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Culture War Roundup for the week of March 30, 2026

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[disclaimer: I'll try to keep personal feelings and experiences out of this one, simply because I don't think most readers here are going to want to hear it, but it will inevitably color my takes.]

LGBT Talk / Conversion Therapy: Chiles v. Salazar

SCOTUS holds:

On matters of sexuality and gender, Ms. Chiles’s clients, including minors, come to her with different goals in mind. Some “are content with” their sexual orientation and gender identity and seek assistance only with “social issues, family relationships,” and the like. In cases like those, Ms. Chiles does not try to persuade her clients to “change their attractions, behavior, or identity,” but aims instead to help them address their stated goals. Other clients, however, come to her hoping to “reduce or eliminate unwanted sexual attractions, change sexual behaviors, or grow in the experience of harmony with [their] bod[ies].” And in these cases, too, Ms. Chiles seeks to help her clients reach their own stated objectives. In doing so, she does not prescribe any medicines, perform any physical treatments, or engage in any coercive or aversive practices. All Ms. Chiles offers is talk therapy.

In 2019, Colorado adopted a law prohibiting licensed counselors from engaging in “conversion therapy” with minors. The State reports that it adopted the law “in response to a growing mental health crisis among Colorado teenagers and mounting evidence that conversion therapy is associated with increased depression, anxiety, suicidal thoughts, and suicide attempts.” Any Coloradan who thinks a licensed counselor is engaging in conversion therapy may file a complaint with a regulatory board. A complaint, in turn, triggers a disciplinary review process that can yield a fine, probation, or the loss of a license.

Colorado’s law banning conversion therapy, as applied to Ms. Chiles’s talk therapy, regulates speech based on viewpoint, and the lower courts erred by failing to apply sufficiently rigorous First Amendment scrutiny.

The opinion, by Gorsuch and joined by a somewhat surprising seven other justices, is pretty standard free speech fare: the statute bans one view and not the other, the state offers little if any historical or legal support for its ban, and it's both an outlier and a recent outlier. The state tried to compare the ban here to requirements to disclose factual, noncontroversial speech during commercial activities, and ran into a brick wall when the case formalizing that standard did a Solomon-level splitting to start with.

The concurrence, by Kagan and joined by Sotomayor, tries to cabin this ruling to its four corners, and saying that viewpoint-neutral restrictions on medical speech would have a much lower bar to pass. Where the state here banned only one side of a controversial topic, but encouraged the other, a law that merely banned this topic in this context entirely could merely need evidence that the state's interests were significant enough and connected enough. Given that we're talking Colorado, here - home of Masterpiece Cakeshop - it's not impossible that the state will try to squeak a neutral-in-theory rule under this view.

It's... somewhat difficult to imagine what that would look like, though. Kagan, during oral arguments, motioned toward a theoretical law that prohibited violating the standard of care, but that would be so wide as to revive the nondelegation doctrine, not least of all because that can range from a creature of statute to a PDF thrown together by randos to five competing and conflicting opposing philosophies. A genuine universal ban by counselors on LGBT-related talk therapy would impact the LGBT movement far more than it would social conservatives. The Colorado statute here specifically excluded "Assistance to a person undergoing gender transition" for several reasons, but the necessity for such therapy before most reasonable doctors would recommend surgical or serious chemical interventions is no small part of it. Restrictions on types of therapy might be more easily be tailored to only hit one side or the other, but while aversive- or confrontational-focused conversion therapy are common focuses for progressive outrage (whether the underlying incident was genuine or not), they're both little-used and little-liked even by social conservatives now, and a restriction that leaves sexual orientation change talk therapy on the table is likely to be seen as an unacceptable compromise.

The dissent is, no surprise, Jackson, and it's a doozy:

“[T]here is no right to practice medicine which is not subordinate to the police power of the States.”

There are steelmen to the Colorado law. Chiles does not contest it as applied to aversives, and even if they did work, they're well-within the bounds of behaviors that states have long-regulated (and which social-conservatives have argued for regulating as recently as Skrmeti). A lot of these programs don't work, don't seem to care that they don't work, and are unwilling to consider alternative approaches that would fit their goals or the goals of their patients but would not match expectations (caveat: not all of them, and some like the SF Kaiser clinic might have been a little more open-minded than the already-libertine-seeming publicly-disclosed records). There are a mass of complicated First Amendment caselaw, epicycle on epicycle, that have left too many opportunities for motivated justice to find outlier or non-representative historical support for hilariously unconstitutional arguments.

