Opinions
Supreme Court’s conversion therapy case tests if science matters
A ruling against Colorado’s ban would endanger LGBTQ youth
Imagine: A 15-year-old in Colorado confides in his therapist that he might be gay. Instead of finding support, he was told to pray harder, to picture himself with a girl, to imagine God “fixing” him. Weeks later, he stopped showing up for sessions. His parents thought he was improving; in reality, he had learned that honesty carried punishment. He’s one of thousands of LGBTQ young people who entered therapy seeking help and left believing they were broken.
Stories like this are why states banned conversion therapy in the first place, and why the Supreme Court’s latest case could undo those protections.
When the justices heard arguments in Chiles v. Salazar on Oct. 7, they weren’t simply weighing a dispute over counseling. They were deciding whether scientific consensus still counts as fact in American law.
The issue before the Court is Colorado’s 2019 law prohibiting licensed mental health professionals from subjecting minors to so-called conversion therapy – interventions that claim to change a person’s sexual orientation or gender identity. Every major medical and public health organization in the United States has rejected these practices as both ineffective and harmful. The American Psychological Association, the American Academy of Pediatrics, and the American Medical Association all warn that such interventions increase anxiety, depression, and suicide risk among youth.
Yet several justices appeared more concerned about the “speech rights” of counselors who wish to continue the practice. They suggested that Colorado’s law might represent “viewpoint discrimination,” because it allows therapists to affirm LGBTQ identities but forbids them from trying to change them. In that framing, evidence-based medicine becomes ideology, and ideology becomes protected speech.
This inversion of expertise has become a recurring theme in modern jurisprudence. During the pandemic, the Court restricted states’ ability to enforce public health orders, treating epidemiological evidence as optional. In Dobbs v. Jackson Women’s Health, the Court majority brushed aside decades of medical testimony about the safety of abortion care. Now, in Chiles v. Salazar, the justices are poised to decide whether overwhelming scientific consensus on psychological harm can be reduced to a matter of personal belief.
But medicine is not a marketplace of ideas in which every viewpoint deserves equal weight. It is a field governed by empirical testing, ethical standards, and the obligation to do no harm. To call conversion therapy “just speech” is to erase the patient sitting across from the clinician – a vulnerable minor whose trust and health depend on professional integrity. The state’s role in setting those standards is not viewpoint censorship; it is public health in action.
Consider the analogy to prescribing medication. A physician who tells patients that antibiotics cure viral infections is not exercising free speech; she is providing substandard care. A state medical board that disciplines her is not policing ideas; it is enforcing evidence-based practice. Mental-health care should be no different. Words are a therapist’s instruments, and when used to shame or pathologize identity, they can wound as deeply as any physical act.
If the Court strikes down Colorado’s law, it will erode the principle that professional conduct must be guided by evidence. States could find themselves unable to regulate misinformation in clinical settings – from anti-vaccine counseling to denial of gender-affirming care. The ripple effects would reach school-based programs, public health campaigns, and any professional discipline that relies on communication as a form of treatment.
For LGBTQ youth, the consequences would be immediate. The Trevor Project reports that LGBTQ young people who have been subjected to conversion efforts are more than twice as likely to attempt suicide. Legalizing such practices under the guise of “speech” does not protect expression. It protects harm.
Public health policy depends on one fragile norm: that evidence and scientific consensus matters. Once the judiciary treats empirically validated standards as partisan viewpoints, we lose the ability to distinguish expertise from ideology. That threatens LGBTQ youth, but it also threatens every patient who expects the doctor’s office to be a refuge from politics.
Science will survive this Court. But its authority, and the health of the people it protects, may not emerge unscathed. Whatever the ruling, we must be clear that protecting youth from harm is not ideology. It’s care, backed by evidence.
Harry Barbee, Ph.D., is an assistant professor at the Johns Hopkins Bloomberg School of Public Health. Their research and teaching focus on LGBTQ+ health, aging, and public policy.
Opinions
Trans people need a politics of ordinary life
Seeking the freedom to stop explaining ourselves
For much of the modern transgender rights movement, our political vocabulary has understandably been a vocabulary of emergency. We talk about healthcare bans, bathroom restrictions, discrimination, violence, court decisions, and executive orders. We organize because something is being taken away, prohibited or threatened.
Those fights are necessary. But they cannot constitute our entire vision of transgender life.
