A frenzy of amicus briefs filed this month in a controversial case set to be heard by the Supreme Court is diversifying the debate around what constitutes “conversion therapy,” especially as it applies to treating children with gender dysphoria.
At issue in Chiles v. Salazar is whether a Colorado law banning conversion therapy for pediatric patients unconstitutionally restricts a mental health counselor’s free speech rights, via viewpoint discrimination, when that therapist wants to counsel gender dysphoric children toward embracing their biological sex.
Of note is a filing from an otherwise progressive third-party observer submitted in support of the Supreme Court challenge to Colorado’s ban on so-called conversion therapy.
The Women’s Liberation Front (WoLF), a self-described “radical feminist” cohort whose membership is 40% lesbian and bisexual, raised concerns in the case about the impact of restrictive counseling laws, such as the one in Colorado, on gay youth. WoLF warns that such bans, which treat sexual orientation and gender identity as equally protected characteristics, will effectively “trans away the gay.” Many transgender-identifying minors ushered along a pathway to medical intervention end up realizing post-transition they were “just a gay kid,” the organization contended.
Our Duty-USA, which represents a group of de-transitioners who had adopted their transgender identities as minors and later on came out as gay, echoed sentiments in a separate submission to the Supreme Court. “Thus, by medicalizing gender-confused minors,” the pro-transgender lobby is “trans’ing the gay away,” Our Duty-USA said.
As the Washington Examiner‘s Hugo Gordon has pointed out, “gender-affirming care” is conversion therapy by another name coercing children to physically alter themselves into something they are not instead of growing up gay.
Conversion therapy has long been a boogeyman buzzword in LGBT circles, considered a catch-all phrase for invoking prior physical and psychological aversion tactics inflicted on gay people in efforts to pathologically change their sexuality.
In the defense’s Supreme Court brief, Colorado Attorney General Philip Weiser, a Democrat who is arguing on behalf of Patty Salazar, executive director of the state’s Department of Regulatory Agencies, and other industry oversight officials, cited past abusive practices, such as electroconvulsive shocks, nausea-inducing procedures, and arousal reconditioning, to describe the type of conversion therapy banned by the law.
However, the treatment in the case at hand consists solely of voluntary talk therapy.
According to the 280-page petition of plaintiff Kaley Chiles, a licensed counselor and practicing Christian who believes in living “consistently with God’s design,” she simply talks to clients suffering from gender dysphoria, and through therapeutic consensual conversation, they work together to alleviate their underlying feelings of bodily discomfort.
Chiles says she never sets out to “cure” clients of same-sex attraction or their transgender identity. Rather, often times, patients seek her out for help addressing these unwanted, intrusive thoughts, she says.
In a friend-of-the-court filing, the American College of Pediatricians (ACPeds), a national collective of 500 board-certified physicians specializing in pediatric medicine, notes that psychotherapy itself is a widely practiced discipline of relieving mental distress that may manifest as anxiety, depression, post-traumatic stress disorder, and other ailments.
To that end, ACPeds says psychotherapy is the best holistic, non-invasive method for treating gender dysphoria, mentioning that transgender youth frequently have pre-existing psychological conditions or co-morbidities that could be the root causes of their gender identity crises.
As referenced in the pediatric association’s legal briefing, a 2018 parental survey of minors experiencing rapid-onset gender dysphoria found that 62.5% of gender dysphoric adolescents were diagnosed with a preceding psychiatric disorder or neuro-developmental disability, while nearly half — 48.4% — previously endured a traumatic or stressful event.
Weighing in on the Supreme Court case as well, the Association of American Physicians and Surgeons (AAPS) said the science concerning psychotherapy’s efficacy remains largely unsettled, so the state should “respect freedom of speech to resolve this in the marketplace of ideas.” Unlike sex-change surgery, talk therapy is reversible and there is no compelling interest by Colorado to ban it, AAPS argued.
Other critics piling on say the Colorado law, as written, silences disfavored dialogue in therapy settings based on whether the discussions are aligned with state-approved messaging.
Enacted as a 2019 amendment to the Mental Health Practice Act, the Minor Conversion Therapy Law (MCTL), or H.B. 19-1129, broadly defines conversion therapy as any treatment “that attempts or purports to change an individual’s sexual orientation or gender identity.”
Therapists face the loss of their license and fines of up to $5,000 for violating MCTL.
On the contrary, the state statute permits practices that provide “assistance to a person undergoing gender transition” or “acceptance, support, and understanding for…identity exploration and development.”
In effect, the law encourages an affirmation-only approach while prohibiting any kind of dissuasive counter-efforts, including conversations, that question a child’s gender identity or advocates against transitioning.
The Alliance for Hippocratic Medicine jointly filed an argument saying this sort of censorship in the therapy industry violates First Amendment safeguards against government bias and muzzles medical professionals who are sworn to abide by an oath of ethics to do no harm. “[Therapists] must be free to fully advise all patients of the risks and dangers of gender transition…” the filing urged.
Several studies show that a majority of transgender youth naturally “desist,” i.e. resolve their gender-related confusion, over time as their sense of self evolves during these formative years.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), reported that 70% to 97.8% of boys and 50% to 88% of girls with gender dysphoria tend to desist by the time they reach adulthood. In 2021, a study on “the largest sample to date of boys clinic-referred for gender dysphoria” discovered an 87.8% desistance rate, and another 2008 peer-reviewed publication found between 80% and 95% of gender dysphoric pre-pubertal children will desist by the end of adolescence.
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Even the Endocrine Society, a proponent of affirming gender identity over biological sex, admitted in updated clinical practice guidelines that “the large majority (about 85%) of prepubertal children with a childhood diagnosis [of gender dysphoria] did not remain GD/gender incongruent in adolescence.”
Oral arguments in Chiles v. Salazar are slated for the fall term, with a Supreme Court decision expected next year.