Jackson's dissent bulldozes them. She tries to draw the statute here as merely incidentally restricting speech coincidental to restrictions on conduct, by defining conduct to include wide varieties of speech so long as the regulators motivations were pure. Her view of the First Amendment and this statute do not merely condone prohibitions far broader than cruel or harmful ones. One note compares the law here to the speech requirements in Casey, where abortion providers were required to give 24-hour notice of the possible risks and complications of procedures - but the law in Casey specifically required providers to give both the risks of abortion and carrying the fetus to term (and other alternative procedures).

It's just a mess, and it's not just me saying that: Kagan and Jackson have dueling footnotes over it.

I'm genuinely confused what Jackson's goal is, here. Bulverism's a fun sin, and all, but for all I've been unimpressed by her Munsingwear asides, I'd at least expect some sort of deep strategic or tactical focus, and it's not just me finding it jank at best (cw: ai analysis of legal documents, aka worth about as much as you paid for it). If the best she's aiming for is to throw the First Amendment to the proverbial wolves of whatever third-party organization can define professional standards, it seems a dissent like this will only motivate people to burn those orgs down faster, and damn whatever happens to the commons in the process.

Some smaller notes:

  • Colorado tried to moot this case at the last moment, again, and the law has (supposedly) never been actually brought to bear. Part of Chiles surmounting that particular barrier is clearly support from SCOTUS (and Colorado's defense not focusing much on the mootness argument), but it's also partly downstream of Colorado seemingly not knowing or understanding what they were trying to moot: the final briefs are entirely talking past each other.
  • There's a more subtle problem that came up repeatedly in oral arguments, and in strangely absent in the final opinion: whether the law would apply to counselors, outside of the context of treatment. The state argued, at length, that it would not, just as it would not apply to non-licensed paid counselors (such as life coaches). I'm glad that SCOTUS didn't take it as an out -- there's a basically no coherent or consistent way to make the distinction work in practice -- but it's weird that it only gets mentioned as evidence that this regulated speech-qua-speech, because it doesn't really fit well there (indeed, this section of the opinion, pg 17, seems to conflate whether the state admitted that other people could give the same advise, with whether other people could lawfully act on the advise).
  • "JUSTICE ALITO: Three generations of idiots are enough?" Bell is still pretty clearly on the minds of SCOTUS, even if no one else of importance puts it high on the list. Hard to tell how much it's genuinely left them worried about following consensus off a cliff, rather than a tool to say they think consensus has gone off a cliff, but still bizarre given the case's status.
  • (As the mirror to Jackson's showboating, there's a section of the opinion that has Alito's fingerprints all over it, where the opinion points out that Colorado's idea of deference to medical consensus would have once permitted not just Bell-style eugenics, but specifically against recognizing homosexuality as acceptable. I'm... skeptical that this will be persuasive to anyone who's not already sold on the free speech arguments. The simple response of 'but my side isn't wrong' hits too hard, here.)
  • I'm generally skeptical of the LGBminusT perspective where trans stuff is primarily or solely an anchor, but I think it's very unlikely that that this case ends up here without the specific context of original-gender affirmation therapy focusing on minors. Even strong advocates of sexual orientation change therapy don't argue for a sizable success rate -- Nicholas Cummings rather infamously claimed an 67% success rate, of which only 20% (aka <14% of total) actually changed orientation rather than calmed the fuck down about being gay, and that for a sample with heavy selection effects -- while the persistent rates for very young children and gender stuff are a lot more favorable to social conservatives.
  • This isn't going to end everything, one way or the other. Trivially, this is just at the motion for preliminary injunction stage, and technically speaking it's just a remand for the lower court to issue a preliminary injunction. You'd think that would be a nitpick, but wouldn't be the first time.
  • One of Jackson's mentions is to Mathew [sic] Shurka's past experiences with sexual orientation conversion therapy, which reading the full background happened under an organization then called JONAH. Emphasis on the past tense, though, since it's been defunct since 2015. Because it got sued into rubble, under a legal theory near-certain to survive the logic of this case. At the time, there were widespread ground preparation for similar lawsuits. In an ideal world, versions focused on the actually-scammy organizations would become prominent and leave better therapists and providers to more seriously consider and describe the limits of their capabilities and theories. I'm not optimistic that there will be good target selection: even at the time, the feds were already getting aimed at other orgs that, while near-certainly wrong, weren't so obviously lying about it. And, of course, this law wouldn't have applied to JONAH or People Can Change (now Brothers Road), either.