The Williams Institute at UCLA estimates that approximately 2.8 million Americans ages 13 and older identify as transgender, including roughly 2.1 million adults. Transgender people are only about 0.8 percent of the adult population. Yet transgender Americans occupy an extraordinary amount of the country’s political attention.
Behind those political arguments are millions of people doing profoundly ordinary things.
We commute to work. We complain about rent. We walk our dogs. We sit in traffic. We buy groceries. We fall in love with people who sometimes disappoint them. We worry about our parents getting older. We try to make enough money to retire. We drink coffee before work and wonder what to make for dinner.
This ordinariness should be part of the political project.
For years, LGBTQ advocacy has emphasized visibility. Visibility was necessary because silence allowed discrimination to flourish. Americans needed to understand that gay and transgender people existed in their families, workplaces and communities.
But visibility is a means, not an end.
The endpoint of civil rights is not permanent visibility. It is freedom.
And freedom includes the freedom to stop explaining yourself.
There should be nothing remarkable about a transgender accountant preparing someone’s taxes, a transgender teacher grading papers, a transgender novelist writing a book that has absolutely nothing to do with gender, or a transgender retiree arguing with the homeowners association about somebody’s fence.
That sounds almost comically mundane. That is precisely the point.
For many transgender Americans, mundane life remains harder to obtain than it should be. The 2022 U.S. Transgender Survey, which collected responses from more than 92,000 people, found that 34 percent of respondents were experiencing poverty and 18 percent were unemployed. Eleven percent of respondents who had ever worked reported losing a job because of their gender identity or expression. Nearly 30 percent had experienced homelessness during their lives.
Those numbers tell us something important about what transgender politics should accomplish.
A successful movement cannot measure progress exclusively by representation in television shows, corporate Pride campaigns or the number of transgender politicians elected to office. It must also ask whether transgender people can build stable, boring lives.
Can you find a job?
Can you rent an apartment?
Can you go to the doctor without becoming a political subject?
Can you walk into a restaurant with your spouse without calculating whether everyone is staring at you?
Can you spend an afternoon thinking about something other than being transgender?
Even healthcare illustrates the distance between formal inclusion and ordinary dignity. A 2024 KFF analysis found that 33 percent of LGBT adults who had recently used healthcare reported being treated unfairly or disrespectfully by a healthcare provider, compared with 15 percent of non-LGBT adults. Thirty-nine percent said a negative healthcare experience had made them less likely to seek care.
Equality therefore cannot simply mean keeping a clinic open. It must mean being able to enter that clinic, receive competent treatment and leave without feeling that your identity has swallowed the entire encounter.
There is a broader political lesson here.
Transgender Americans have sometimes been transformed into abstractions by both sides of the culture war. To some conservatives, we are evidence of social decline. To some progressives, we become symbols of resistance. Neither description leaves much room for the complicated, frequently uninteresting reality of being a person.
Most people do not wake up every morning thinking about their demographic categories. They think about deadlines, relationships, bills, ambitions, annoyances and whether there is enough milk in the refrigerator.
Transgender people deserve that luxury too.
A politics of ordinary life would therefore defend transgender healthcare and civil rights vigorously while articulating something beyond defense. Its objective would be integration: transgender Americans participating in civic life without every interaction becoming a referendum on gender.
That means protecting employment and housing. It means making competent healthcare routine rather than exceptional. It means creating communities where transgender children can imagine futures that extend beyond surviving adolescence. And it means allowing transgender adults to become bankers, mechanics, professors, parents, entrepreneurs and retirees without expecting them to become activists simply because they are transgender.
There will always be people who choose activism. We need them. There will always be people who speak publicly about their transitions. Their testimony matters.
But there should also be room for the transgender person who wants none of that.
Civil rights movements succeed not merely when marginalized people become visible, but when their presence stops requiring explanation.
The most radical future I can imagine for transgender Americans is therefore surprisingly conventional: a country in which being transgender can become one fact among hundreds about a person rather than the organizing principle of a life.
Perhaps the ultimate measure of transgender equality will not be how frequently America talks about transgender people. It will be the day when it no longer has to.
Isaac Amend is a transgender man and writer based in D.C. In 2017, Isaac starred in National Geographic’s “Gender Revolution” documentary. He sits on the board of the LGBT Democrats of Virginia. His author’s portfolio is available at isaacamend.com and you can find him on Instagram at: @isaacamend.
