WASHINGTON — The U.S. Supreme Court has declined to hear a challenge to the state of Washington’s ban on so-called 'conversion therapy' for minors seeking help with unwanted same-sex attraction or gender-identity issues. 

The Dec. 11 split decision by the high court ended the legal challenge to Washington state’s ban brought by Brian Tingley, a Tacoma-based Christian marriage and family counselor. 

The law imposes fines and other penalties, including possible revocation of a professional license, on therapists who violate the restrictions, and Tingley argued that the state Legislature had improperly censored his ability to speak freely during counseling sessions about sexual orientation and gender identity.

But while the high court’s ruling was a bitter disappointment for the therapist and his lawyers at the Alliance Defending Freedom, legal experts told the Register that the justices would likely take up a similar case soon — and that there was reason for hope if they do, with three justices already registering support for the therapist’s appeal and circuit courts issuing split rulings. 

“I think the court will take one of these cases sooner or later, but they aren’t ready yet,” Douglas Laycock, a leading First Amendment scholar and the Robert E. Scott Distinguished Professor of Law Emeritus at the University of Virginia Law School, told the Register.

Washington is among more than 20 U.S. states, along with the District of Columbia, to bar counseling designed to help minors overcome same-sex attraction or gender dysphoria — a treatment often referred to as SOCE, or sexual orientation change efforts.

Washington’s statute defines conversion therapy as “efforts to change behaviors or gender expressions, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex.” But while the state law bans SOCE for minors, it allows therapies that promote “acceptance, support and understanding” of same-sex attraction and gender expression that does not align with a client’s biological sex. 

In 2022, the 9th U.S. Court of Appeals rejected Tingley’s First Amendment claim in a ruling that backed the Evergreen State’s right “to regulate the safety of medical treatments performed under the authority of a state license.” 

However, Tingley’s legal challenge got a more respectful hearing when his appeal reached the desks of Justices Clarence Thomas, Samuel Alito and Brett Kavanaugh. 

“This petition asks us to consider whether Washington can censor counselors who help minors accept their biological sex,” Thomas wrote in his dissent. “Because this question has divided the courts of appeals and strikes at the heart of the First Amendment, I would grant review.” 

The dissents from the three justices have encouraged opponents of conversion therapy bans to nurture hopes for a future victory at the high court. 

“It takes only four justices to put another case on the court’s docket,” Gerard Bradley, a specialist on the U.S. Constitution at the University of Notre Dame Law School, told the Register. 

“I also think that, when the court hears such an appeal, a majority will strike down the bans as violative of the constitutional guarantee of free speech.”
Bradley noted that the court’s denial of review in the Washington case “sets no precedent of any kind and does not cast a negative light on so-called conversion therapies in states where it is lawful to practice them.” 

Of equal importance, he said, the high court’s decision did not critique rulings from the appellate bench that have “questioned or even struck down bans on this form of counseling.”

The 11th U.S. Circuit Court of Appeals, which previously heard an appeal to conversion therapy bans enacted in Palm Beach County and in the city of Boca Raton, Florida, ruled in favor of the plaintiffs. 

Debate Over the Science

But for now, at least, Tingley’s high-profile case spotlights the interplay between shifting cultural norms on sexuality and professional standards for licensed psychologists. While LGBTQ activists advance their claim that SOCE damages self-acceptance and fosters guilt among sexual minorities, the American Psychological Association (APA) has filed amicus briefs defending conversion therapy bans, and Christian family therapists like Tingley have struggled to defend their right to provide faith-based counseling to clients who seek it. 

“There’s no science on the side of people who believe in conversion therapy,” Dr. Jack Drescher, a Columbia University psychiatry professor, told NPR this year. “There’s just faith and belief.”

Yet even as the APA and other professional organizations condemn conversion therapy as harmful and even dangerous for minors, some courts, as well as therapists and other experts, have openly disputed the scientific basis for the sweeping attacks. 

The 11th Circuit, which struck down local bans on SOCE in two Florida localities in 2020, reviewed the evidence against the practice and concluded that widely cited studies “offer assertions rather than evidence, at least regarding the effects of purely speech-based SOCE.”

Writing for the majority, U.S. circuit Judge Britt Grant further noted that a statement from the “American Psychological Association, relied on by the defendants, concedes that ‘nonaversive and recent approaches to SOCE have not been rigorously evaluated.’”

But 11th circuit Judge Beverly Martin, in her dissent from the majority opinion, contended that the potential harms from conversion therapy justified the restrictions placed on therapists’ speech. Martin also suggested, without evidence, that well-designed studies evaluating SOCE’s impact on juvenile clients would be unethical — because of the potential harm to young subjects — and so could not be approved. 

Two years later, the Minnesota Department of Health reviewed the body of evidence against SOCE and offered a mixed assessment.

The 2022 report acknowledged that coercive, sometimes physically abusive, practices once employed to alter same-sex attraction had been discontinued back in the mid-1990s and that talk therapy and counseling were the norm today. 

