Exploring the Boundaries of Therapy and State Regulation: A Deep Dive into Colorado’s Conversion Therapy Ban

In a recent episode of The Unmentionables podcast, hosts Evan and Melissa tackle the complex and contentious issue of Colorado’s House Bill 19-1129, a law banning licensed mental health professionals from practicing “conversion therapy” on minors. This legislation, and the legal challenge it faces in Chiles v. Salazar, raises profound questions about the intersection of free speech, religious freedom, professional ethics, and state regulation. Below, we unpack the key themes from their discussion, explore the implications of the law, and consider the broader societal questions it raises.

What is House Bill 19-1129?

House Bill 19-1129, passed in 2019, prohibits licensed mental health professionals in Colorado—such as psychologists, social workers, and counselors—from engaging in conversion therapy with clients under 18. The law defines conversion therapy as any practice that “attempts or purports to change an individual’s sexual orientation or gender identity,” including efforts to alter behaviors, gender expressions, or same-sex attractions. Notably, the law explicitly excludes practices that provide “acceptance, support, and understanding” for identity exploration or facilitate gender transition, as long as the goal isn’t to change orientation or identity.

The case of Chiles v. Salazar centers on Kaylee Chiles, a licensed professional counselor who runs a faith-based practice. Chiles argues that the ban infringes on her free speech and free exercise of religion by restricting her ability to counsel clients in line with their faith-based goals. The state, however, frames the law as a regulation of professional conduct, not speech, aimed at protecting minors from harm. With oral arguments heard by the U.S. Supreme Court on October 7, 2025, the outcome could redefine the boundaries of professional speech for therapists, doctors, and even teachers.

Therapy as Speech: Where’s the Line?

The podcast discussion begins with a fundamental question: when a therapist helps a minor explore their identity, is that speech or treatment? If the state bans certain conversations, is it regulating professional conduct or policing thought? Melissa, a licensed clinical social worker, emphasizes the principle of “first, do no harm,” a cornerstone of her profession’s code of ethics. She argues that therapists should prioritize client autonomy, tailoring their approach to the client’s needs rather than imposing personal beliefs.

In a faith-based practice like Chiles’, clients often seek counseling that aligns with their religious values. For example, a teen might ask for help reconciling same-sex attractions with their faith, which could conflict with the law’s prohibition on efforts to “change” sexual orientation. Melissa distinguishes between exploration—guiding a client to understand their feelings—and direction, where a therapist pushes a client toward a predetermined outcome. The former respects autonomy; the latter risks harm, especially if it disregards the client’s goals.

The Religious Carve-Out: Fair or Inconsistent?

One of the most intriguing aspects of HB 19-1129 is its carve-out for clergy. Pastors and religious leaders can engage in conversations about sexual orientation or gender identity without restriction, as they fall outside the state’s licensing system. Licensed faith-based counselors, however, are held to stricter standards, creating a tension between professional regulation and religious freedom.

Melissa points out that many faith-based counseling agencies operate without taking insurance and employ unlicensed practitioners, which allows them to sidestep state oversight. This raises a critical question: does the law push sensitive identity discussions into less regulated spaces, potentially increasing the risk of harm? For instance, unlicensed counselors might impose their values without accountability, as there’s no licensing board to report misconduct. Conversely, licensed professionals like Chiles face disciplinary action for conversations that align with a client’s faith-based goals, which she argues violates her constitutional rights.

The Science and Ethics of Age Limits

The podcast also grapples with the law’s focus on minors, questioning why 18 is the cutoff for conversion therapy bans. Evan and Melissa explore the “follow the science” argument, noting that the prefrontal cortex, responsible for decision-making, continues developing into the mid-20s. If minors lack the capacity for certain decisions, why allow gender-affirming care for those under 18 while banning conversion therapy? Melissa argues that if the state’s goal is to protect developing brains, the logic should apply consistently across interventions.

This inconsistency highlights a broader issue: can the state separate medical harm from moral disagreement? The law assumes conversion therapy is inherently harmful, citing decades of consensus from major mental health organizations. However, the definition of “harm” remains slippery. Is it harmful to explore a client’s faith-based goals, even if they request it? What if a teen seeks affirmation of their gender identity but faces family conflict? Melissa stresses that therapy should neither affirm nor negate a client’s beliefs automatically—it should explore options and consequences, letting the client chart their path.

Harmful Speech vs. Radical Candor

A particularly thorny question is what constitutes “harmful speech” in therapy. Evan references Dr. Laura Schlessinger, known for her blunt, no-nonsense approach. While her style can feel harsh, Melissa argues it’s not inherently harmful unless it actively undermines a client’s well-being (e.g., telling someone they’re unworthy of love). In contrast, radical candor—challenging a client’s perspective to foster growth—can be therapeutic if done with care.

For example, Melissa recounts a hypothetical scenario where a pregnant teen seeks counseling. A secular therapist might explore all options—keeping the baby, adoption, or abortion—while a faith-based counselor might focus only on options aligned with their values. Neither approach is inherently harmful, but condemning a client’s choices or imposing a therapist’s beliefs crosses an ethical line. The key, Melissa argues, is respecting the client’s autonomy while providing a safe space to explore complex decisions.

Broader Implications: A Patchwork of Laws

Colorado’s law is part of a broader trend, with 23 states and Washington, D.C., enacting similar bans on conversion therapy for minors. Pennsylvania, for instance, passed a 2023 statute prohibiting the practice, reinforced by a 2022 executive order banning state funds for conversion therapy. These laws reflect a growing consensus that conversion therapy, particularly when forced, can harm vulnerable youth. However, the patchwork of state regulations and conflicting federal court rulings create uncertainty for practitioners.

The Supreme Court’s decision in Chiles v. Salazar could resolve this split, clarifying how far states can go in regulating professional speech. If the court sides with Chiles, it may expand protections for faith-based counselors, potentially loosening restrictions on therapy aligned with religious values. If it upholds the ban, states may gain broader authority to regulate what professionals can say, raising concerns about overreach into private conversations.

Final Thoughts: Balancing Autonomy and Protection

The Unmentionables discussion doesn’t offer easy answers, but it underscores the need for thoughtful debate. Should therapists be free to counsel minors in line with their faith-based goals, or does the state have a duty to protect vulnerable youth from potentially harmful practices? The answer hinges on how we define harm, autonomy, and the role of government in private therapeutic spaces.

Evan and Melissa invite listeners to weigh in: Should licensed therapists have the freedom to counsel minors consistent with their faith, or should the state set boundaries? Share your thoughts on social media (Facebook, Instagram, and Tiktok0 at @theunmentionables, on X @unmentionablesX, or in the comments section below, and join the conversation about where therapy ends and state power begins.