On International Transgender Day of Visibility (TDOV) in March, the U.S. Supreme Court ruled 8–1 that therapists’ speech is protected under the First Amendment. Religious and conservative groups celebrated the ruling.

The case of Chiles v. Salazar centered on conversion therapy. The plaintiff, Kaley Chiles – an evangelical Christian and licensed therapist – argued that Colorado’s conversion therapy ban violated her free speech rights when working with young people “who have same-sex attractions or gender identity confusion” and who seek to “live a life consistent with their faith.”

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Why is conversion therapy so harmful? It’s all about how young people form their identities.

Conversion therapy, also known as reparative therapy, is rooted in the Christian ex-gay movement that spread rapidly in the 1980s and 1990s before largely fading in the 2000s. However, it resurfaced during Donald Trump’s first term. In his second, it has reemerged more openly and assertively.

This form of psychotherapy, which purports to help LGBTQ+ people become heterosexual and transgender people become cisgender, is hardly new, despite overwhelming evidence discrediting it as ineffective pseudoscience. In 1997, the American Psychological Association issued a position statement affirming that “homosexuality per se is a normal and positive variation of human sexual orientation.” In 2021, it strengthened its opposition to conversion therapy with new resolutions.

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In 1973, the American Psychiatric Association removed homosexuality from the DSM, declaring it not a mental disorder. In 2000, it expressed its formal opposition to conversion therapy.

The emotional and psychological harms associated with conversion therapy are profound. They are linked to high rates of depression, anxiety, self-destructive behavior, sexual dysfunction, avoidance of intimacy, loss of faith, suicide, and the deepening of internalized self-hatred, among other damaging outcomes.

Progressive religious groups have condemned the Supreme Court ruling. As DignityUSA executive director Marianne Duddy-Burke stated in a press release: “Throughout our more than 57 years of ministry, we have worked with hundreds of LGBTQ+ people who have undergone conversion therapy. Every one of them described it as a dehumanizing, horrific experience. Not only was it ineffective at changing their sexual orientation or gender identity, but it resulted in deep shame that many tried to treat with alcohol, drugs, or even suicide attempts. It took years to recover, in most cases.”

When it became clear that conversion therapies could not “pray the gay away” and failed to achieve their aims, religion alone became a less effective tool for discrimination against LGBTQ+ Americans. But now, those same anti-LGBTQ+ efforts are being reframed and protected under the banner of free speech.

The truth remains: Conversion therapies have an estimated failure rate of at least 88 percent. Numerous “ex-gay” organizations have shut down after their leaders publicly acknowledged their own sexual orientation or gender identity. Many prominent figures within the movement have been exposed as fraudulent.

A well-known example is John Paulk, once a nationally recognized “ex-gay” figure. In 2000, he was photographed in a Washington, D.C., gay bar by Wayne Besen of the Human Rights Campaign.

The Kodak moment caused a stir as Paulk attempted to conceal his identity. His explanation – that he entered only to use the bathroom – was widely questioned, given that he remained there for 40 minutes.

Paulk, a former drag performer known as Candi and a runner-up in the Miss Ingenue pageant, was at the time married to a woman who also identified as a former lesbian through an Exodus International ministry.

The couple became high-profile symbols of the ex-gay movement, appearing in 1997 on the cover of Newsweek, as well as on 60 Minutes and Oprah. They co-authored Love Won Out, a memoir that became foundational to Focus on the Family’s ex-gay conferences. They divorced in 2013, the same year Exodus International closed its doors.

In a public apology, Paulk later renounced the ex-gay movement and expressed remorse for the harm caused. He stated: “I no longer support the ex-gay movement or efforts to attempt to change individuals—especially teens who already feel insecure and alienated. I feel great sorrow over the pain that has been caused… I am working hard to be authentic and genuine in all of my relationships.”

When we fail to recognize that human life is varied, precious, and of equal worth, as conversion therapies do, we deny the unique gifts each person brings to the world. These practices, whether administered by clergy or licensed therapists, do not honor human diversity; they attempt to erase it. In doing so, they diminish not only individuals but also violate fundamental civil rights.

Sadly, with the ruling in Chiles v. Salazar, there is now concern that existing bans on conversion therapy in 26 other states could also be overturned.

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