Supreme Court weighs case on conversion therapy for youth

Reproduced from Movement Advancement Project; Map: Axios VisualsThe Supreme Court on Tuesday will debate how far states can go regulating mental health treatment when it takes up a case about conversion therapy — the discredited practice aimed at changing youths' sexual orientations or gender identities.Why it matters: The outcome will determine whether therapists' conversations with patients are regarded as medical treatment or as a form of speech protected by the First Amendment.It also will likely decide the fate of laws in almost half of the states that restrict the practice, which major medical associations and LGBTQ+ advocates condemn as harmful and unscientific.Zoom in: The case revolves around a 2019 Colorado law that banned conversion therapy aimed at kids.Supporters of the law say it was a response to a mental health crisis among Colorado teens and evidence that the practice has led to increased depression, anxiety and suicidal thoughts and attempts.A study from the Trevor Project found that young people who reported going through conversion therapy were more than twice as likely to have reported attempting suicide. Where it stands: The Alliance Defending Freedom, a conservative group, is representing Christian therapist Kaley Chiles, who contends the law is a de facto gag order that violates her First Amendment rights. The Trump administration is backing the challenge.Chiles' lawyers say the ban favors the expression of some views over others, by forbidding therapists from encouraging youths with gender dysphoria from realigning their identity with their birth sex but allowing support for a person transitioning from his or her birth sex.Colorado says the law is part of its broader regulation of licensed mental health professionals. It argues there's no therapeutic need or ability to change variations in gender identity, which are now recognized as "part of the normal spectrum of human diversity." Legal scholars say the case could settle First Amendment issues that have emerged with the expansion of occupational licensing in medicine and other fields.The case has already been argued at two appeals courts, which split on the question of whether talk therapy qualifies as speech connected to the licensed practice and therefore subject to regulation, or whether it's protected speech.Many mental health professionals and patient advocates say treating this as First Amendment speech could set a precedent under which any counseling is claimed to be free speech and no longer subject to professional standards, even if it's dangerous or inappropriate."Therapy is not casual conversation, it is evidence-based mental health treatment provided by licensed professionals who are trained and regulated to protect patient well-being," said Lynn Bufka, the American Psychological Association's head of practice. "State licensing laws require years of graduate education, supervised clinical experience and adherence to professional standards of care."Siding with Chiles "would also nullify countless state regulations that restrict attorney speech for the benefit of the public—and, in so doing, would interfere with the judicial process and ultimately erode faith in the legal profession," a group of legal ethics scholars wrote in a brief to the court. What they're saying: "Losing those protections against conversion therapy treatment would just in itself cause incalculable harm," said Shannon Minter, legal director of the National Center for LGBTQ Rights. Between the lines: The Supreme Court held earlier this year that states could ban transition-related medical care for transgender youths. The court decided that the bans within states' rights to regulate the practice of medicine, and that they were not discriminating on the basis of sex, as advocates for gender-affirming care argued. Minter sees a parallel between that case and the one being argued on Tuesday. "It would be so hypocritical for the court to say states can ban health care for transgender youth, but they can't restrict conversion therapy for young people," he said. "It would be very distressing and disturbing to see that blatant type of inconsistency."Context: The Supreme Court previously weighed in on whether states can regulate health providers' speech in 2018, when it struck down a California law that required anti-abortion "crisis pregnancy centers" to provide women with information about how to obtain the procedure.What we're watching: Whether the court's conservative justices appear receptive to arguments that the Colorado law is a restriction on protected speech, and that it prevents therapists from exploring patients' potential conflicts and family history.