That report also briefly touched on the disconnect between the ongoing campaign against conversion therapy and the relatively poor quality of studies documenting problems with the contested practice. 

“While studies that meet the rigorous standards required for scientific certainty are few,” stated the report, “scientific, medical, and educational communities reject conversion therapy because it lacks scientific validation, poses health risks to people and communities involved, and contributes to health and social inequities.” 

Catholic Perspectives

Now, as state bans on “gay conversion therapy” are extended to include counseling for teens with gender dysphoria (a gender identity that does not align with their biological sex), parents worried about a child exploring life-altering medical treatments will have limited options for assistance — at least if they live in a state that bars minors from SOCE counseling. Catholic bioethicists are also worried about the “unidirectional” scope of restrictions imposed on therapists.

“The approaches enshrined by such legislation are clearly very unidirectional and result in a contradictory stance,” Father Tadeusz Pacholczyk, senior ethicist at the National Catholic Bioethics Center, told the Register. “‘Change’ is lauded when this is understood as coming out [as gay or transgender], but condemned when it is understood as going back [to a heterosexual identity] or offering support to others who might wish to do so. Good psychotherapy will not seek to railroad all patients along a particular, legislatively mandated path.”

The Catholic Church does not explicitly endorse or oppose the use of SOCE. Paragraph 2359 of the Catechism of the Catholic Church teaches that “homosexual persons are called to chastity.”

But Father Paul Sullins, a research professor at The Catholic University of America, has devoted much of his recent work to addressing claims against SOCE and shedding light on its potential benefits.

In 2022, Father Sullins published a paper that took direct aim at one of the most influential and widely cited U.S. studies that purported to show a link between “conversion therapy” and increased suicidal ideation. 

Father Sullins concluded that the findings of the 2020 study, which is generally referred to as “Blosnich et al” (John Blosnich is the director of the University of Southern California’s Center for LGBTQ+ Health Equity), were seriously flawed because the researchers failed to control for suicidal ideation that existed before the subjects had ever gone to SOCE. 

When Father Sullins performed a reanalysis of the same “very good” data used in the Blosnich study but controlled for preexisting distress — in other words, looking at whether the subjects involved already had suicidal thoughts and actions before being exposed to SOCE — he found that the negative conclusions of the Blosnich 2020 study were flawed.

“They made the fundamental error of associating a cause that took place after the effect,” Father Sullins told Catholic News Agency in a December 2023 interview. 

Indeed, Father Sullins also found that in the Blosnich data, for those subjects who expressed suicidal ideation, 36% went on to attempt suicide — unless they had been to SOCE, in which case that likelihood was only 10%.

Blosnich pushed back against Sullins’ initial findings, arguing that the latter had failed to allow for the possibility that SOCE attempts may have occurred earlier than a young client’s record suggested, and so the link between the therapy and the suicide attempt may be justified. But Father Sullins told the Register that his updated research that addressed this oversight still “invalidates the conclusions” of the Blosnich study.

The Current Christian Approach

Father Sullins’ research has stirred considerable controversy, but Blosnich’s study is still widely cited by professional associations, legislatures and media outlets. And that means Christian therapists who work with adult clients grappling with unwanted same-sex attraction must also take time to clarify that their approach to counseling is neither coercive nor damaging. 

“More accurate terms for how contemporary therapists work with clients who have unwanted same-sex attractions include ‘change-exploring therapy’ or ‘sexual attraction fluidity exploration in therapy’ (SAFE-T),” Christopher Rosik, a licensed psychologist in Fresno, California, told the Register.

“This therapy is always client-initiated and client-led and is speech-based in nature, often borrowing from several mainstream therapeutic modalities,” he said. “There is no such thing as some exotic and abhorrent therapy called ‘conversion therapy.’”

Timothy Lock, a licensed psychologist who runs the Goretti Center for Healing and Forgiveness in Connecticut and also serves as director of clinical services for St. Joseph Seminary in Dunwoodie, New York, also questioned the sweeping nature of government bans on SOCE. He noted that a client’s struggle with same-sex attraction might surface later in therapy, which may have been initiated for other reasons. 

“Studies have shown that both ‘mindfulness’ therapy and therapies that address trauma may change a person’s same-sex attraction,” he said. “Does that mean we should outlaw trauma therapy?”

And yet, under the advice of his attorney, Lock has declined to work with minors dealing with sensitive issues of sexuality.

Even if the young client sought assistance with unwanted sexual feelings and was comfortable with SOCE, said Lock, the teenager might refer to it in school as “conversion therapy,” and Lock could be found in violation of Connecticut law, with his professional license at risk.

Thus, until a fourth justice approves the next appeal to a state conversion therapy ban, psychologists Lock and Tingley must walk a careful line. 

“Those who pursue this sort of therapy in states like Washington,” said Notre Dame’s Bradley, “proceed at some risk.”

 

Catholic News Agency contributed to this report.