By Adrian Shanker
Los Angeles Blade
October 16th, 2025
Debunked practice causes significant damage to youth
The Supreme Court recently heard oral arguments in Chiles v Salazar, regarding Colorado’s ban on conversion therapy practices. Media reports suggest that the conservative Supreme Court majority is inclined to strike down Colorado’s law. This would have a profound impact on 27 states, D.C., and Puerto Rico, as well as numerous municipalities, that have taken action to protect youth from this pseudo-science quackery. Many of these laws passed with significant bipartisan support.
First, we should never predict how the court will rule, comments during oral arguments are not equal to the final opinion released by the court many months later. But we should challenge the premise of one issue that came up in oral arguments, about the evidence of the harm of conversion therapy. The New York Times reported on Justice Barrett’s question on if conversion therapy truly causes harm. I’m not sure that the evidence could be clearer or the medical consensus stronger. But Justice Alito questioned if the medical consensus was ideological. There is also a scientific consensus on gravity, and, for that matter, the efficacy of vaccines. But the attempt to disregard scientific evidence because some people disagree with it doesn’t make it less scientific. And yes, there have been times when the scientific consensus was ideologically driven, the eugenics movement comes to mind — and frankly the scientifically driven attempts at conversion therapy for more than a century. The scientific consensus today is based on the clear and unquestionable evidence of harm that results from past harms.
I led policy work at the U.S. Department of Health and Human Services in the Biden administration to safeguard youth from the harms of conversion therapy. The work we did in the Biden administration on this issue was significant. We prevented conversion therapy practices from being forced on youth in the foster care system and in runaway and homeless youth shelters across our nation. SAMSHA, the HHS division that addresses mental health and substance use, published a groundbreaking report outlining the mountain of evidence about how conversion therapy doesn’t work, and causes significant harm to youth. And on the global stage, HHS, State Department, Treasury, and USAID collaborated on a global plan to protect youth from conversion therapy practices around the world.
Conversion therapy is proven to increase depression, self-harm, and suicidal ideation. In reality, it is nothing more than junk science. This is presented as a case about free speech, but it’s not. It’s a case about medical ethics. Can a licensed healthcare professional provide a discredited modality of treatment to minor patients, even when we know it doesn’t work and causes immense harm? Conversion therapy is wrong no matter how you slice it, and regardless of what the Supreme Court concludes sometime next year.
Free speech is a central tenet of American democracy, and one that we should always strive to uphold. For a number of years I served on the board of directors of the Pennsylvania affiliate of the ACLU – I believe in free speech and am wary of attempts to undermine it. Conversion therapy is not free speech. Perpetuating medical harm is not free speech. Healthcare providers are welcome to hold and share opinions in the public square, that is free speech. They can write op-eds, attend rallies, and present their views on social media. They have free speech. But when they share information in a clinical environment to their patients, there is an expectation that they share evidence-based information. This is basic medical ethics. This is “do no harm.”
Conversion therapy has taken many forms over the decades. Beginning in the 1800s as a response to efforts in Europe to shift away from criminalized homosexuality to a so-called cure, conversion therapy at times has appeared as chemical castration, frontal lobotomies, electro-shock therapy, “ex-gay” camps, and today it appears as a form of “Christian counseling.” Not all Christian counseling is conversion therapy, and there are a significant number of Christian denominations that have official stances against conversion therapy, joining every major medical and public health organization in discrediting conversion therapy.
This case comes down to a simple question: can patients trust that the information their healthcare providers share with them is safe and grounded in evidence. My firm hope is that the Supreme Court agrees that the only fair-minded answer is “of course.”
Adrian Shanker is Senior Fellow at the Lehigh University College of Health. He served as Deputy Assistant Secretary for Health Policy at the U.S. Department of Health and Human Services in the Biden-Harris administration.