Opinions
Enlarging the Supreme Court keeps making more sense
If effort to restrict mail in voting stands, we are in major trouble
I have been going back and forth on whether I think adding justices to the Supreme Court is the right thing to do. But if the court takes the final step of allowing the felon’s executive order on mail in ballots to move forward, I am definitely for enlarging the court. There are many things this court has done that I find reprehensible, but this would be by far the worst. It would irreparably impact the very cornerstone of our democracy — the right to vote.
The order requires the Department of Homeland Security (DHS) be sent voter lists from each state, and then compile/verify a list of U.S. citizens in each state who are eligible to vote. DHS would undertake the effort to compile the list with the Social Security Administration. We are talking about a list of more than 200 million names. The list would be by state, and then sent to each state. It then directs the U.S. Attorney General to prioritize the investigation and prosecution of “election officials, individuals, and other entities that violate the law by issuing or distributing Federal ballots to ineligible voters.” Then according to the White House fact sheet on the EO, It directs the AG to withhold federal funds from noncompliant states.
In addition, it involves the Postal Service in determining correct ballots, and instructs ballots it transmits to be “placed in secure ballot envelopes marked as Official Election Mail, with unique Intelligent Mail barcodes, that facilitate tracking. So, one has to question does Homeland Security then track every ballot? It is all insane, meant to limit voting, and scaring people into not voting when we already have a safe, proven system in place. All this being done at the whim of the felon in the White House when it is very clear the Constitution vests the administration of elections with the states. It does allow Congress to pass laws pertaining to elections, but is clear the Executive Branch has NO official role in changing election laws, or carrying out elections. The court must be deaf, blind, and dumb, if they don’t know the Congress has refused to pass the President’s SAVE Act, which would have made some changes. Again, they know this, and if they choose to disregard this, and the constitution, and allow the felon to proceed to implement any part of his EO, they should be impeached.
It is clear to anyone with half a brain, that all this, even if it were constitutional, would be totally impossible to do in the eight weeks before the midterm elections. In the 2022 midterm elections, nearly 107.7 million valid votes were cast. Currently, is it difficult to determine the exact number of registered voters, as they are registered by state, but it is generally agreed to be approximately 200 million. The idea the Trump administration could in any way try to validate 200 million names in the next eight weeks is totally insane. Again, this is why it is left to the states to do, and it is an ongoing process. Trump filed 60 lawsuits to try to prove invalid votes in the 2020 election, and he lost all 60. Recently, DHS looked at the Nevada voting rolls, and initially claimed there were about 16,000 illegal voters listed. But when it came down to returning the supposed illegal names to Nevada, election officials there received a list with only about 185 names on it. Over the years where Trump has sued, and there have been recounts, there have never been more than a handful of illegal votes and it was clear they made no difference in the results.
Voting by mail is crucial for so many. Even the felon votes by mail. So, if the court were to side with the felon on this, and approve even part of his executive order, they are clearly doing it to screw up our elections, and be complicit with the felon. Based on such an outcome I would lobby the Senate to add justices to the court. The number of justices on the court has changed five times before. Today we have two justices, Alito and Thomas, whose votes you know in advance on any case before it is even heard. We know there are six conservative justices. So, if Democrats take the Senate they could add four more liberal justices to the court for a liberal majority. Even adding three would provide for an even balance which could make for a serious debate on the issues within the court, and final decisions wouldn’t be forgone conclusions as they so often are today.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
American democracy on the brink
When Trump threatens voting rights to undermine midterms, we should believe him
President Trump’s favorability is at record lows, dragged down by a reckless and unpopular war, soaring food and gas prices, economic instability and a general sense that he is flagrantly corrupt, more focused on vengeance than governing, flailing and mentally unwell. Assuming the elections take place without interference, Democrats are expected to regain control of the House in November, with odds increasing of a Senate takeover as well.
In normal times, a rational president facing such headwinds would pursue policies designed to regain public support. But we see no sign of that. Instead, we are seeing a renewed focus on repeating the well-litigated and demonstrably false claims that he won in 2020, and that our elections are rife with voter fraud. He recently devoted most of what was billed as a major speech to the nation on regurgitating these imaginary claims, this time alleging that the Chinese had interfered in the 2020 election, thereby augmenting the pretextual narrative with a national security rationale. Although it is unclear whether Trump believes any of this himself, he has convinced most of his supporters to believe it, and that serves a very important purpose. Those false claims drove thousands to storm the Capitol to prevent the certification of the 2020 election, and he appears again to be setting the stage for what he seems willing to do to avoid defeat at the polls.
