Statement Upholding Professional Treatment Standards and Reconfirming Opposition to Conversion Practices

New York, NY – April 21, 2026 – From the earliest medical dictum, “first, do no harm,” up to the modern era’s professional standards governing every licensed clinician, health and mental health professions have recognized a simple truth: treatment carries responsibility.  

These standards of care have been undermined by the Supreme Court’s decision in Chiles v. Salazar, a case that challenged the constitutionality of Colorado’s ban on conversion practices for minors and now threatens to undermine state licensing boards’ ability to set or regulate minimum safety and standard-of-care requirements for talk therapy, also known as psychotherapy. 

The court’s decision has grossly mischaracterized trained and licensed clinicians’ speech when providing psychotherapeutic treatment to patients as ordinary speech protected by the First Amendment right to speak one’s mind and faith in the free marketplace of ideas.  

The American Psychoanalytic Association (APsA) rejects this distortion.  

Psychotherapy is neither conventional speech nor casual conversation. It is a clinical intervention delivered by trained and licensed professionals within a therapeutic relationship where the method of treatment is spoken language. That treatment is administered through words, rather than medications or physical interventions, is irrelevant.  

Words spoken in psychotherapy are not incidental to treatment; they are the treatment. Further, psychotherapeutic treatment is governed by ethics, evidence, and a duty to protect patients from harm. 

Consequently, a therapist in the consulting room is not functioning as an ordinary citizen in the public square. Although therapists retain their First Amendment rights as citizens, writers, teachers, and participants in public debate, licensed mental health practitioners are regulatorily constrained from using discredited or harmful practices and are ethically bound to provide treatment to patients that, at a bare minimum, meets the standard of care. 

Mainstream medical and mental health bodies in the United States and abroad now concur that conversion practices are discredited and cause psychological harm. As such, conversion practices fail to meet the standard of care and have been identified as unprofessional conduct warranting discipline.  

This is particularly the case with minors. Children’s fundamental rights include the need for heightened protections, and LGBTQ+ youth are an even more vulnerable population, with increased likelihoods of depression, anxiety, suicidal ideation, and suicide attempts.  

APsA has stated previously that attempts to “convert,” “repair,” change or shift an individual’s sexual orientation, gender identity, or gender expression violate the fundamental principles of psychoanalytic treatment and often result in substantial harm. 

APsA continues to oppose conversion practices and will continue to affirm every child’s and all patients’ right to mental healthcare rooted in evidence, professional responsibility, and human dignity. 

 

References: 

Supreme Court of the United States: Chiles V. Salazar, Executive Director of the Colorado Department of Regulatory Agencies, et al Certiorari to the United States Court of Appeals for the Tenth Circuit No. 24–539. Argued October 7, 2025—Decided March 31, 2026 [JACKSON, J., dissenting – p 32]. https://www.supremecourt.gov/opinions/25pdf/24-539_fd9g.pdf 

American Psychoanalytic Association’s Statement Upholding Opposition to Conversion Therapy. September 2025. https://apsa.org/wp-content/uploads/2025/10/APsA-Statement-on-Upholding-its-Opposition-to-Conversion-Therapy.pdf  

American Psychological Association concerned about far-reaching consequences from Supreme Court decision regarding therapy as ‘free speech’ https://www.apa.org/news/press/releases/2026/03/chiles-salazar-therapy-free-speech  

Chiles v. Salazar, et al. Amicus Brief filed: 5/23 United States Court of Appeals for the Tenth Circuit https://www.apa.org/about/offices/ogc/amicus/chiles | https://www.apa.org/about/offices/ogc/amicus/chiles.pdf  

American Psychiatric Association Statement on the Supreme Court Decision in Chiles v. Salazar https://www.psychiatry.org/news-room/news-releases/apa-on-supreme-court-decision-chiles-v-salazarr  

American Medical Association Statement https://searchlf.ama-assn.org/case/documentDownload?uri=/unstructured/binary/case/Chiles_v_Salazar.pdf 

Report of the Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity in the Practice of so-called “conversion therapy” United Nations Human Rights Council. Forty-fourth session. 15 June–3 July 2020. A/HRC/44/5.
https://docs.un.org/en/A/HRC/44/53  

The Supreme Court’s Systemic Failure to Recognize the Rights of Children Is Glaring in the Chiles Decision. April 15, 2026. American Constitution Society for Law and Policy (ACS). https://www.acslaw.org/expertforum/the-supreme-courts-systemic-failure-to-recognize-the-rights-of-children-is-glaring-in-the-chiles-decision/