Daniel Fusch
Image Credit: Pexels // cottonbro studio
As the U.S. Supreme Court prepares to rule on a landmark case that could reshape protections for minors across the country, a troubling trend has emerged: conversion therapy is being rebranded under new names like “exploratory therapy,” even as research continues to document its harms.
The case, Chiles v. Salazar, centers on a Colorado law that prohibits licensed mental health professionals from subjecting minors to practices that attempt to change their sexual orientation or gender identity. Twenty-three states currently have similar protections in place, covering nearly half of all young people in the United States.
But the legal challenge comes at a moment when conversion therapy practices are evolving, making it harder for families to recognize when a child might be at risk.
The Rise of “Exploratory Therapy”
In May 2025, the Department of Health and Human Services released a controversial report recommending what it called “exploratory therapy” for young people experiencing questions about their gender identity. The report’s authors insisted this approach differed from conversion therapy, arguing that therapists were simply “trying to help children and adolescents come to terms with their bodies.”
Medical experts and advocates immediately pushed back. The practice described in the HHS report is conversion therapy by another name, according to Casey Pick, director of law and policy at The Trevor Project.
“Despite the report’s claims, this is the same harmful practice of conversion therapy, just using friendlier language,” Pick stated in response to the HHS report.
Research published in Healthcare Dive noted that Arjee Restar, a social and legal epidemiologist at Yale University, found the report’s framing troubling. “The report’s framing of psychotherapy as an alternative to medical affirmation, especially in a way that delays or discourages access to competent gender-affirming care providers, echoes the same ideology and pathologizing practices that underpinned past conversion therapy practices,” Restar explained.
The rebranding represents a shift in tactics for practitioners who face growing legal restrictions. According to a 2023 report from The Trevor Project, more than 1,300 active conversion therapy practitioners operate across the United States, with 600 holding active professional licenses and 700 working in official religious capacities.
The report noted that conversion therapy is “increasingly underground and conducted in secret with many practitioners not publicly advertising their services,” making it difficult for families to know what they’re getting into.
What the Research Shows
Despite claims that newer approaches differ from discredited methods, the research on conversion therapy’s effects remains consistent and clear.
A comprehensive study from San Francisco State University’s Family Acceptance Project found that young adults who experienced attempts to change their sexual orientation or gender identity during their teenage years showed dramatically higher rates of mental health struggles. Those who were subjected to conversion efforts by parents, therapists, or religious leaders were more than twice as likely to attempt suicide (48% compared to 22% among peers who didn’t experience such interventions).
The long-term effects extended beyond mental health. The same research documented lower educational attainment, reduced income levels, and diminished self-esteem and life satisfaction persisting into adulthood.
Research published in 2023 using data from the U.S. Transgender Survey found that exposure to conversion therapy increased the likelihood a young person would attempt suicide by 55% and more than doubled the risk of running away from home.
Every major medical and mental health organization in the United States has condemned conversion therapy. The American Psychological Association, American Medical Association, and American Psychiatric Association all maintain that these practices are ineffective and harmful, regardless of what they’re called.
The Hidden Cost to Families
Beyond documented health risks, conversion therapy creates financial and relational burdens that can devastate families for years.
A 2022 study published in JAMA Pediatrics estimated the total annual cost of conversion efforts targeting minors at $650 million, with associated harms (including increased substance abuse, suicide attempts, and other mental health interventions) totaling an economic burden of $9.23 billion.
For individual families, the costs accumulate through fees for programs, therapy sessions, and religious counseling, often reaching thousands of dollars. But the emotional toll may prove even steeper.
According to research and family testimonies collected by Conversion Truth for Families, many practitioners employ techniques that blame parents for a child’s identity, creating rifts that can take years or decades to repair. Some families report that conversion therapy drove their children away rather than bringing them closer, with young adults later describing feelings of betrayal and mistrust toward the parents who sent them to these programs.
“Conversion therapy isolates and harms kids, it scapegoats parents, and it really does divide families through blame and rejection,” Pick noted in an October 2025 interview with CNN.
The Supreme Court Case and What’s at Stake
The Supreme Court heard oral arguments in Chiles v. Salazar in October 2025, with a decision expected before the end of June 2026. Early reporting from the arguments suggested several justices appeared skeptical of Colorado’s law, raising concerns among advocates that key protections could be rolled back.
The case centers on whether states can regulate what happens in therapy sessions between licensed professionals and minor patients, or whether such regulations violate the First Amendment’s protection of speech.
Kaley Chiles, the licensed counselor challenging Colorado’s law, argues that her “faith-informed counseling” would be “speech only” and that clients would voluntarily seek her services. She rejects the term “conversion therapy” and describes her intended work as helping clients who “have a goal to become comfortable and at peace” with their body.
Colorado and other states defending similar laws argue that therapy is more than speech. It’s professional conduct that states have traditionally regulated to protect vulnerable populations, particularly minors, from harm. Twenty state attorneys general filed briefs supporting Colorado’s position, emphasizing that conversion therapy fails to meet acceptable standards of professional medical practice and puts young people at risk.
According to legal analysis, if the Supreme Court strikes down Colorado’s law, it could undermine the ability of states to regulate professional conduct more broadly, potentially affecting licensing standards for other medical and mental health practices.
Bipartisan Support for Protections
Despite the politically charged nature of current debates around gender and identity, protections against conversion therapy have historically drawn bipartisan support.
A report from the Movement Advancement Project documented that in the 23 states with conversion therapy bans, every bill passed with Republican support. Republican lawmakers have co-sponsored, voted for, or signed such legislation over 1,000 times since 2012. One-third of existing state protections were signed into law by Republican governors.
Public opinion has remained consistently opposed to the practice. Both a 2025 Data for Progress poll and a 2019 Reuters-Ipsos poll found that 56% of U.S. adults believe conversion therapy should be illegal when used on minors.
Recognizing the Warning Signs
As conversion therapy goes underground and adopts new terminology, families need to know what questions to ask when seeking help for a child navigating questions about identity.
Red flags include:
- Therapists who begin with the premise that a child’s identity is wrong or needs to be changed
- Programs that promise to make a young person “comfortable” with the sex they were assigned at birth
- Counselors who suggest that parents are to blame for a child’s identity
- Services described as “exploratory” that discourage or delay other forms of care
- Practitioners who work primarily in religious settings without proper licensing
Ethical, evidence-based therapy helps young people understand themselves and develop healthy coping strategies. It does not start with predetermined outcomes or attempt to suppress core aspects of identity.
Moving Forward
As the Supreme Court deliberates, families across the country face decisions about how to support children who may be questioning their identity. The stakes are high: research consistently shows that family acceptance protects young people’s mental health and wellbeing, while rejection, whether through conversion therapy or other means, increases risk.
The Family Acceptance Project’s research demonstrates that when families accept their children as they are, those young people show better mental health outcomes, stronger family relationships, and greater success as they grow into adulthood.
The debate over conversion therapy bans will ultimately be decided by the courts. But the question each family must answer remains personal: what kind of support will help a child thrive, and what approaches risk causing lasting harm?
For more information about conversion therapy and its effects on families, visit Conversion Truth for Families or consult with licensed mental health professionals who practice affirming, evidence-based care.