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Can Therapists Refuse Conversion Therapy if Parents Request It?
A licensed therapist can decline to provide conversion therapy when a parent asks for it, and the ethics codes that govern the profession point toward that refusal rather than away from it.
Yes. A licensed therapist can decline to provide conversion therapy when a parent asks for it, and the ethics codes that govern the profession point toward that refusal rather than away from it. When a family requests treatment intended to change a young person's sexual orientation or gender identity, the therapist's first obligation is to the person in the chair, not solely to the adult making the request. Declining is not a therapist overstepping. In most cases, it is the therapist doing exactly what their license requires.
That answer surprises many parents, especially parents of faith who came to a counselor in good conscience, hoping to help a child they love. This article walks through why refusal is permitted, what the profession's own rules say, how the 2026 Supreme Court decision in Chiles v. Salazar changed the legal picture (and what it left untouched), and what the evidence tells us about why so many clinicians say no.
Therapists can refuse, and their ethics codes back that choice
A therapist who declines to attempt sexual orientation or gender identity change is acting within, not against, professional standards. Two duties sit at the center of clinical ethics: the obligation to avoid harm, and the obligation to base treatment on the best available evidence. Because attempts to change orientation or gender identity have no demonstrated efficacy and a documented association with harm, offering them can place a clinician in conflict with their own code of conduct. Refusal resolves that conflict.
Informed consent reinforces the same conclusion. Practitioners have a duty to ensure clients understand the nature, risks, and limits of any proposed service before it begins. As one 2026 analysis of the post-ruling landscape put it, a practice being legally permissible does not make it clinically appropriate. A therapist weighing a parent's request is expected to explain what the research shows, explore the family's underlying concerns, and offer supported alternatives.
Who is the client when a parent requests therapy for a minor?
When a parent brings a minor for counseling, the young person is the client whose welfare governs the clinician's decisions. This is the quiet pivot most families do not expect. A therapist can hear a parent's fears with compassion and still conclude that the treatment being requested would harm the child they were hired to help. The American Medical Association, in a widely cited teaching case, walks a physician through exactly this tension: a devout family asks for help steering a son away from being gay, and the clinician's duty of care runs to the boy's long-term health, not to the parents' request.
This does not mean a therapist dismisses a parent. Good practice begins with nonjudgmental inquiry: what the family understands about the practice, what they fear, and what alternatives they have considered. The goal is to keep the family in the room while protecting the young person from an intervention the evidence does not support.
Every major medical body opposes conversion therapy
Refusal is not one clinician's personal politics. It reflects a consensus that spans essentially every mainstream medical and mental health organization in the United States. The practice, often labeled sexual orientation change efforts or SOGICE in the literature, has been rejected across the field for decades.
Organization | Position |
|---|---|
American Psychological Association | Opposes SOCE; cites risk of harm and lack of efficacy |
American Psychiatric Association | Opposes therapy premised on LGBTQ+ identity as illness |
American Academy of Pediatrics | Opposes; flags risk to minors |
American Academy of Child & Adolescent Psychiatry | Opposes for youth |
American Counseling Association | Advises against; cautions on referrals |
National Association of Social Workers | Opposes "reparative" and "conversion" therapies |
American Medical Association | Opposes the practice |
SAMHSA (federal) | Called to end the practice for youth in 2015 |
The federal Substance Abuse and Mental Health Services Administration called for an end to the practice for children and adolescents in 2015, a position developed with input from the broader clinical community. A therapist declining a parent's request is standing on that shared ground.
Does Chiles v. Salazar force therapists to provide conversion therapy? No.
The Supreme Court's 2026 decision in Chiles v. Salazar limited how states may ban talk therapy aimed at changing identity. It did nothing to require any therapist to offer it. On March 31, 2026, the Court ruled 8 to 1 that Colorado's ban, as applied to a counselor's talk therapy, regulated speech based on viewpoint and had to survive strict scrutiny. The justices reversed the lower court and sent the case back for reconsideration under that stricter standard.
