A conversion therapy ban is a state law that prohibits licensed mental health professionals from trying to change a minor’s sexual orientation or gender identity, and twenty-four states plus the District of Columbia have one on the books. What those laws can still enforce changed in March 2026, when the U.S. Supreme Court held 8-1 in Chiles v. Salazar that Colorado’s ban, as applied to talk therapy, regulates speech based on viewpoint and must survive strict First Amendment scrutiny.1Supreme Court of the United States. Chiles v Salazar, 607 US ___ (2026) Physical techniques, consumer fraud claims, and malpractice suits sit on firmer ground than the talk-therapy provisions do.
What These Laws Prohibit
State bans target any practice by a licensed professional intended to change a person’s sexual orientation or gender identity. Definitions focus on the goal of the intervention rather than the label a clinician puts on it, so renaming the same approach does not create compliance.
Two categories of practice have historically been covered. The first is aversion-based technique: pairing physical discomfort with same-sex attraction through electric shocks, nausea-inducing substances, or extreme temperature exposure. The second is talk-based reparative therapy, where a clinician treats a patient’s sexual orientation or gender identity as a disorder requiring correction, often using shame, stereotype reinforcement, or pressure to conform.
The bans do not stop a therapist from providing supportive counseling to a young person exploring their identity. A clinician can help a patient work through confusion or distress without steering them toward a predetermined outcome. The legal line falls where the therapist’s goal shifts from neutral exploration to actively trying to change who the patient is. That distinction matters more now, because Chiles casts doubt on states’ ability to police talk therapy while leaving physical, conduct-based interventions open to regulation on a different constitutional footing.
Who Is Covered
These laws apply to professionals who hold state-issued licenses to provide mental health services: psychologists, psychiatrists, licensed clinical social workers, and marriage and family therapists. Because licensing boards run enforcement, the bans function as professional conduct rules. Violate one and your license is what is at stake.2American Psychological Association. Can Licensed Practitioners Be Prohibited From Engaging in Conversion Therapy Efforts
Almost every state ban applies only when the patient is a minor under 18. Adults who seek conversion therapy from a willing licensed practitioner generally fall outside the scope of these laws, though some local ordinances have reached further.
Religious Counselors
Clergy and religious advisors who provide purely pastoral or spiritual counseling generally fall outside these bans. The Supreme Court noted in reviewing Colorado’s statute that the law “regulates licensed professionals only and does not extend to religious ministers or others who provide private counseling to young people.” A religious counselor who also holds a state clinical license and represents themselves as a licensed practitioner does not shed the professional rules because the counseling has a religious character.
Telehealth Across State Lines
In telehealth, the session legally takes place wherever the patient is physically sitting. A therapist licensed in a state without a ban who provides video sessions to a minor in a ban state is subject to that ban state’s law. Most states require out-of-state telehealth providers to hold a license in, or register with, the patient’s state, and registering means consenting to that state’s professional standards. Logging in from a different state does not work around a ban.
What the 2026 Supreme Court Ruling Changed
Federal courts had disagreed for years about whether conversion therapy bans violated the First Amendment. The Eleventh Circuit struck down local Florida bans in 2020 as content-based speech restrictions that could not survive strict scrutiny.3Justia Law. Otto v City of Boca Raton, No 19-10604 (11th Cir 2020) The Ninth and Tenth Circuits upheld similar bans as regulation of professional conduct. The Supreme Court took up the split in Chiles v. Salazar, brought by Kaley Chiles, a licensed Colorado counselor challenging the state’s 2019 law.
The 8-1 decision in March 2026 held that the ban, as applied to Chiles’s talk therapy, “regulates speech based on viewpoint” and that the lower courts had failed to apply sufficiently rigorous First Amendment scrutiny.1Supreme Court of the United States. Chiles v Salazar, 607 US ___ (2026) Justice Gorsuch wrote that “the 1st Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech in this country,” regardless of how essential a state considers its policy.
The ruling did not formally strike down every ban in the country, but any ban reaching talk therapy must now survive strict scrutiny, and very few speech regulations do. States are left with three practical paths: narrow their laws to physical aversion techniques and other non-speech conduct, defend existing statutes under strict scrutiny in future litigation, or accept that the talk-therapy provisions are effectively unenforceable. The Court left room for regulation of conduct-based interventions, which do not raise the same speech concerns.
