National Review Online
Thursday, October 09, 2025
Colorado is at
it again, trying to put the heavy hand of the law on one side of a roiling
social debate about sex and gender. This time, instead of coercing cake bakers and wedding website designers to celebrate
same-sex weddings against their own convictions, the once-proud Centennial
State is abusing its regulatory power over the licensing of counselors and
therapists as a lever to insist that if they counsel gender-confused minors,
they may only promote gender transition and homosexuality; they are not allowed
to speak against either.
That’s a
flagrant violation of the First Amendment. As Justice Clarence Thomas wrote for
the Court’s majority in 2018, such an approach “gives the States unfettered
power to reduce a group’s First Amendment rights by simply imposing a licensing
requirement.” In First Amendment terms, that’s called a prior restraint, and
it’s a big, red line. The Court’s 2018 decision in National Institute of
Family and Life Advocates v. Becerra (NIFLA) involved compelling
state-licensed crisis pregnancy centers to distribute pro-abortion speech. But
its rejection of the “professional-speech doctrine” applies just as well to Chiles
v. Salazar, the case challenging the Colorado law which was argued before
the Supreme Court on Tuesday.
Judging from
the oral argument, the justices are skeptical of Colorado’s blandishments that
it is just regulating medical practice and won’t launch a Javert-like pursuit
of therapists who try to work within a Christian framework on such matters. It
certainly isn’t helping Colorado’s case that it has been a recidivist
speech-policer in this area. The counselor challenging the law, Kaley Chiles,
is represented by the Alliance Defending Freedom, which previously bested
Colorado at the Court in the Masterpiece Cakeshop and 303 Creative
cases. Everyone knows the recent history.
Colorado’s law
forbids “any practice or treatment by a licensee, registrant, or certificate
holder that attempts or purports to change an individual’s sexual
orientation or gender identity, including efforts to change behaviors or
gender expressions or to eliminate or reduce sexual or romantic
attraction or feelings toward individuals of the same sex.” (Emphasis added.)
Counseling minors in the opposite direction is permitted. This is an aggressive
version of the laws against “gay conversion therapy” that exist in 25 states.
In a last-minute footnote, Colorado argued that it wasn’t going to enforce the
law, so Chiles didn’t have standing to sue over a threat to her rights. But
even Justice Sonia Sotomayor, who advanced the standing issue at the argument’s
opening, concluded after listening to how Colorado’s lawyer aimed to interpret
its law, “That settles the standing question.”
As in the 2018
NIFLA case, Chiles involves two clashing constitutional visions.
Chiles’s lawyers argue that states can regulate medical conduct such as
prescribing drugs and performing surgeries, as Tennessee did in United States v. Skrmetti, and
can regulate speech incidental to that conduct — but they must comply with the
strict-scrutiny standards of the First Amendment when they try to regulate
speech on its own. Colorado argues that states have always regulated medicine,
so even speech is easily regulated if it comes from licensed medical
professionals. Even Justice Elena Kagan had to interject that perhaps the Court
should consider how to evaluate the case “in normal free speech land rather
than in this kind of doctor land.”
Only Justice
Ketanji Brown Jackson seemed to warm to Colorado’s argument that whether to
apply the normal First Amendment strict-scrutiny standard or the relaxed
rational-basis review that is ordinarily accorded to state regulation of
medical treatments depends on how many studies the state can marshal to support
its position — although Colorado’s collection of studies was notably irrelevant
to the kind of therapy Chiles provides. We think the Court should recall that a
self-governing people had power to make laws long before they had peer-reviewed
medical studies — but they constitutionally restricted that power when
regulating speech. The strength of scientific evidence should matter only to
whether the state can meet its burden, not to what burden it must meet in the
first instance.
Both Justice
Samuel Alito, who remarked that Colorado was making “the argument that I
thought we rejected in NIFLA that professional speech is a special
category that’s outside normal First Amendment scrutiny,” and Justice Amy Coney
Barrett, who pressed Colorado on what the standard should be when the medical
community is divided and lacks a clear consensus, seemed to understand the
commonsense reality of medical speech in a divided society susceptible to
political pressures and prone to needing a few tries to get the scientific
facts straight. Colorado’s lawyer did not help matters by appearing unfamiliar
with the history Justice Alito cited of the Court’s upholding
forced-sterilization laws in 1927. Kagan emphasized that whatever rule the
Court chooses for laws that restrict therapist speech against gender
transitions and homosexuality must apply equally to laws that restrict such
speech in favor of those things. While that means granting falsehood as much
protection as truth, it at least gets the state out of mandating orthodoxy.
Chiles has run
away from defending gay conversion therapy in general, which in some instances
involved dubious treatments such as electroshock therapy rather than solely
speech. The Court is likely, prudently, to leave the full resolution of that
question for another day. But it should not hesitate to rule that the state
must provide a compelling justification and a narrowly tailored remedy before
it attempts to ban speech — especially speech that simply states the
plain truth.
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