The distinction matters for families and clinicians alike. The ruling concerned a therapist who wanted to provide these services and challenged a law stopping her. It created no obligation running the other way. A clinician who believes the practice is harmful remains free to decline, and the ethical duties described above are unchanged by the decision. At the time of the ruling, 23 states and the District of Columbia had laws restricting conversion therapy for minors, and the decision placed those laws in legal jeopardy without compelling a single therapist to perform the practice.
A therapist's right to say no did not depend on a state ban, and it did not disappear when one fell.
Why so many clinicians refuse: the documented harms
Therapists decline because the record on outcomes is stark, and much of it centers on the exact age group parents are trying to protect. Research consistently ties conversion therapy to depression, anxiety, suicidality, substance misuse, loss of community, and damaged family relationships.
Suicide risk. In peer-reviewed work by researchers at the Trevor Project, young people who underwent conversion therapy were more than twice as likely to report a suicide attempt than LGBTQ+ peers who did not. A more recent brief found that the more recently a young person was exposed, the higher their reported rates of considering and attempting suicide.
The parental dimension specifically. One study isolated four minority-stress experiences, including attempts by parents to change a child's identity. Young people who faced all four had twelve times the odds of a suicide attempt compared with those who faced none. The request itself, coming from a parent, is part of the harm the research describes.
Alienation from the family unit. The landmark work of Caitlin Ryan and colleagues at the Family Acceptance Project found that young adults who experienced high family rejection in adolescence were 8.4 times more likely to have attempted suicide and nearly six times as likely to report severe depression. Conversion therapy communicates rejection in one of its most formal forms.
Alienation from church and community. The same body of evidence links these practices to loss of connection with the communities that once anchored a young person, including their congregation. For families of faith, this is the cruel irony: an intervention sought to keep a child close to the family and the church is associated with driving them away from both.
Scale. The human and economic weight is measurable. A 2022 study in JAMA Pediatrics estimated that conversion therapy and its associated harms cost the United States roughly 9.23 billion dollars a year.
What ethical therapists offer instead
A therapist who declines conversion therapy is not declining to help. The alternative is care that keeps the young person safe while supporting the family through a hard season. Clinicians are guided to provide accurate information, strengthen family and school support, and reduce rejection of the young person, an approach the American Psychological Association has advised families to seek out directly.
For religious families, the most encouraging finding is that acceptance is protective and that small changes help. Trevor Project data links an affirming home to 37% lower odds of suicidal thoughts, and high family support to markedly lower odds still. The Family Acceptance Project built a family-centered model designed for ethnically and religiously diverse families precisely so parents can support a child without abandoning deeply held values. That is the work a good therapist offers in place of the request a parent walked in with.
Frequently asked questions
Can a therapist legally refuse to provide conversion therapy? Yes. No law requires a therapist to perform conversion therapy, and professional ethics codes give clinicians clear grounds to decline. The 2026 Chiles v. Salazar decision limited how states may ban the practice; it did not compel any therapist to offer it.
Is conversion therapy still legal after Chiles v. Salazar? The ruling did not legalize or endorse the practice. It held that Colorado's ban on identity-change talk therapy must be reviewed under strict scrutiny and returned the case to a lower court. State bans for minors remain contested, but every major medical association continues to oppose the practice.
Who is the client when a parent requests therapy for a minor? The minor is the client whose welfare guides the clinician's decisions. A therapist can respect a parent's concerns while concluding that a requested treatment would harm the young person they are treating.
Does refusing conversion therapy violate a parent's rights? No. Parents can seek care for their children, but they cannot compel a licensed professional to deliver an intervention the clinician judges harmful and unsupported by evidence. Refusal is consistent with informed consent and the duty to avoid harm.
What are the risks of conversion therapy for minors? Peer-reviewed research associates it with depression, anxiety, substance misuse, family and community estrangement, and more than double the risk of a suicide attempt among youth who undergo it.
What can parents ask a therapist for instead? Parents can ask for accurate information about identity, family counseling that lowers conflict, and support that strengthens the relationship. Family acceptance is one of the strongest protective factors against suicide risk.
