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`Appellate Case: 22-1445 Document: 010110855630 Date Filed: 05/05/2023 Page: 1 Appellate Case: 22-1445 Document: 101 Date Filed: 05/05/2023 Page: 1
`
`Nos. 22-1445 & 23-1002
`
`
`
`
`
`IN THE UNITED STATES COURT OF APPEALS
`FOR THE TENTH CIRCUIT
`
`
`KALEY CHILES,
`Plaintiff-Appellant/Cross-Appellee,
`v.
`PATTY SALAZAR, in her official capacity as Executive Director of
`the Department of Regulatory Agencies, et al.,
`Defendants-Appellees/Cross-Appellants.
`
`
`On Appeal from the United States District Court
`for the District of Colorado
`
`
`BRIEF OF AMICI CURIAE THE TREVOR PROJECT, INC.,
`AMERICAN FOUNDATION FOR SUICIDE PREVENTION,
`AND AMERICAN ASSOCIATION OF SUICIDOLOGY,
`IN SUPPORT OF DEFENDANTS-APPELLEES/CROSS-
`APPELLANTS
`
`Shireen A. Barday
`Mark C. Davies
`PALLAS PARTNERS (US) LLP
`75 Rockefeller Plaza
`New York, NY 10019
`
`Kate Googins
`Caelin Moriarity Miltko
`GIBSON, DUNN & CRUTCHER LLP
`1801 California Street, Suite 4200
`Denver, CO 80202
`
`
`
`Abbey Hudson
`Theo Takougang
`GIBSON, DUNN & CRUTCHER LLP
`333 South Grand Avenue
`Los Angeles, CA 90071
`(213) 229-7000
`ahudson@gibsondunn.com
`
`Kelly E. Herbert
`GIBSON, DUNN & CRUTCHER LLP
`200 Park Avenue
`New York, NY 10166
`
`Attorneys for Amici Curiae The Trevor Project, Inc., American Foundation for
`Suicide Prevention, and American Association of Suicidology
`
`[additional listed counsel on inside cover]
`
`

`

`
`
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`
`
`
`Maxwell A. Baldi
`Brandon Willmore
`GIBSON, DUNN & CRUTCHER LLP
`1050 Connecticut Avenue, N.W.
`Washington, DC 20036
`
`
`
`
`
`
`

`

`
`
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`
`CORPORATE DISCLOSURE STATEMENT
`
`Pursuant to Federal Rule of Appellate Procedure 26.1, Amicus
`
`Curiae The Trevor Project, Inc. certifies that it is a non-profit crisis
`
`services, advocacy and research organization that has no publicly held
`
`corporate parents, affiliates, and/or subsidiaries.
`
`Pursuant to Federal Rule of Appellate Procedure 26.1, Amicus
`
`Curiae American Foundation for Suicide Prevention certifies that it is a
`
`non-profit health, research, education, and advocacy organization that
`
`has no publicly held corporate parents, affiliates, and/or subsidiaries.
`
`Pursuant to Federal Rule of Appellate Procedure 26.1, Amicus
`
`Curiae American Association of Suicidology certifies that it is a non-profit
`
`health, research, education, and advocacy organization that has no
`
`publicly held corporate parents, affiliates, and/or subsidiaries.
`
`
`
`
`
`i
`
`
`
`

`

`
`
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`
`
`
`B.
`
`TABLE OF CONTENTS
`INTRODUCTION ....................................................................................... 4
`ARGUMENT ............................................................................................... 7
`I. Colorado’s Statute Redresses Significant Harms to the Health
`and Safety of Minors. ........................................................................ 7
`A. The Trevor Project’s Data Confirms That Conversion
`Therapy Causes Significant Harm to LGBTQ Youth. ........... 9
`Social Science Overwhelmingly Confirms the
`Significant Harm of Conversion Therapy on LGBTQ
`Youth. ..................................................................................... 18
`C. Every Major Medical and Mental Health Organization
`Has Rejected Conversion Therapy as Scientifically
`Unsound, Harmful to the Recipient, and Ineffective at
`Changing Sexual Orientation or Gender Identity. .............. 26
`D. Uninterrupted Enforcement of Colorado’s Law Is
`Crucial to Preventing this Significant Harm to LGBTQ
`Youth. ..................................................................................... 32
`CONCLUSION ......................................................................................... 34
`CERTIFICATE OF COMPLIANCE ........................................................ 36
`CERTIFICATE OF SERVICE ................................................................. 37
`
`ii
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`