A bigger note: Even on the strict law-of-the-case matter, this is going to be a mess. There's been active lawsuits dating back to at least California's SB 1172 in 2012, which was upheld by the Ninth Circuit in 2013, in a case that SCOTUS named and shamed in 2017. There's been a circuit split since 2020's Otto v. City of Boca Raton; cases had reached SCOTUS as far back as 2014, and as recent as 2023, only to have cert denied. 23 states have laws that are near mirrors of this one, another 4 states have partial variants. One was overturned days after SCOTUS granted cert in this case. I... do not expect clarity from the First, Second, Third, or Ninth Circuit in the next year, outright. We might not know for the Tenth Circuit, or just the bounds of Colorado, specifically, in a year.

From a legal realism perspective, it doesn't 'matter'. This specific law hadn't been enforced yet, and indeed (despite that decade-plus legal limbo and wide spread), I couldn't find any clear cases of legal enforcement. If a licensing board was going to pull a therapist's card over this sorta thing, they can readily and rapidly find other fig leafs causes, even while focusing on the exact same therapy.

From a more pragmatic one than even that, though, the court's intransigence seems likely to have a longer-term impact. At minimum, this points to a no-go-zone for a philosophy, and one that's been allowed to sit for well over a decade: whatever natural resistance the psychiatric world might have toward social conservatives, this one there on top of that, and coincidentally no one in good standing with the APA will ever argue in favor of these policies, a note that should be relevant even or especially if they are clearly wrong. Therapists are more law-abiding than average (at least on the job), and even a purely illusory law will lead the marginal therapists to be just that little bit more cautious, even if only in extreme outlier cases.

I benefited from conversion talk therapy. Nobody claimed a particularly high success rate, but I got the impression that most of these therapists thought a majority of people improved somewhat. I never heard discussion of aversive practices, I didn't get the impression it was common or normal, or even really part of the same world. Everybody was religious and had strong views about family systems and the like. It was, mostly, fairly standard therapy with some unusual homework exercises centered around a self conception as a man/woman designed by God for that role. These therapists took other, non-conversion therapy clients and cases, I suspect the bulk of their clientele were dealing with trauma or whatever. The list I was given was, overwhelmingly, male, and a few women were highlighted for those that preferred a woman to talk to(this was, clearly, intended for women who don't feel comfortable discussing certain things with men). Unlike with most therapists, they freely and frequently recommended talking to someone else, changing therapists often, etc, as it was thought that different people specialized on different specific issues within the complex that causes homosexual ideation. The theory of treatment was based on a book written by some Dutch reactionary psychiatrist, this was freely shared with me and I read it out of curiosity(unfortunately, I purchased it on an old kindle account which I no longer have access to).

I should note that it did, factually, work in my case. I not only lost disordered urges but also became more stereotypically masculine, developed a greater interest in sports and the like. I'm happier for it.

As far as the vote pattern goes, it seems like the most intelligent liberal justice is attempting to mitigate the damage done to state mandation of official social liberalism. This is an issue in which I am, of course, keenly interested in given my ideological views, but it does seem like Kagan and Sotomayor recognize at least some constitutional limitations, whereas KJB simply rambles in favour of whatever the current dem party line is. No wonder Kagan is reportedly tired of her.

I never heard discussion of aversive practices, I didn't get the impression it was common or normal, or even really part of the same world.

Most of the information I've seen suggests that formal use of 'hard' aversive stimuli (eg, electric shocks, physical impacts, harsh chemicals) fell out of favor by the mid 1980s. There's claims of it since, but they tend to revolve around extremely marginal cults and/or really sketchy political activist backstories. Even before it was marginalized in the social conservative sphere, it was considered (probably reasonably!) as likely to backfire, end up with asexual or otherwise less-sexually-functional-than-before outcomes, or trigger even weirder behaviors in the Nicholas Cummings side of the sphere.

(Although I was under the impression van den Aardweg himself was prone to flirting closer than most talk therapy-focused groups: there's always some fuzzy edges between exercise as process versus exercise and punishment, but the whole Failed Male and Failed Social Relationship framework seemed prone to leaping off that edge, in addition to just being hilariously wrong in a number of cases I know firsthand.)

I should note that it did, factually, work in my case. I not only lost disordered urges but also became more stereotypically masculine, developed a greater interest in sports and the like. I'm happier for it.

Yeah, that's not unprecedented or unbelievable. I was trying to keep to the legal arguments above, but the factual side of this is an ungodly mess.