Recent posts
Can Therapists Refuse Conversion Therapy if Parents Request It?
A licensed therapist can decline to provide conversion therapy when a parent asks for it, and the ethics codes that govern the profession point toward that refusal rather than away from it.
Yes. A licensed therapist can decline to provide conversion therapy when a parent asks for it, and the ethics codes that govern the profession point toward that refusal rather than away from it. When a family requests treatment intended to change a young person's sexual orientation or gender identity, the therapist's first obligation is to the person in the chair, not solely to the adult making the request. Declining is not a therapist overstepping. In most cases, it is the therapist doing exactly what their license requires.
That answer surprises many parents, especially parents of faith who came to a counselor in good conscience, hoping to help a child they love. This article walks through why refusal is permitted, what the profession's own rules say, how the 2026 Supreme Court decision in Chiles v. Salazar changed the legal picture (and what it left untouched), and what the evidence tells us about why so many clinicians say no.
Therapists can refuse, and their ethics codes back that choice
A therapist who declines to attempt sexual orientation or gender identity change is acting within, not against, professional standards. Two duties sit at the center of clinical ethics: the obligation to avoid harm, and the obligation to base treatment on the best available evidence. Because attempts to change orientation or gender identity have no demonstrated efficacy and a documented association with harm, offering them can place a clinician in conflict with their own code of conduct. Refusal resolves that conflict.
Informed consent reinforces the same conclusion. Practitioners have a duty to ensure clients understand the nature, risks, and limits of any proposed service before it begins. As one 2026 analysis of the post-ruling landscape put it, a practice being legally permissible does not make it clinically appropriate. A therapist weighing a parent's request is expected to explain what the research shows, explore the family's underlying concerns, and offer supported alternatives.
Who is the client when a parent requests therapy for a minor?
When a parent brings a minor for counseling, the young person is the client whose welfare governs the clinician's decisions. This is the quiet pivot most families do not expect. A therapist can hear a parent's fears with compassion and still conclude that the treatment being requested would harm the child they were hired to help. The American Medical Association, in a widely cited teaching case, walks a physician through exactly this tension: a devout family asks for help steering a son away from being gay, and the clinician's duty of care runs to the boy's long-term health, not to the parents' request.
This does not mean a therapist dismisses a parent. Good practice begins with nonjudgmental inquiry: what the family understands about the practice, what they fear, and what alternatives they have considered. The goal is to keep the family in the room while protecting the young person from an intervention the evidence does not support.
Every major medical body opposes conversion therapy
Refusal is not one clinician's personal politics. It reflects a consensus that spans essentially every mainstream medical and mental health organization in the United States. The practice, often labeled sexual orientation change efforts or SOGICE in the literature, has been rejected across the field for decades.
Organization | Position |
|---|---|
American Psychological Association | Opposes SOCE; cites risk of harm and lack of efficacy |
American Psychiatric Association | Opposes therapy premised on LGBTQ+ identity as illness |
American Academy of Pediatrics | Opposes; flags risk to minors |
American Academy of Child & Adolescent Psychiatry | Opposes for youth |
American Counseling Association | Advises against; cautions on referrals |
National Association of Social Workers | Opposes "reparative" and "conversion" therapies |
American Medical Association | Opposes the practice |
SAMHSA (federal) | Called to end the practice for youth in 2015 |
The federal Substance Abuse and Mental Health Services Administration called for an end to the practice for children and adolescents in 2015, a position developed with input from the broader clinical community. A therapist declining a parent's request is standing on that shared ground.
Does Chiles v. Salazar force therapists to provide conversion therapy? No.
The Supreme Court's 2026 decision in Chiles v. Salazar limited how states may ban talk therapy aimed at changing identity. It did nothing to require any therapist to offer it. On March 31, 2026, the Court ruled 8 to 1 that Colorado's ban, as applied to a counselor's talk therapy, regulated speech based on viewpoint and had to survive strict scrutiny. The justices reversed the lower court and sent the case back for reconsideration under that stricter standard.