`

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`
`
`
`
`TABLE OF AUTHORITIES
`
`CASES
`
`Doyle v. Hogan,
`411 F. Supp. 3d 337 (D. Md. 2019) ...................................................... 33
`
`Evergreen Ass’n v. City of New York,
`740 F.3d 233 (2d Cir. 2014) .................................................................... 5
`
`Nat’l Inst. of Family & Life Advocates v. Becerra,
`138 S. Ct. 2361 (2018) ............................................................................. 5
`
`Sammon v. N.J. Bd. of Med. Examiners,
`66 F.3d 639 (3d Cir. 1995) ...................................................................... 5
`
`Tingley v. Ferguson,
`47 F.4th 1055 (9th Cir. 2022) ........................................................... 5, 33
`
`Turner Broad. Sys., Inc. v. FCC,
`520 U.S. 180 (1997) ............................................................................... 22
`
`United States v. Rutherford,
`442 U.S. 544 (1979) ................................................................................. 8
`
`Winter v. Nat. Res. Def. Council, Inc.,
`555 U.S. 7 (2008) ............................................................................... 7, 33
`
`STATUTES
`
`Colo. Rev. Stat. § 12-240-104 .................................................................. 5, 7
`
`Colo. Rev. Stat. § 12-240-121 .................................................................. 5, 7
`
`Colo. Rev. Stat. § 12-245-202 .................................................................. 5, 7
`
`Colo. Rev. Stat. § 12-245-224 .................................................................. 5, 7
`
`iii
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`

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`
`
`
`
`OTHER AUTHORITIES
`
`Am. Acad. of Nursing, American Academy of Nursing Position
`Statement on Reparative Therapy, 63 Nursing Outlook 368 (May
`2015), https://www.nursingoutlook.org/article/S0029-6554(15)00125-
`6/pdf; ...................................................................................................... 27
`
`Am. Acad. Pediatrics, Homosexuality and Adolescence, 92 Pediatrics 631
`(1993) ..................................................................................................... 30
`
`Am. Ass’n Child & Adolescent Psychiatry, Fact Sheet – Conversion
`Therapy (Sept. 2019),
`https://www.aacap.org/App_Themes/AACAP/docs/Advocacy/policy_re
`sources/AACAP-conversion-therapy-issue-brief.pdf ........................... 28
`
`Am. Ass‘n of Suicidology, Suicidal Behavior Among Lesbian, Gay,
`Bisexual, and Transgender Youth Fact Sheet (2019),
`https://suicidology.org/wp-content/uploads/2019/07/Updated-LGBT-
`Fact-Sheet.pdf ....................................................................................... 19
`
`Am. Found. for Suicide Prevention, LGBTQ Individuals & Populations,
`https://afsp.org/conversion-therapy-bans .............................................. 8
`
`Am. Found. for Suicide Prevention, Policy Priority: LGBTQ Individuals
`& Communities (2023), https://www.datocms-
`assets.com/12810/1677790627-lgbtq-individuals-populations-issue-
`brief-1-20-2023.pdf ................................................................................ 19
`
`Am. Found. for Suicide Prevention, Recent Legislation Targeting the
`Rights of Trans Individuals Deepens Concerns Around the Mental
`Health of LGBTQ Communities: Leading Suicide Prevention
`Organization Strongly Opposes Bills that Can Harm the Mental
`Health and Wellbeing of LGBTQ People (Apr. 26, 2023)
`https://afsp.org/story/recent-legislation-targeting-the-rights-of-trans-
`individuals-deepens-concerns-aro ........................................................ 28
`
`Am. Med. Ass’n, Health Care Needs of Lesbian, Gay, Bisexual,
`Transgender and Queer Populations H-160.991,
`https://policysearch.ama-assn.org/policyfinder/detail/H-
`160.991?uri=%2FAMADoc%2FHOD.xml-0-805.xml .......................... 27
`
`
`
`iv
`
`

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`
`
`
`
`Am. Psychiatric Ass’n, Position Statement on Conversion Therapy and
`LGBTQ Patients (Dec. 2018),
`https://www.psychiatry.org/File%20Library/About-
`APA/Organization-Documents-Policies/Policies/Position-Conversion-
`Therapy.pdf ........................................................................................... 29
`
`Am. Psychiatric Ass’n, Report of the American Psychological Association
`Task Force on Appropriate Therapeutic Responses to Sexual
`Orientation (2009),
`https://www.apa.org/pi/lgbt/resources/therapeutic-response.pdf ....... 29
`
`Am. Psychol. Ass’n, APA Resolution on Sexual Orientation Change
`Efforts 5 (Feb. 2021), https://www.apa.org/about/policy/resolution-
`sexual-orientation-change-efforts.pdf .................................................. 30
`
`Am. Psychol. Ass’n, Just the Facts About Sexual Orientation and Youth
`(2008), http://www.apa.org/pi/lgbt/resources/just-the-facts.pdf ......... 27
`
`Amy E. Green et al., Self-Reported Conversion Efforts and Suicidality
`Among US LGBTQ Youths and Young Adults, 2018, 110 Am. J. Pub.
`Health 1221 (2020) ............................................................................... 13
`
`Amy Przeworski, et al., A Systematic Review of the Efficacy, Harmful
`Effects, and Ethical Issues Related to Sexual Orientation Change
`Efforts, 28 Clinical Psychol. Sci. & Prac. 81 (2020),
`https://psycnet.apa.org/fulltext/2021-45656-010.pdf .................... 18, 30
`
`Bente Birkeland, Colorado’s Statewide Conversion Therapy Ban Is Now
`In Effect, Colo. Pub. Radio (May 31, 2019), https://bit.ly/3KLwLgT .... 8
`
`Caitlin Ryan et al., Family Acceptance in Adolescence and the Health of
`LGBT Young Adults, 23 J. Child & Adolescent Psychiatric Nursing
`205 (2010), https://pubmed.ncbi.nlm.nih.gov/21073595/ .................... 25
`
`Caitlin Ryan et al., Parent-Initiated Sexual Orientation Change Efforts
`with LGBT Adolescents: Implications for Young Adult Mental Health
`and Adjustment, J. Homosexuality (Nov. 2018),
`https://www.utah.gov/pmn/files/513643.pdf .................................. 20, 23
`
`
`
`v
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`

