Imagine a 17-year-old who identifies as transgender is unsure that she wants to continue to be identified as such. She has a lot of questions about stopping her “gender-affirming” medical treatments. What if the first person she turns to for answers is you, her trusted primary care clinician? Or perhaps you work in pediatric psychiatry where you encounter kids that think they may have gender dysphoria? Do you practice in a state in which you could be fined, even have your license revoked if you give her advice and referrals for the purpose of helping someone feel more comfortable as his or her biological sex or in a heterosexual relationship if that is what they want? I do in Massachusetts, as does Kaley Chiles, a licensed professional counselor in Colorado.
Clinicians in 17 states are similarly threatened by laws banning “any practice by a health care provider that attempts or purports to impose change of an individual’s sexual orientation or gender identity including, but not limited to, efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex,” of someone under 18 years old, unless, of course, you are facilitating a change from one’s biological sex to a different chosen gender, or encouraging same-sex attraction.
Kaley has challenged the Colorado ban. She is represented by The Alliance Defending Freedom (ADF), an active and successful organization defending religious freedom, free speech, the sanctity of life, marriage and the family, and parental rights – the largest in the country – that has had 16 SCOTUS victories to date.
The U.S. Supreme Court has taken up Kaley’s case, Chiles v. Salazar. According to SCOTUSblog, Kaley claims these laws violate her First Amendment rights to free speech and free exercise of her Christian religion. Because she is a therapist, this does not give states a “freer hand to regulate speech”. The 10th Circuit disagreed because “Conversion Therapy” was harmful and the state was regulating her conduct, not her speech.
Kaley and ADF are asking for our prayers on Tuesday, October 7th, the day the Supreme Court will hear oral arguments in this case – the feast of Our Lady of the Rosary (aka Our Lady of Victory.)
The Long-Term Impact of These Laws
These laws came about starting in 2013 in response to media reports of individuals harmed by “conversion therapy,” known as reparative therapy by those who successfully treat patients. While predominantly therapy for those with same-sex attraction, the laws also specify “gender identity”. Reports have increasingly focused on the LGBT experience with it. In 2021, the UK’s Government Equalities Office (dedicated to issues relating to women, sexual orientation, and transgender equality) published a report and a qualitative study on the evidence regarding “conversion therapy” that it lacked “robust” evidence that it was effective, and was “associated with self-reported harms…for example, negative mental health effects like depression and feeling suicidal.” Thus, it must be banned, the narrative goes.
Meanwhile, the number of children and adolescents – especially females – with a gender-related diagnosis has skyrocketed, as has “gender-affirming” interventions like puberty blockers and disfiguring surgeries (see trends from SEGM and Reuters). Eventually, the UK commissioned Dr. Hilary Cass to head an independent review of the gender-related treatment evidence for children and adolescents. The Cass Report notes, “There are conflicting views about the clinical approach, with expectations of care at times being far from usual clinical practice. This has made some clinicians fearful of working with gender-questioning young people, despite their presentation being similar to many children and young people presenting to other NHS services.” As for the evidence, the report states:
- While a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.
- The strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate.
“Gender-affirming” medical interventions for minors has since been halted in the UK as a result of the investigation.
An article in Medium quoted at length from a statement by academics supportive of “gender-affirming” care after multiple reports demonstrating no evidence of efficacy were published. They said, “The high respect for autonomy becomes particularly important when the certainty of the evidence is low or very low.” Yet they likely support outlawing the autonomy of Kaley’s patients.
This also stands in stark contrast to detransitioners trying to tell their stories of the irreversible harm they have suffered from being rushed and pushed into treatment. In 2021, when 60 Minutes ran a segment on detransitioners, it received a severe backlash from LGBTQ+ advocates. Only now, in 2025, are more outlets are presenting these stories, like Reuters and the New York Times. Still, individuals are ignored, maligned, and blocked from colleges. See here and here, though the MIT Open Discourse Society invited the latter, and the school provided “event response ambassadors” for those upset by it).
I recently heard Ambassador Sam Brownback on the Humanize podcast. He is co-chair of the International Religious Freedom Summit and is a Senior Fellow at Global Christian Relief. He is also chairman of the National Committee for Religious Freedom, which he founded in 2021. He characterizes religious freedom as a “cornerstone human right” because “if you can get this one right in a country, you can build out your other rights,” like freedom of speech, assembly, and the press. “Get it wrong and the others start caving in.” That is what we are experiencing and what this case is pushing back against.
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