Since returning to power last year, Trump has systematically fired and replaced personnel at all levels who might not comply with illegal directives and taken other actions to remove the obstacles that constrained him before. He has thoroughly purged the military and the Department of Justice of career professionals and replaced them with die-hard loyalists who will reliably do his bidding. He has totally neutered the Congress, rendering this once-powerful co-equal and independent branch of government totally subservient. And he has cowed much of the judiciary, including the Supreme Court, into a state of complicit compliance. The Department of Justice has been so thoroughly co-opted by him that he routinely and publicly directs the prosecution of his enemies on tenuous or non-existent grounds and indictments soon follow in virtually every case.
Trump has also militarized America’s streets through the deployment of a federalized National Guard deployed primarily in Democratic cities under the pretext of a crime epidemic that local authorities could not contain. Trump has unleashed a highly aggressive and unaccountable Immigration and Customs Enforcement (ICE) force of masked gunmen ostensibly to round up and deport people who were in the country illegally. In fact, ICE has acted with such wanton brutality that it has disappeared and summarily deported people, and murdered people, including several American citizens, in broad daylight and on video with no consequences. These troops, who function almost as independent and unaccountable militias of the president, have terrorized segments of the population and acclimated Americans to a menacing armed presence roaming the streets in a manner that Americans have never experienced before. It is not hard to imagine how these forces could be put to use during the election: to intimidate and suppress the vote in Democratic precincts, to seize voting machines or otherwise interfere with the election process, and/or to provoke chaos and unrest to provide a pretext for the president to contest or nullify the election results.
This is not theoretical. It is telling that Trump’s two top priorities are premised on the big lie about the 2020 election and on creating a pretext for interfering in the upcoming election. He has prioritized legislation called the SAVE Act, which would interfere with states’ rights to administer elections by mandating enhanced voter ID requirements in a manner that would disenfranchise voters, particularly those that tend to vote for Democrats. His other top priority is a $1.8 billion “anti-weaponization” fund designed to compensate and reward convicted Jan. 6 rioters who, at Trump’s instigation, ransacked the Capitol, brutally assaulting police officers and hunting members of Congress with the intent of killing them. The rationale for this massive slush fund is the fiction that these convicted felons were innocents unfairly subjected to baseless, politically motivated prosecutions. This fund was so controversial that two Republican senators had blocked the nomination of Todd Blanche as attorney general until they received a very dubious written assurance — quickly disavowed by Trump — that the fund would not be deployed.
It is also alarming that Trump repeatedly calls for nationalizing the elections process, despite the Constitution specifically vesting these powers with the individual states, and he has demonstrated that he means business. He has pressured states to turn over confidential voter data and taken punitive measures against the non-compliant, including withholding allocated federal funds. He has harassed and intimidated state election officials with threats of criminal prosecution for a variety of specious reasons and has sought confidential personal information about these officials. Notably, he recently abolished the U.S. Elections Assistance Commission, a watchdog agency established by Congress after January 6 to ensure the integrity of our elections. And perhaps most disturbing of all, his servile FBI took the unprecedented step of raiding election offices in Atlanta, Georgia to seize and confiscate voter rolls. There is no reason to believe that he will hesitate to do so again in November. In fact, he recently stated that he may send ICE and National Guard troops to polling places, and some members of Congress and MAGA influencers are calling for him to do just that. Under the right circumstances, which would include accusations of voter fraud and chaos at the polls that could easily be provoked or manufactured, he would have the legal authority to do so.
At the same time, Trump has openly mused that the public might prefer a dictatorship and repeatedly hinted that he might seek an unconstitutional third term. At the White House Correspondents’ Dinner last month, he wore a red cap emblazoned with “Trump 2028”, and just this week, he indicated that he is willing to declare a national security emergency to cancel elections. “Stranger things have happened,” he said, seeming to prepare the public for what might be in store. Trump has so successfully inured the public and the media to such incendiary and anti-democratic threats that they no longer induce opprobrium or outrage.
This president has repeatedly demonstrated and flexed his authoritarian impulses, admired dictators, and increasingly signaled a determination to seize control of the upcoming election up to and including cancelling it. He tried to stage a coup once and came very close to succeeding. This time his actions are increasingly speaking the quiet part out loud. What should alarm anyone paying attention is that the groundwork for Version 2.0 has been very well laid and that, when Trump signals so clearly that he is determined to win by any means necessary, we should believe him.
Peter Pappas is an attorney who served in senior positions in the Obama and Clinton administrations.
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