The distinction matters for families and clinicians alike. The ruling concerned a therapist who wanted to provide these services and challenged a law stopping her. It created no obligation running the other way. A clinician who believes the practice is harmful remains free to decline, and the ethical duties described above are unchanged by the decision. At the time of the ruling, 23 states and the District of Columbia had laws restricting conversion therapy for minors, and the decision placed those laws in legal jeopardy without compelling a single therapist to perform the practice.
A therapist's right to say no did not depend on a state ban, and it did not disappear when one fell.
Why so many clinicians refuse: the documented harms
Therapists decline because the record on outcomes is stark, and much of it centers on the exact age group parents are trying to protect. Research consistently ties conversion therapy to depression, anxiety, suicidality, substance misuse, loss of community, and damaged family relationships.
Suicide risk. In peer-reviewed work by researchers at the Trevor Project, young people who underwent conversion therapy were more than twice as likely to report a suicide attempt than LGBTQ+ peers who did not. A more recent brief found that the more recently a young person was exposed, the higher their reported rates of considering and attempting suicide.
The parental dimension specifically. One study isolated four minority-stress experiences, including attempts by parents to change a child's identity. Young people who faced all four had twelve times the odds of a suicide attempt compared with those who faced none. The request itself, coming from a parent, is part of the harm the research describes.
Alienation from the family unit. The landmark work of Caitlin Ryan and colleagues at the Family Acceptance Project found that young adults who experienced high family rejection in adolescence were 8.4 times more likely to have attempted suicide and nearly six times as likely to report severe depression. Conversion therapy communicates rejection in one of its most formal forms.
Alienation from church and community. The same body of evidence links these practices to loss of connection with the communities that once anchored a young person, including their congregation. For families of faith, this is the cruel irony: an intervention sought to keep a child close to the family and the church is associated with driving them away from both.
Scale. The human and economic weight is measurable. A 2022 study in JAMA Pediatrics estimated that conversion therapy and its associated harms cost the United States roughly 9.23 billion dollars a year.
What ethical therapists offer instead
A therapist who declines conversion therapy is not declining to help. The alternative is care that keeps the young person safe while supporting the family through a hard season. Clinicians are guided to provide accurate information, strengthen family and school support, and reduce rejection of the young person, an approach the American Psychological Association has advised families to seek out directly.
For religious families, the most encouraging finding is that acceptance is protective and that small changes help. Trevor Project data links an affirming home to 37% lower odds of suicidal thoughts, and high family support to markedly lower odds still. The Family Acceptance Project built a family-centered model designed for ethnically and religiously diverse families precisely so parents can support a child without abandoning deeply held values. That is the work a good therapist offers in place of the request a parent walked in with.
Frequently asked questions
Can a therapist legally refuse to provide conversion therapy? Yes. No law requires a therapist to perform conversion therapy, and professional ethics codes give clinicians clear grounds to decline. The 2026 Chiles v. Salazar decision limited how states may ban the practice; it did not compel any therapist to offer it.
Is conversion therapy still legal after Chiles v. Salazar? The ruling did not legalize or endorse the practice. It held that Colorado's ban on identity-change talk therapy must be reviewed under strict scrutiny and returned the case to a lower court. State bans for minors remain contested, but every major medical association continues to oppose the practice.
Who is the client when a parent requests therapy for a minor? The minor is the client whose welfare guides the clinician's decisions. A therapist can respect a parent's concerns while concluding that a requested treatment would harm the young person they are treating.
Does refusing conversion therapy violate a parent's rights? No. Parents can seek care for their children, but they cannot compel a licensed professional to deliver an intervention the clinician judges harmful and unsupported by evidence. Refusal is consistent with informed consent and the duty to avoid harm.
What are the risks of conversion therapy for minors? Peer-reviewed research associates it with depression, anxiety, substance misuse, family and community estrangement, and more than double the risk of a suicide attempt among youth who undergo it.
What can parents ask a therapist for instead? Parents can ask for accurate information about identity, family counseling that lowers conflict, and support that strengthens the relationship. Family acceptance is one of the strongest protective factors against suicide risk.
