| Carol Norris, MFT : Psychotherapy for the body, mind, brain and spirit |
Conversion "therapy" in any form is an abomination
On March 31, 2026, the Supreme Court ruled to overturn Colorado’s ban on so-called conversion “therapy” on minors. (Chiles v. Salazar, Docket No. 24-539)
I’ll begin by briefly explaining conversion “therapy” for those who might not know. Conversion “therapy” is an alleged treatment that attempts to change a person’s sexual orientation, gender identity, and any and all expressions of those, that don’t conform to rigid cishetero norms. But it’s not therapy, of course, which is why I will forever put that word in quotation marks. It’s attempted indoctrination. It’s bigotry impersonating help. It’s oppression masquerading as liberation. It’s a handmaid of privileged, cishetero, male supremacy.
I won’t go into the legal weeds, mostly because I’m not an attorney, but in this case SCOTUS seems to be making a distinction between the “physical interventions” of conversion “therapy” and talk therapy. SCOTUS isn’t okay with the physical interventions, but says the ban on talk therapy is censorship based on “verbal viewpoint,” and thus limits a mental health professional’s 1st Amendment rights. So, the premises of this decision, as far as I can tell, are that mental health professionals should be able to say whatever we want to in therapy because of the 1st Amendment, and that talk therapy in this context isn’t conversion therapy. Both, in my opinion, are absolute horse shit. (Even if I’ve missed a legal nuance, the following stands.)
I’ve had the privilege of doing therapy with quite a few people who’ve gone through conversion “therapy” as both kids and adults. And I have quite a few friends who’ve gone through the same. It was all “just” talk therapy. Nothing physical. But if you were to ask me the most damaging thing I could do in therapy it would be to try to convince someone that they’re not okay being who they inherently are. And that’s precisely what conversion talk “therapy” does. You can never engage in any physical interventions and name your private practice/clinic, “This Is Totally Not Conversion Therapy, I Pinky Swear,” but if you’re trying to talk someone out of being LGBTQ+ for whatever reason (as if!), you’re doing conversion therapy. Full stop.
I’ve heard the horror stories. The agonizing shame and self-hatred and disorientation created by the attempted brainwashing can’t be overstated. It’s profound. And it can take many years to undo the extreme damage not only to one’s very sense of self, but the damage caused by the tremendous betrayal of friends and family, the therapist, and some mental health, medical and religious communities.
I believe that anyone who may be troubled by their sexual orientation or gender identity is almost always troubled because they’re navigating the internalized shame projected onto them, or the interpersonal strife caused by, these bigoted people and institutions.
As to the supposed 1st Amendment violation: It seems Kaley Chiles, the counselor who brought the case, claims she’s unable to talk to her minor clients about gender dysphoria issues for fear it’ll be misconstrued as conversion “therapy.” And as a result, she says she can’t provide a full-throated therapy that aligns with her religious convictions, violating her 1st Amendment rights. And, as mentioned previously, except for stalwart Justice Ketanji Brown Jackson, SCOTUS has agreed.
I was a supervisor for grad students studying to be psychotherapists for over a decade. Maybe Chiles needs more training to feel more skilled in working within the legal and ethical boundaries all licensed counselors and psychotherapists and mental health professionals have to, and realize those boundaries do not oppress the clinician and their 1st Amendment rights, even when talking about gender and sexual orientation issues, but rather protect the patient.
And secondly, maybe Chiles, in fact, thinks she holds some higher truth since she sees her role to help people be more “in line with who God created them to be,” as she said in part of her statement. If so, maybe she needs to be a minister in a church that espouses her beliefs, and not a mental health professional. No snark. I mean this sincerely.
Something neither Chiles nor SCOTUS seem to understand is that it’s the job of mental health professionals to follow a patient’s lead, helping them uncover the truth within themselves without inserting our biases, even when we have them, and we all do. It’s our job to put those aside and focus on the patient. If after reflection, our own therapy and/or consultation, we can’t, it’s our ethical responsibility to refer out.
