On Tuesday, October 7, 2025, the Supreme Court heard oral arguments in Chiles v. Salazar, a case in which the petitioner, a licensed mental health counselor, asked the Court to invalidate a Colorado law that prohibits licensed medical professionals from subjecting minors to “conversion therapy.” Aside from the Court seeming poised to hold that state laws banning conversion therapy in clinical settings violate the First Amendment, there is another notable take away: many of the justices questioned the quality of research that routinely informs established and widely accepted standards of care. It is especially noteworthy that the Court spent significant time questioning legitimate science and pushing for additional research given the federal government’s recent actions to gut vital research opportunities, including for LGBTQ+ issues at the heart of Chiles, and to adopt an Agency for Healthcare Research and Quality (AHRQ) strategic plan regarded as hostile to LGBTQ+ populations.
Despite being widely rejected by experts, “conversion therapy” is gaining traction.
“Conversion therapy” is any intervention that attempts to change an individual’s sexual orientation, sexual behavior, or gender identity. Twenty-seven states, the District of Columbia, and Puerto Rico have laws that either restrict or prohibit licensed professionals from subjecting minors to “conversion therapy.” Half of LGBTQ+ youth live in states with these protections. “Conversion therapy” has been widely discredited as ineffective and harmful, including by leading professional organizations like the American Academy of Child and Adolescent Psychiatry (AACAP), the American Medical Association (AMA), and the American Psychiatric Association (APA). Decades of research have demonstrated an association between “conversion therapy” and suicidal ideation and attempts and depression, leading the United Nations to call for the practice to be banned worldwide. Notwithstanding this call to action, “conversion therapy” persists in many corners of the United States. Proponents of the practice, including the petitioner in Chiles v. Salazar, have sought to discredit or dismiss the evidence against “conversion therapy.” As this blog post explores, our courts are not immune to the distrust of science. In Chiles, SCOTUS justices delegitimized established science and undermined the valuable role of evidence in policymaking.
While not essential to the issue on the merits, the justices debated the role of research.
In Chiles, a Christian woman who works as a licensed counselor argued that the Colorado law banning “conversion therapy” violates her First Amendment right to freedom of speech. According to Chiles, the law restricts her ability to engage in consensual conversations with patients who “want to reduce unwanted same-sex attraction, change unwanted same-sex behavior, and to resolve dysphoria[.]” Chiles only engages in “talk therapy,” as she does not prescribe medication or provide other medical treatment.
The justices wrestled with many questions: whether Ms. Chiles has standing; whether the law constituted viewpoint discrimination; whether “talk therapy” is medical treatment; whether “talk therapy” is speech or conduct; and what level of scrutiny should apply. Regardless of the level of review applied in this case, no level of review for laws regulating speech requires the government to demonstrate harm through studies. Regulations that implicate free speech must address a “real” harm, but the government is not required to present studies to demonstrate said harm. However, Chiles’s attorney suggested the opposite. Within the first two minutes of oral arguments, Chiles’s attorney asserted that the law should be invalided because “Colorado can't prove harm because it hasn't cited a study focusing on what's at issue here: voluntary speech between a licensed professional and a minor.”
Some justices challenged Chiles’s argument while others joined in questioning the science.
When Justice Sotomayor pressed Chiles’s attorney on this position, asking, “[Y]ou agree then that you don’t always need a study? An absolute statement like that misstates the law?” Chiles’s attorney defended the position. He stated that research demonstrating harm is necessary when the law at issue regulates "debated science”—suggesting that the research underlying “conversion therapy” restrictions is a “debated science.” Justice Jackson also pressed Chiles’s attorney, asking him how the Court should view the research Colorado cited about the harmful effects of “conversion therapy.” Chiles’s response discredited the research as “suffer[ing] from significant flaws” because the studies did not focus on or separate findings for the specific “voluntary conversations” Chiles allegedly seeks to have with minor patients.
The lawyer for the federal government also weighed in, arguing that the law could only survive the highest level of scrutiny (i.e., strict scrutiny) if Colorado showed that “talk therapy” caused “a direct harm to patients” and possesses “no countervailing benefit.” He later went on to tell Justice Sotomayor that Colorado could not cite “any studies that say that [‘voluntary’ ‘talk therapy’ with minors] is either harmful or ineffective”—a mischaracterization of the research relied on by the state. Never mind the years of reliable research establishing “conversion therapy” as harmful to minors, these arguments misstate the law and distort the role of science in evidence-based policymaking.
Seeming to agree with Chiles, Justices Gorsuch, Barrett, and Alito scrutinized the scientific logic of Colorado’s argument. Justice Gorsuch pressed the state’s attorney about whether a state could regulate the standard of care even when there is “medical uncertainty,” something that, as the justices (who are not researchers or practitioners) may or may not know, always exists to some degree. Justice Gorsuch’s remarks also imply that there is “medical uncertainty” as to whether “talk therapy” is harmful, which is not guided by the evidence. Justice Barrett, building off Justice Gorsuch’s questioning, conflated issues with “competing medical views” (i.e., medical professionals on each side of a medical or scientific debate with evidence-based arguments) with issues in which an overwhelming majority of researchers, professional organizations, and practitioners are in agreement, yet a small number of persons disagree. For example, Justice Barrett pushed Colorado’s attorney to answer whether a state should be given deference to ban a practice with “competing medical views,” such as the issue in Skrmetti v. United States, where some medical professionals believed gender-affirming care for minors to be beneficial and others believed it to be harmful. The justices' positions would give credence to the handful of dissenting professionals who seek to override overwhelming evidence and support from researchers, professional organizations, and practitioners.
If any level of “medical uncertainty” or “debated science” is enough to invalidate a policy that relies on sound research and vast medical and scientific consensus, then what use is research in policymaking? Uncertainty is inherent to science, and science is meant to be debated. Good science has its uncertainties and generates further questions. Research should not be discredited merely because a study’s results do not perfectly answer a complex, real-world legal question. Chiles’s argument and the Court's treatment of research sets policymakers up for failure while also undermining the valuable contributions of researchers to policy debates.
And this case was not heard in a vacuum; just as the lawyers and justices question robust research and vocalize a desire for better research, the administration has obstructed vital research opportunities. Agencies, such as AHRQ, the federal government's home for health services research, have been decimated under the current administration, bringing research opportunities nationwide to a screeching halt. This is especially true for research seeking to better understand issues particular to the LGBTQ+ community, such as those at issue in Chiles. The Court is right to desire a legislative process that is guided by sound and reliable research, but that requires research to be adequately funded, supported, and respected.