Recent posts
Can Therapists Refuse Conversion Therapy if Parents Request It?
A licensed therapist can decline to provide conversion therapy when a parent asks for it, and the ethics codes that govern the profession point toward that refusal rather than away from it.
Yes. A licensed therapist can decline to provide conversion therapy when a parent asks for it, and the ethics codes that govern the profession point toward that refusal rather than away from it. When a family requests treatment intended to change a young person's sexual orientation or gender identity, the therapist's first obligation is to the person in the chair, not solely to the adult making the request. Declining is not a therapist overstepping. In most cases, it is the therapist doing exactly what their license requires.
That answer surprises many parents, especially parents of faith who came to a counselor in good conscience, hoping to help a child they love. This article walks through why refusal is permitted, what the profession's own rules say, how the 2026 Supreme Court decision in Chiles v. Salazar changed the legal picture (and what it left untouched), and what the evidence tells us about why so many clinicians say no.
Therapists can refuse, and their ethics codes back that choice
A therapist who declines to attempt sexual orientation or gender identity change is acting within, not against, professional standards. Two duties sit at the center of clinical ethics: the obligation to avoid harm, and the obligation to base treatment on the best available evidence. Because attempts to change orientation or gender identity have no demonstrated efficacy and a documented association with harm, offering them can place a clinician in conflict with their own code of conduct. Refusal resolves that conflict.
Informed consent reinforces the same conclusion. Practitioners have a duty to ensure clients understand the nature, risks, and limits of any proposed service before it begins. As one 2026 analysis of the post-ruling landscape put it, a practice being legally permissible does not make it clinically appropriate. A therapist weighing a parent's request is expected to explain what the research shows, explore the family's underlying concerns, and offer supported alternatives.
Who is the client when a parent requests therapy for a minor?
When a parent brings a minor for counseling, the young person is the client whose welfare governs the clinician's decisions. This is the quiet pivot most families do not expect. A therapist can hear a parent's fears with compassion and still conclude that the treatment being requested would harm the child they were hired to help. The American Medical Association, in a widely cited teaching case, walks a physician through exactly this tension: a devout family asks for help steering a son away from being gay, and the clinician's duty of care runs to the boy's long-term health, not to the parents' request.
This does not mean a therapist dismisses a parent. Good practice begins with nonjudgmental inquiry: what the family understands about the practice, what they fear, and what alternatives they have considered. The goal is to keep the family in the room while protecting the young person from an intervention the evidence does not support.
Every major medical body opposes conversion therapy
Refusal is not one clinician's personal politics. It reflects a consensus that spans essentially every mainstream medical and mental health organization in the United States. The practice, often labeled sexual orientation change efforts or SOGICE in the literature, has been rejected across the field for decades.
Organization | Position |
|---|---|
American Psychological Association | Opposes SOCE; cites risk of harm and lack of efficacy |
American Psychiatric Association | Opposes therapy premised on LGBTQ+ identity as illness |
American Academy of Pediatrics | Opposes; flags risk to minors |
American Academy of Child & Adolescent Psychiatry | Opposes for youth |
American Counseling Association | Advises against; cautions on referrals |
National Association of Social Workers | Opposes "reparative" and "conversion" therapies |
American Medical Association | Opposes the practice |
SAMHSA (federal) | Called to end the practice for youth in 2015 |
The federal Substance Abuse and Mental Health Services Administration called for an end to the practice for children and adolescents in 2015, a position developed with input from the broader clinical community. A therapist declining a parent's request is standing on that shared ground.
Does Chiles v. Salazar force therapists to provide conversion therapy? No.
The Supreme Court's 2026 decision in Chiles v. Salazar limited how states may ban talk therapy aimed at changing identity. It did nothing to require any therapist to offer it. On March 31, 2026, the Court ruled 8 to 1 that Colorado's ban, as applied to a counselor's talk therapy, regulated speech based on viewpoint and had to survive strict scrutiny. The justices reversed the lower court and sent the case back for reconsideration under that stricter standard.