That’s Psychotherapy Ethics 101, not a 1st Amendment violation.
When the patient uncovers their truth, we then honor and support and celebrate whatever that truth is. That places the knowing and expertise about gender identity or sexual orientation (in this case) squarely where it belongs: within the mind and body of the person reflecting on it. Mental health professionals have expertise, for sure, but we’re not the omniscient holder of anyone’s truth. We only hold our own. You can have fervent religious beliefs and also navigate this easily and skillfully. So, this isn’t an invective about religion. But if as a mental health professional you think you hold a truth about someone else that they don’t inherently hold at their core when all the socialization and difficult life experiences and trauma and survival strategies are worked through, and your job is to help convert someone to something, methinks you’re in the wrong profession.
That SCOTUS took the case in the first place was extremely disturbing to so many of us. That it decided in favor of Kaley Chiles is devastating and deeply cruel, and flies in the face of countless studies that show conversion “therapy” – even “just” talk therapy - to be not only fruitless, but harmful. What Chiles and SCOTUS surely know, and perhaps hope, is that this decision could very well have a ripple effect, paving the way for the overturning of bans on conversion “therapy” in other states. It’s yet another bigoted blow that the LGBTQ+ community has had to endure time and time again.
Despite this abominable SCOTUS decision, psychotherapy won’t now become a conversion talk “therapy” free for all. Even with all of the serious issues the mental health profession admittedly has, the vast majority of counselors, psychotherapists, and mental health professionals will continue to follow norms and honor studies that recognize conversion “therapy” is cruel hogwash. This ruling won’t change that. We know we have patients to respect. Psyches to protect. We never forget what a privilege it is to work with the varied human experience that we learn so much from. We hold as a given that the beautiful range of gender identities, sexual orientations, and all the ways humans express them, are as natural as can be. No amount of conversion “therapy” will ever change that. And together we’ll stand strong with our LGBTQ+ patients (and friends and family and selves) in asserting that the only thing that needs to be converted is bigotry and oppression and the small-mindedness that creates them.
I’ll begin by briefly explaining conversion “therapy” for those who might not know. Conversion “therapy” is an alleged treatment that attempts to change a person’s sexual orientation, gender identity, and any and all expressions of those, that don’t conform to rigid cishetero norms. But it’s not therapy, of course, which is why I will forever put that word in quotation marks. It’s attempted indoctrination. It’s bigotry impersonating help. It’s oppression masquerading as liberation. It’s a handmaid of privileged, cishetero, male supremacy.
I won’t go into the legal weeds, mostly because I’m not an attorney, but in this case SCOTUS seems to be making a distinction between the “physical interventions” of conversion “therapy” and talk therapy. SCOTUS isn’t okay with the physical interventions, but says the ban on talk therapy is censorship based on “verbal viewpoint,” and thus limits a mental health professional’s 1st Amendment rights. So, the premises of this decision, as far as I can tell, are that mental health professionals should be able to say whatever we want to in therapy because of the 1st Amendment, and that talk therapy in this context isn’t conversion therapy. Both, in my opinion, are absolute horse shit. (Even if I’ve missed a legal nuance, the following stands.)
I’ve had the privilege of doing therapy with quite a few people who’ve gone through conversion “therapy” as both kids and adults. And I have quite a few friends who’ve gone through the same. It was all “just” talk therapy. Nothing physical. But if you were to ask me the most damaging thing I could do in therapy it would be to try to convince someone that they’re not okay being who they inherently are. And that’s precisely what conversion talk “therapy” does. You can never engage in any physical interventions and name your private practice/clinic, “This Is Totally Not Conversion Therapy, I Pinky Swear,” but if you’re trying to talk someone out of being LGBTQ+ for whatever reason (as if!), you’re doing conversion therapy. Full stop.
