18. Kaley Chiles, a licensed counsellor who for some reason thinks MAGA Jesus wants her to torture LGBTQ children, objected. The Alliance Defending Freedom—a conservative law firm that has made it its mission to legalize bigotry in the name of religious freedom—took up her case, arguing that Colorado violated Chiles’s First Amendment rights to free speech and free exercise of her religion.
If you stop the inquiry there, Chiles has the contours of a compelling case. Therapists talk to people, and we for sure don’t want the government telling therapists what they can or cannot talk about. Right? It would be awful if a professional therapist were barred from talking about available medical treatments, or if a state placed, I don’t know, a “bounty” on the head of a professional who helped a patient receive medical treatment in a state willing to provide it. Right?
Chiles has what looks like a good case—if you skip over the part that the bigots would have you overlook: She is licensed by the state of Colorado. The conversion therapy ban does not apply to, say, priests. It does not apply to parents. It does not apply to any random individual who wants to strap on a sandwich board and preach the gospel of bigotry. It applies only to people who have received a professional license from Colorado and have thus been given the imprimatur of authority and expertise by the state government. Colorado bans conversion therapy from being discussed by this subset of people, and no one else.
Indeed, the entire point of a state licensing board is to separate out quacks like Chiles from the broader consensus of the medical community. It’s to distinguish people selling snake oil and fertility candles and anal rosary beads from science. Getting a state license means you agree to provide medically sound services, and conversation therapy is not regarded as a medically sound practice by any panel of scientific experts.
Unfortunately, the six Republicans in robes who rule this country consider themselves to be the experts in literally everything. At oral arguments, a couple of justices with absolutely no medical training declared themselves in a better position to judge the efficacy of medical treatments than the entire medical community.
To raise themselves above the consensus of the medical community, Justices Sam Alito and Neil Gorsuch took the most obvious route: They attacked the actual experts. Alito declared the medical experts “politicized” and likened the current ban on conversion therapy to the medical community’s previous embrace of eugenics. He directly referenced Buck v. Bell, a famous case from the 1920s in which the Supreme Court endorsed forced sterilization of institutionalized, “feeble-minded” women on the theory that they were too stupid to be allowed to have children.
Buck v. Bell is widely (and correctly) regarded as one of the worst decisions in the history of the Supreme Court, but it is completely irrelevant to the issue with conversion therapy. Buck v. Bell concerned the involuntary mutilation of women completely under state control (it also took away women’s reproductive freedom, which men throughout history have been interested in doing). The medical “experts” who believed in eugenics and endorsed these sterilizations could not have done it without accessing the monopoly of force enjoyed by the state. It’s one thing for experts to incorrectly assert that “all apples are red.” It’s quite a different thing for the state government, at the experts’ behest, to gouge out the eyes of people who contend they’ve seen a green apple, and for the Supreme Court to agree.
Neil Gorsuch, who at this point is a walking Dunning-Kruger effect with a lifetime appointment, noted that, in the past, homosexuality was considered a disorder by the medical community. He asked, “Can we really trust healthcare professionals?” The question reminded me of Jack Nicholson’s Joker line from the first Batman movie: “Hubba, hubba, hubba, money, money, money, who do you trust? Me? I’m giving away free money. And where is the Batman? He’s at home, washing his tights.” Sure, Neil, sometimes the medical experts are wrong, but that doesn’t mean we should trust your clownish ass to make all of our medical decisions.
But the deeper problem with Gorsuch’s question is that nobody is asking him, or us, to “trust” medical experts. Trust ain’t got nothing to do with it. MAGA and their justices always want to make culture war fights personal, as if every issue can be boiled down to some deeply myopic intuition about how we should live our lives. But that’s not true. Nobody is asking the court to rule on whether “trust me, bro” is sound medical advice.
The question, the only legal question, is whether the state of Colorado can determine its own standards for people licensed to practice medicine. If Colorado cannot rely on the medical consensus of experts, then who the hell is it supposed to rely on to make these scientific decisions? Neil Gorsuch? Jesus Christ? Cheech and Chong? Alito and Gorsuch are trying to supplant the considered decisions of medical experts with their own, and that is lunacy. That’s how you get people going to church to fight the plague, instead of exterminating the rats.
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In any event, arguments like mine fell on deaf ears at the Christo-fascist court, as there were at least five votes to rule the Colorado ban on conversion therapy unconstitutional. (Alleged attempted rapist Brett Kavanaugh kept his mouth shut during oral arguments—it was the first day back after summer vacation, so maybe he was still recovering—but he can probably be counted on to provide a sixth vote for child abuse.)
Still, how they rule against this law could be a little tricky. That’s because a ruling that says medical professionals cannot be barred from suggesting and practicing treatments under their First Amendment right to free speech means… abortion counseling is back on the table. It means bounty hunter laws prohibiting people from “aiding” in the procurement of abortion services are back off the table. If doctors have a right to say anything they want, and cannot be brought under state control, then, at the very least, “gag rules” can no longer apply, even to doctors working with government funding in foreign countries.
Don’t get me wrong, trapping the Republican justices in their own logical pretzels doesn’t actually work, because Republican justices are more than comfortable living with their own hypocrisy. They have no problem making one set of rules for policies they like while offering a directly contradictory set of rules for policies they don’t like. They like conversion therapy, they don’t like abortion, and they will rule accordingly. But if they can avoid flatly hypocritical rulings, they’ll try. That means they’re likely to strike down conversion therapy as narrowly as possible, just so they don’t have to deal with a bunch of lower courts’ taking advantage of a gap in the abortion bans the Supreme Court has invited.
At oral arguments, Justice Elena Kagan seemed to give her Republican colleagues a way out. She sounded amenable to sending the case back down to Colorado to review under the Supreme Court’s made-up standard of “strict scrutiny.” That would essentially allow the courts to strike down the conversion therapy ban as too broad. Or perhaps Colorado and other states would amend their bans to say, I don’t know, that licensed professionals can “talk” about conversion therapy and suggest seeking help from a member of the clergy, but couldn’t “practice” it in some way or another.
It’s a bit of a dodge, and doesn’t address the fundamental problem of this court supplanting medical consensus with their own, uneducated opinions. But a 7–2 ruling punting this case back to Colorado is probably better than a 6–3 ruling written by Sam Alito that he reads while on Tucker Carlson’s show tanning his testicles.
What this case shows is that the Republicans on the Supreme Court are as much at war with “facts,” “science,” and “experts” as any MAGA yokel watching TikTok doctors and doing “their own research.” The difference between these Republicans and those refusing vaccines and taking Ivermectin is not education or enlightenment; it’s just that the Supreme Court justices have really good health insurance and can get a same-day appointment with the best doctor of their choice every time they get the sniffles.
When they feel unwell, no one sends them to Kaley Chiles to pray it away. That is a torture the court reserves for the rest of us, the people the court doesn’t care about, whose health and sanity is just a bargaining chip in their ongoing culture war. People will be harmed by the Supreme Court’s ruling in this case, but that is a sacrifice this Supreme Court is willing to make.
Elie MystalTwitterElie Mystal is The Nation’s justice correspondent and a columnist. He is also an Alfred Knobler Fellow at the Type Media Center. He is the author of two books: the New York Times bestseller Allow Me to Retort: A Black Guy’s Guide to the Constitution and Bad Law: Ten Popular Laws That Are Ruining America, both published by The New Press. You can subscribe to his Nation newsletter “Elie v. U.S.” here.