The distinction matters for families and clinicians alike. The ruling concerned a therapist who wanted to provide these services and challenged a law stopping her. It created no obligation running the other way. A clinician who believes the practice is harmful remains free to decline, and the ethical duties described above are unchanged by the decision. At the time of the ruling, 23 states and the District of Columbia had laws restricting conversion therapy for minors, and the decision placed those laws in legal jeopardy without compelling a single therapist to perform the practice.
A therapist's right to say no did not depend on a state ban, and it did not disappear when one fell.
Why so many clinicians refuse: the documented harms
Therapists decline because the record on outcomes is stark, and much of it centers on the exact age group parents are trying to protect. Research consistently ties conversion therapy to depression, anxiety, suicidality, substance misuse, loss of community, and damaged family relationships.
Suicide risk. In peer-reviewed work by researchers at the Trevor Project, young people who underwent conversion therapy were more than twice as likely to report a suicide attempt than LGBTQ+ peers who did not. A more recent brief found that the more recently a young person was exposed, the higher their reported rates of considering and attempting suicide.
The parental dimension specifically. One study isolated four minority-stress experiences, including attempts by parents to change a child's identity. Young people who faced all four had twelve times the odds of a suicide attempt compared with those who faced none. The request itself, coming from a parent, is part of the harm the research describes.
Alienation from the family unit. The landmark work of Caitlin Ryan and colleagues at the Family Acceptance Project found that young adults who experienced high family rejection in adolescence were 8.4 times more likely to have attempted suicide and nearly six times as likely to report severe depression. Conversion therapy communicates rejection in one of its most formal forms.
Alienation from church and community. The same body of evidence links these practices to loss of connection with the communities that once anchored a young person, including their congregation. For families of faith, this is the cruel irony: an intervention sought to keep a child close to the family and the church is associated with driving them away from both.
Scale. The human and economic weight is measurable. A 2022 study in JAMA Pediatrics estimated that conversion therapy and its associated harms cost the United States roughly 9.23 billion dollars a year.
What ethical therapists offer instead
A therapist who declines conversion therapy is not declining to help. The alternative is care that keeps the young person safe while supporting the family through a hard season. Clinicians are guided to provide accurate information, strengthen family and school support, and reduce rejection of the young person, an approach the American Psychological Association has advised families to seek out directly.
For religious families, the most encouraging finding is that acceptance is protective and that small changes help. Trevor Project data links an affirming home to 37% lower odds of suicidal thoughts, and high family support to markedly lower odds still. The Family Acceptance Project built a family-centered model designed for ethnically and religiously diverse families precisely so parents can support a child without abandoning deeply held values. That is the work a good therapist offers in place of the request a parent walked in with.
Frequently asked questions
Can a therapist legally refuse to provide conversion therapy? Yes. No law requires a therapist to perform conversion therapy, and professional ethics codes give clinicians clear grounds to decline. The 2026 Chiles v. Salazar decision limited how states may ban the practice; it did not compel any therapist to offer it.
Is conversion therapy still legal after Chiles v. Salazar? The ruling did not legalize or endorse the practice. It held that Colorado's ban on identity-change talk therapy must be reviewed under strict scrutiny and returned the case to a lower court. State bans for minors remain contested, but every major medical association continues to oppose the practice.
Who is the client when a parent requests therapy for a minor? The minor is the client whose welfare guides the clinician's decisions. A therapist can respect a parent's concerns while concluding that a requested treatment would harm the young person they are treating.
Does refusing conversion therapy violate a parent's rights? No. Parents can seek care for their children, but they cannot compel a licensed professional to deliver an intervention the clinician judges harmful and unsupported by evidence. Refusal is consistent with informed consent and the duty to avoid harm.
What are the risks of conversion therapy for minors? Peer-reviewed research associates it with depression, anxiety, substance misuse, family and community estrangement, and more than double the risk of a suicide attempt among youth who undergo it.
What can parents ask a therapist for instead? Parents can ask for accurate information about identity, family counseling that lowers conflict, and support that strengthens the relationship. Family acceptance is one of the strongest protective factors against suicide risk.