On March 31, the US Supreme Court handed down its ruling in Chiles v. Salazar, a Colorado case centering on the practice of “conversion therapy” for minors.

The court ruled correctly, by eight votes to one, with only associate justice Ketanji Brown Jackson dissenting,  on the main issue in dispute: The free speech rights of Kaley Chiles.

Chiles is a “licensed professional counselor” who uses “talk therapy” to — in accordance with her belief in a version of Christian dogma —  assist non-heterosexual clients who want to become heterosexual (or maybe, if the client is a minor, whose parents want a heterosexual, rather than non-heterosexual, child).

BECAUSE Chiles engages only in “talk therapy” rather than, say, electroconvulsive therapy, drug therapy, aversion/punishment therapy, etc., she’s clearly engaged in conduct that’s protected by the First Amendment. The state of Colorado doesn’t get to decide what people believe or want and whether they’re allowed to talk about it with each other.

As it happens, I’m extremely skeptical of “conversion therapy.” So far as I can tell, sexual orientation isn’t something that can be consciously/intentionally altered using talk or any other kind of “therapy.”

Nor, for that matter, is it a “medical condition” at all. It doesn’t need to be “treated.” It’s just a characteristic (and perhaps an evolving, rather than static/permanent characteristic) that people discover in themselves.

But that doesn’t mean people shouldn’t be able to think or say otherwise, or to attempt to “convert” consenting others through speech.

Note the qualifier: “Consenting.”

When a news story mentioned that Jackson’s dissent brings up consent, I was hoping for a thoughtful analysis of what constitutes consent and whose consent should be required for “conversion therapy.”

Unfortunately, the “consent” hooks in Jackson’s opinion are just about “informed” consent — whether “conversion therapy” practitioners adequately warn “patients” of possible risks. And she seems to be fully on board with the idea that the state, rather than patients, should get to decide what constitutes “treatment” (for anything), who may provide that “treatment,” etc.

The question of “patient consent” versus “parental consent” doesn’t seem to show up at all in the justices’ opinions.

As both a legal matter and cultural norm, it’s understood that parents and guardians have broad authority to make medical decisions for children … but there are limits.

I suspect that most people (me included) would oppose a claimed right of parents to “consent” to, say, “sex reassignment” surgery, cosmetic breast implants/reductions, etc., “for” their minor child over that child’s opposition and stated non-consent.

If “conversion therapy” really is “therapy,” it should be held to the same consent standard.  Kaley Chiles should only be talking to “patients” who have consented for themselves, not “patients” whose parents force her on them.

If you disagree, let’s apply your disagreement to a flip-side analogous situation:

One day, Mom and Dad decide their little boy is “really” a girl and needs “gender-affirming” counseling. If the boy says “no, I’m a boy and happy that way,” do the parents have a right to force that “therapy” on him without his consent?

If you say “yes,” well, at least you’re consistent. But wrong.

And if something is only “therapy” when it agrees with your religous or social beliefs, it’s not “therapy,” it’s just attempted brainwashing … and the “patient” should be free to refuse it or walk out on it. Even if the “patient” is your child.

I’m glad SCOTUS got it right on the First Amendment implications of this particular case. I hope they eventually take a case that lets them reach, and correctly handle, the issue of minor vs. parental consent for medically unnecessary “therapies.”

Thomas L. Knapp (X: @thomaslknapp | Bluesky: @knappster.bsky.social | Mastodon: @knappster) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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