I am writing this as a queer therapist who specializes in religious trauma and cult recovery. I sit with people who are trying to rebuild a sense of self after systems tried to erase them.

This is not abstract for me. It shows up in sessions every week. It shows up in how people speak about themselves, how they regulate their emotions, and how safe they feel existing in their own bodies. I, myself am a queer person who is still recovering from a high control religion I have been out of for many years now.

So I want to be clear. What is happening in the courts right now has direct psychological consequences.

The Supreme Court Ruling and What It Means

On March 31, the Supreme Court issued an 8 to 1 decision in Chiles v. Salazar.

This case challenged a Colorado law that banned licensed mental health professionals from engaging in conversion practices with minors.

The Court held that these bans raise serious First Amendment concerns related to therapist speech. In practice, this opens the door for limits on a state’s ability to prohibit these practices.

Here is the impact. If states cannot regulate this, licensed providers gain more protection to engage in practices that major medical and mental health organizations have already identified as harmful. There were NO mental health professionals consulted in this ruling. 

This shifts protection away from vulnerable clients and toward those in positions of power.

Naming the Practice for What It Is

The term “conversion therapy” suggests treatment.

That is inaccurate.

This is conversion abuse.
This is coercive identity suppression.

These practices attempt to change or suppress a person’s sexual orientation or gender identity through authority, shame, and fear.

From a clinical perspective, the structure is clear.
There is a power imbalance.
There is coercion.
There is removal of autonomy.

That meets the definition of abuse.

What the Data Shows

The harm is well documented.

Research supported by the NIH and large national studies on LGBTQ youth show consistent outcomes.

• LGBTQ youth exposed to conversion efforts are more than twice as likely to attempt suicide compared to those who are not exposed.

• One large study found about 28% of youth exposed to these practices reported a suicide attempt, compared to around 12% who were not exposed.

• Exposure before age 18 is associated with higher rates of depression, anxiety, severe psychological distress, and long term trauma symptoms.

These findings repeat across studies.

This is not a question of belief. This is a question of measurable harm.

What I See in the Therapy Room

People who have experienced conversion abuse do not come in confused about who they are.

They come in after being told who they are is wrong.

They present with:

• chronic shame

• dissociation

• hypervigilance

• fear tied to identity expression

• difficulty trusting their own thoughts and feelings

Many folks have learned to disconnect from themselves in order to stay safe in environments where authenticity historically led to punishment.

That is not identity exploration.
That is trauma adaptation.

The Link to Religious Trauma and High-Control Systems

Conversion abuse often exists within high-control environments.

The patterns are consistent with what we see in religious trauma and cult dynamics:

• authority defines identity

• questioning is punished

• fear is used to enforce compliance

• belonging is conditional

When identity becomes something controlled by an external authority, the nervous system shifts into survival mode.

People suppress parts of themselves to avoid rejection, harm, or abandonment.

That suppression does not resolve distress. It internalizes it.

Book Bans and the Removal of Representation

At the same time, there is a growing push to remove books with queer and trans representation from schools and libraries.

This is not separate from what is happening in the courts.

Representation serves a critical psychological function.
It provides language.
It reduces isolation.
It supports identity development.

When you remove representation, you remove access to self-understanding. I use literature in the therapy space constantly to support my clients and to give them something they can see themselves in, and see someone like them flourishing and thriving.

A young person who cannot see themselves reflected anywhere is more likely to internalize shame and accept narratives that frame them as wrong.

That increases vulnerability to coercive systems, including conversion abuse.

The Ethical Responsibility of Therapists

As a licensed clinical social worker, I am bound by the NASW Code of Ethics.

Three principles are central here:

• self determination

• nonmaleficence

• dignity and worth of the person

Conversion abuse violates all three.

A client cannot exercise self determination if their identity is treated as something to change.

A provider violates nonmaleficence when engaging in practices known to increase suicide risk and psychological distress.

Dignity is undermined when identity is framed as disordered or immoral.

This is not an ethical gray area within the profession.

I am beyond livid as I type this thinking about the catastrophic impacts of this ruling.

The Larger Pattern

When you look at these issues together, a pattern emerges.

Limit access to affirming information.
Remove representation.
Frame identity as dangerous or immoral.
Protect systems that enforce conformity.

This is how erasure operates.

It does not begin with identity disappearing.
It begins with making identity unsafe to acknowledge.

The Psychological Impact Right Now

When your existence becomes a topic of legal debate, your nervous system responds.

I am seeing increases in:

• anxiety and hypervigilance

• emotional shutdown

• identity suppression driven by fear

• internalized stigma

These responses are not exaggerated. They are adaptive responses to perceived threat.

What Ethical, Affirming Care Looks Like

Affirming therapy does not attempt to direct identity.

It supports you in understanding yourself.

It focuses on:

• restoring autonomy

• rebuilding trust in your internal experience

• processing trauma without reinforcing shame

No ethical framework supports attempting to change a person’s core identity.

What Needs to Happen

At the policy level:
States need the ability to ban conversion abuse and protect minors from these practices.

At the professional level:
Mental health providers must adhere to ethical standards and refuse to legitimize harmful practices.

At the community level:
Access to queer and trans representation must remain protected.
Support for queer-led organizations needs to increase.

At the individual level:
Seek affirming care.
Build supportive networks.
Stay informed about policy changes that impact your safety.

Refusing Erasure

This is not about competing beliefs.

This is about whether systems are allowed to override a person’s identity under the label of care.

Queer and trans identities are not conditions.
They are not symptoms.
They are not problems to solve.

The harm comes from systems that insist they are.