My impression is that there's a small portion of people (either bisexual or malleable for other reasons like their approach to sexuality or very pressing in the 'every hole is a goal' sense sex drives) for whom even the 'standard' form of Man Up works, or could probably even work themselves into a pretty wide variety of results in the Dodo Bird Verdict sense. There have been a few bihackers that were successful going the other direction, and happy with it, and I kinda do have to mention that there's a ton of guys who were perfectly straight and then spent some time in the furry fandom and discovered Oh No He's Hot.

But the flip side is that a lot don't, even within the small group who seek this out the hardest: a large portion who try are only able to shove down same-sex interests for short periods, or they're able to function with women but still crave men in ways that they're not really comfortable with. Likewise, you get bihackers that aren't grossed out by gay sex anymore, but wouldn't actually look out for the stuff, or might struggle to even top (or even top the 'most gay lite' guy available, cw: furry comic).

I'm not kidding when I say Cumming's 14% number seems really optimistic.

The flip side to that is that we've got a lot more tooling available, now. At the moderate level, there was a long-standing theory that gay guys just needed to have a couple good rounds of 'healthy' sex with a woman to Become A Man, and contra the invasive therapies and wireheading from erwgv3g34's older example, these days some gay guys can do it with a Little Blue Pill and a weekend in Vegas. It doesn't work -- a few still can't get it up or keep it up, and a much larger number can pump away and just don't really feel satiated at the end -- but it seems like it should be something that redefines how a lot of frameworks around everything here should go, and it really hasn't.

People having widespread changes to their sexuality as a result of hormonal supplementation is common, if not universal.

(At the more extreme, I'd expect rTMS to have some impact, and while I think experimenting like that is a terrible idea regardless of what you're trying to change your mind on, it's far from the most terrible idea to get massive support and grants. On the flip side, I can understand why both social conservatives and LGBT advocates think it's a really dumb weapon to invent and then leave around for someone else to mandate!)

On the flipside, with the possible exclusion of the Kaiser SF program, it's weird how messy "improved somewhat" is as a term of art. Does that mean they were still gay, just got perceived hypersexuality under control? Still gay, but could run on the masc4masc side of grindr? Still gay, but less conflicted about it? Could they now have sex with their wives, and if so did they enjoy it or see it as a chore? Or did they have reduced same-sex attraction, in the sense that they jorked it to gay porn instead of cheating on their significant other? Because some of these endpoints -- even and maybe especially if they are desirable for the patients in question -- seem like they could be confronted in ways that don't revolve around 'changing orientation' as the central result, rather than a rare side effect.

Even assuming as a given the whole progressive mainstream philosophy as true, there’s a lot of this stuff that could be relevant and interesting and important, completely divorced from sexual orientation change, and they’re not looking into it deeply either.

Most of the information I've seen suggests that formal use of 'hard' aversive stimuli (eg, electric shocks, physical impacts, harsh chemicals) fell out of favor by the mid 1980s.

I think using positive punishment in order to create a conditioned response is just a very, very bad idea to do to people and can mess them up in ways that we don't fully understand. #JusticeForLittleAlbert

But the flip side is that a lot don't, even within the small group who seek this out the hardest: a large portion who try are only able to shove down same-sex interests for short periods, or they're able to function with women but still crave men in ways that they're not really comfortable with.

Ok, this is one of your sentences I had to read thrice before I got it. I thought you were talking about the straight-to-gay people here (I guess you call them the 'bihackers'?) and I was genuinely confused for a few minutes because I thought you were saying "they could only shove down" in the sense of "avoid throwing up because of" same-sex interests for short periods, and I was trying to discern how that was different from your next sentence about the guys who were no longer grossed out by gay sex. It took me longer than I care to admit to understand you meant "repress" and not "keep a full stomach on", which are very much the opposite thing.

bihackers

I thought about making a matrix joke, but then I realized that making a matrix joke about gender and sexuality wasn't particularly original.

(or even top the 'most gay lite' guy available, cw: furry comic).

Wait, is the point that the 'most gay lite guy available' is a trans man with a vagina? I will admit that I've found some people who call themselves trans men attractive, but this is on the "I have changed literally nothing about my appearance--I am now wearing masculine clothing but I've done nothing irreversible--I am a proud trans-masc-femboy and this is a masculine pink skirt I'm wearing" spectrum of trans men, or in other words the ones where they could just say 'I am a woman' and no one would think anything of it. When male-pattern hair or surgeries start getting involved that's where my brain nopes out. I suppose that's a long-winded way of saying I'm not attracted to trans men.

At the more extreme, I'd expect rTMS to have some impact, and while I think experimenting like that is a terrible idea regardless of what you're trying to change your mind on

I mean, this doesn't not sound like someone's kink. We already live in a world in which gay hypnosis pornography exists.