What Penalties and Claims Still Work
Licensing boards keep authority to discipline practitioners for conduct that falls outside First Amendment protection. Physical aversion techniques, fraudulent billing, and treatment that causes documented harm through non-speech means remain subject to board action, with tools ranging from formal reprimand and mandatory supervision to temporary suspension and permanent revocation. Board findings go on a publicly searchable disciplinary record. Enforcement has been sparse in practice: no practitioner had been sanctioned under Colorado’s ban as of the time of the Supreme Court case, and other states’ bans have seen little activity either. Because these are licensing-board matters, the penalties are administrative rather than criminal.
Consumer Fraud Claims
A cleaner post-Chiles path targets the marketing of conversion therapy as effective treatment rather than what a therapist says in session. False commercial claims have never received full First Amendment protection. The landmark case is Ferguson v. JONAH, a 2015 New Jersey jury verdict finding that a conversion therapy provider violated the state consumer fraud act by claiming its services could change sexual orientation. The jury awarded $72,400 in compensatory damages, and the provider was permanently shut down.
Civil Malpractice Lawsuits
Former patients can also bring traditional malpractice claims, arguing that a therapist deviated from the accepted standard of care. Major professional organizations uniformly oppose conversion therapy, which supports the argument that performing it falls below professional norms. These claims generally require expert testimony that the treatment was inappropriate, evidence of harm, and proof that the treatment caused the harm. Statutes of limitations vary, generally running between two and seven years from the date of harm or its discovery.
Why Medical Organizations Oppose the Practice
The American Psychological Association passed resolutions in 2021 opposing sexual orientation and gender identity change efforts, concluding that these practices lack evidence of effectiveness and carry documented risks of harm.4American Psychological Association. The Evidence Against Conversion Therapy The American Medical Association, American Academy of Pediatrics, and American Psychiatric Association hold similar positions. A study of over 1,100 men found that those exposed to conversion therapy had roughly two to two-and-a-half times the odds of reporting multiple psychosocial conditions compared to those who were not exposed, with higher rates of depressive symptoms, internalized homophobia, and scores consistent with probable PTSD.5National Library of Medicine. Lifetime Exposure to Conversion Therapy and Psychosocial Health Outcomes The Chiles ruling addressed the constitutional question without reaching the scientific merits.
How to File a Complaint
Board complaints remain a live option, particularly for physical interventions or professional misconduct that stands independent of any conversion therapy statute. Start by identifying the provider and gathering documentation.
What to Gather
Collect the practitioner’s full legal name and license number. Most states maintain searchable online databases through the Department of Health or licensing board. Note the specific dates and locations of sessions where the prohibited conduct occurred, and write out an account of what the practitioner said and did. Treatment plans, session notes, invoices, and written communications with the provider strengthen a complaint. If others witnessed relevant interactions, note their names and contact information.
Where to Send It
Each state’s licensing board handles complaints against practitioners it licenses. Most boards accept complaints through an online portal along with digital copies of supporting documents. Certified mail also works and creates a delivery record. Some boards accept anonymous complaints, though giving your identity gives investigators more to work with. A licensing board complaint is not a police report, and law enforcement is generally not involved.
After submission, an intake team decides whether the allegations fall within the board’s jurisdiction. If the complaint moves forward, the board notifies the practitioner and an investigator collects evidence, which can include records, witness interviews, and expert consultation. Roughly 43 state medical boards use a preponderance of the evidence standard at hearings, while about 11 require the higher clear and convincing evidence threshold.6Federation of State Medical Boards. Standard of Proof Board-by-Board Overview Investigations can take many months, and boards communicate outcomes in writing once a final decision is reached.
The Federal Picture
There is no federal law banning conversion therapy. The Prohibition of Medicaid Funding for Conversion Therapy Act (H.R. 4244) was introduced in the 119th Congress and would bar the use of federal Medicaid dollars for these services.7Congress.gov. HR 4244 – 119th Congress: Prohibition of Medicaid Funding for Conversion Therapy Act Broader federal bans have been proposed in prior sessions. None have passed as of mid-2026, and Chiles makes the constitutional path for any federal talk-therapy ban substantially narrower. Consumer-fraud-based federal approaches, such as treating conversion therapy advertising as deceptive under Federal Trade Commission authority, would face fewer speech obstacles but have not advanced.
If you were harmed by conversion therapy, the strongest legal options depend on what happened, where it happened, and whether the practitioner held a license. Physical aversion techniques are the clearest target for both board complaints and civil suits. Talk therapy claims face new uncertainty after Chiles, but consumer fraud theories and traditional malpractice suits remain viable in many jurisdictions.