Court Decision Leaves Room for State Action on Harmful Therapy

The Supreme Court’s ruling in the Chiles v. Salazar case does not grant special protection to conversion therapy, nor does it declare the practice safe or effective. Instead, the Court sent the matter back to lower courts, focusing on a narrow issue: Colorado’s law was too one‑sided in that it did not clarify whether licensed therapists could pressure a child about sexual orientation or gender identity. The Court held that the First Amendment stops the government from regulating professional speech solely based on its viewpoint. This leaves two main options for states. First, the Court made clear that physical tactics used in some conversion practices—such as electric shock, forced medication, or confinement—are distinct from speech and can be regulated. Second, states can strengthen malpractice laws for victims of conversion therapy. The Court noted that proving injury from a breach of duty can be difficult, so extending the statute of limitations would help those who realize harm years later.In Maryland, legislators have introduced bills to improve malpractice protections for conversion therapy victims. Although the measures did not pass before the 90‑day session ended, they will be reintroduced. The Court’s stance is that when a professional’s breach causes harm, malpractice law should offer relief. The debate is not about free speech or patient choice. Major medical and mental‑health organizations agree that attempts to change a person’s sexual orientation or gender identity are ineffective and harmful. Professionals who cause such harm should face the same accountability as any provider delivering discredited care. The First Amendment protects speech, but it does not shield clinicians from the consequences of harming patients. The Court’s decision clarifies this distinction and sets a path for Maryland to provide accountability and compensation to those who suffered from discredited practices.