I’ve heard the horror stories. The agonizing shame and self-hatred and disorientation created by the attempted brainwashing can’t be overstated. It’s profound. And it can take many years to undo the extreme damage not only to one’s very sense of self, but the damage caused by the tremendous betrayal of friends and family, the therapist, and some mental health, medical and religious communities.
I believe that anyone who may be troubled by their sexual orientation or gender identity is almost always troubled because they’re navigating the internalized shame projected onto them, or the interpersonal strife caused by, these bigoted people and institutions.
As to the supposed 1st Amendment violation: It seems Kaley Chiles, the counselor who brought the case, claims she’s unable to talk to her minor clients about gender dysphoria issues for fear it’ll be misconstrued as conversion “therapy.” And as a result, she says she can’t provide a full-throated therapy that aligns with her religious convictions, violating her 1st Amendment rights. And, as mentioned previously, except for stalwart Justice Ketanji Brown Jackson, SCOTUS has agreed.
I was a supervisor for grad students studying to be psychotherapists for over a decade. Maybe Chiles needs more training to feel more skilled in working within the legal and ethical boundaries all licensed counselors and psychotherapists and mental health professionals have to, and realize those boundaries do not oppress the clinician and their 1st Amendment rights, even when talking about gender and sexual orientation issues, but rather protect the patient.
And secondly, maybe Chiles, in fact, thinks she holds some higher truth since she sees her role to help people be more “in line with who God created them to be,” as she said in part of her statement. If so, maybe she needs to be a minister in a church that espouses her beliefs, and not a mental health professional. No snark. I mean this sincerely.
Something neither Chiles nor SCOTUS seem to understand is that it’s the job of mental health professionals to follow a patient’s lead, helping them uncover the truth within themselves without inserting our biases, even when we have them, and we all do. It’s our job to put those aside and focus on the patient. If after reflection, our own therapy and/or consultation, we can’t, it’s our ethical responsibility to refer out.
That’s Psychotherapy Ethics 101, not a 1st Amendment violation.
When the patient uncovers their truth, we then honor and support and celebrate whatever that truth is. That places the knowing and expertise about gender identity or sexual orientation (in this case) squarely where it belongs: within the mind and body of the person reflecting on it. Mental health professionals have expertise, for sure, but we’re not the omniscient holder of anyone’s truth. We only hold our own. You can have fervent religious beliefs and also navigate this easily and skillfully. So, this isn’t an invective about religion. But if as a mental health professional you think you hold a truth about someone else that they don’t inherently hold at their core when all the socialization and difficult life experiences and trauma and survival strategies are worked through, and your job is to help convert someone to something, methinks you’re in the wrong profession.
That SCOTUS took the case in the first place was extremely disturbing to so many of us. That it decided in favor of Kaley Chiles is devastating and deeply cruel, and flies in the face of countless studies that show conversion “therapy” – even “just” talk therapy - to be not only fruitless, but harmful. What Chiles and SCOTUS surely know, and perhaps hope, is that this decision could very well have a ripple effect, paving the way for the overturning of bans on conversion “therapy” in other states. It’s yet another bigoted blow that the LGBTQ+ community has had to endure time and time again.
Despite this abominable SCOTUS decision, psychotherapy won’t now become a conversion talk “therapy” free for all. Even with all of the serious issues the mental health profession admittedly has, the vast majority of counselors, psychotherapists, and mental health professionals will continue to follow norms and honor studies that recognize conversion “therapy” is cruel hogwash. This ruling won’t change that. We know we have patients to respect. Psyches to protect. We never forget what a privilege it is to work with the varied human experience that we learn so much from. We hold as a given that the beautiful range of gender identities, sexual orientations, and all the ways humans express them, are as natural as can be. No amount of conversion “therapy” will ever change that. And together we’ll stand strong with our LGBTQ+ patients (and friends and family and selves) in asserting that the only thing that needs to be converted is bigotry and oppression and the small-mindedness that creates them.
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Copyright 2014 | Carol Norris, MFT
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