The Supreme Court has refused to hear a case challenging Washington state's ban on so-called gay "conversion therapy" for licensed therapists, allowing the law to remain intact. Justices Samuel Alito, Clarence Thomas, and Brett Kavanaugh publicly dissented from the denial, stating that they would have granted a review of the case. The case was brought by Brian Tingley, a licensed counselor practicing in the state for over two decades, who argued that the law violated his First Amendment rights by dictating what he can discuss with patients in "talk therapy," particularly those dealing with gender dysphoria and related issues.

Under the Washington state law, licensed counselors cannot express any opinion other than the state-approved viewpoint on minors with gender dysphoria without facing punishment. Justice Thomas, in his dissent, criticized the Ninth Circuit for condoning this regime and expressed his belief that the issue would come before the Court again. He argued that the Court should have granted certiorari to consider what the First Amendment requires.

Lawyers at Alliance Defending Freedom (ADF), a nonprofit civil rights firm representing Tingley, had argued that the government should not be able to control a counselor's speech. They claimed that the law violated freedom of speech and harmed both counselors and clients. The law threatens fines, suspension, and possible revocation of a counselor's license for violations.

The Supreme Court's decision not to hear the case upholds a 2018 Washington state law that prohibits licensed therapists from performing conversion therapy on individuals under the age of 18. Conversion therapy is defined as a "regime that seeks to change an individual's sexual orientation or gender identity." The law does not prevent licensed therapists from expressing their views about conversion therapy with minor clients, recommending it be performed by religious counselors, or promoting it publicly or privately.

In his dissent, Justice Thomas argued that Washington's law is viewpoint-based and content-based discrimination, as it restricts the message that licensed counselors can convey to minors. Justices Alito and Kavanaugh also dissented, with Alito stating that the case raises a question "of national importance" and arguing that all restrictions on speech should receive careful scrutiny.

The decision not to take up the appeal leaves intact a lower court opinion that upheld the law. Judge Ronald Gould, writing for the U.S. Court of Appeals for the 9th Circuit, stated that Washington's licensing scheme for health care providers, which disciplines them for practicing conversion therapy on minors, does not violate the First or Fourteenth Amendments. The 9th Circuit panel's decision was affirmed by the full 9th Circuit.

The Alliance Defending Freedom, representing Tingley, argued that the panel's decision has devastating consequences for young people with gender dysphoria who live in states with similar laws, as they will be deprived of care. They claimed that Tingley's clients seek his counsel voluntarily because they want the help his viewpoint provides, and that the law prevents him from speaking freely. They emphasized that a private conversation is speech, not conduct, and that the government cannot silence professional speech.

Washington state officials, on the other hand, urged the Supreme Court to uphold the 9th Circuit's decision. They argued that states have the power to regulate conduct by licensed professionals, even if those rules incidentally impact speech. They noted that Tingley is the only licensed therapist in Washington who has alleged harm from the law and stated that any licensed therapist who wants to perform conversion therapy on minors can do so in other capacities, such as religious counseling. Major medical and mental health associations have rejected conversion therapy, and 26 states and the District of Columbia have restricted the practice on minors.

Overall, the Supreme Court's refusal to hear the case maintains Washington state's ban on conversion therapy for licensed therapists, despite concerns about its impact on freedom of speech. Justices Thomas, Alito, and Kavanaugh expressed their dissent, arguing that the law infringes upon First Amendment rights. The decision has implications for the regulation of speech in the context of therapy and counseling, and the issue may come before the Court again in the future.