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`
`
`
`
`Christina Buttons, Finland’s Leading Gender Dysphoria Expert Says 4
`Out of 5 Children Grow Out of Gender Confusion, Daily Wire (Feb. 6,
`2023) ...................................................................................................... 26
`
`Colo. Dep’t of Pub. Health & Envir., Healthy Kids Colorado Survey
`Dashboard (2019), https://cdphe.colorado.gov/center-for-health-and-
`environmental-data/survey-research/healthy-kids-colorado-survey-
`data ........................................................................................................ 13
`
`D. Paul Sullins, Sexual Orientation Change Efforts Do Not Increase
`Suicide: Correcting a False Research Narrative, 51 Archives of Sexual
`Behavior 3377 (Sept. 2022) .................................................................. 21
`
`Eliana Dockterman, Transgender Teen’s Death Sparks Outcry From
`Advocates, Time (Dec. 31, 2014), http://time.com/3651037/leelah-
`alcorn-transgender/............................................................................... 24
`
`European Psychiatric Ass’n, EPA Statement on Conversion “Therapies”
`and LGBTQ Patients (Jan. 2022),
`https://www.europsy.net/app/uploads/2022/01/EPA-statement-on-
`ban-on-conversion-therapy.pdf ............................................................ 31
`
`Ilan H. Meyer & John R. Blosnich, Commentary: Absence of Behavioral
`Harm Following Non-Efficacious Sexual Orientation Change Efforts:
`A Retrospective Study of United States Sexual Minority Adults, 2016–
`2018, 13 Frontiers in Psych. 997513 (2022) ................................. 21, 22
`
`Jason Rafferty et al., Ensuring Comprehensive Care and Support
`forTransgender and Gender-Diverse Children and Adolescents, 142
`Pediatrics 4,
`https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/
`Ensuring-Comprehensive-Care-and-Support-for ................................ 31
`
`Joanna Almeida et al., Emotional Distress Among LGBT Youth: The
`Influence of Perceived Discrimination Based on Sexual Orientation,
`38 J. Youth & Adolescence 1001 (2009),
`https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707280/pdf/nihms26
`1853.pdf ................................................................................................. 24
`
`
`
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`
`
`
`
`John R. Blosnich et al., Correcting a False Research Narrative: A
`Commentary on Sullins, 52 Archives of Sexual Behavior 885 (2023)
` ......................................................................................................... 21, 22
`
`John R. Blosnich et al., Sexual Orientation Change Efforts, Adverse
`Childhood Experiences, and Suicide Ideation and Attempt Among
`Sexual Minority Adults, United States, 2016–2018, 110 Am. J. Pub.
`Health 1024 (2020),
`https://dworakpeck.usc.edu/sites/default/files/2020-
`10/Blosnich%20Henderson%20Coulter_0.pdf ..................................... 19
`
`Joseph G. Kosciw et al., GLSEN, The 2015 National School Climate
`Survey: The Experiences of Lesbian, Gay, Bisexual, Transgender, and
`Queer Youth in Our Nation’s Schools (2016),
`https://www.glsen.org/sites/default/files/2020-
`01/GLSEN%202015%20National%20School%20Climate%20Survey%
`20%28NSCS%29%20-%20Full%20Report.pdf .................................... 25
`
`Laura Kann et al., Youth Risk Behavior Surveillance — United States,
`2017, 67 Ctrs. for Disease Control & Prevention Morbidity &
`Mortality Wkly. Rep. 23 (June 15, 2018),
`https://www.cdc.gov/mmwr/volumes/67/ss/pdfs/ss6708a1-H.pdf . 23, 24
`
`Lisa M. Diamond & Clifford J. Rosky, Scrutinizing Immutability:
`Research on Sexual Orientation & U.S. Legal Advocacy for Sexual
`Minorities, 53 J. of Sex Research 1 (2016) .......................................... 25
`
`Michelle M. Johns et al., Violence Victimization, Substance Use, and
`Suicide Risk Among Sexual Minority High School Students — United
`States, 2015–2017, 67 Morbidity and Mortality Wkly. Rep. 1211–15
`(Nov. 2, 2018),
`https://www.cdc.gov/mmwr/volumes/67/wr/mm6743a4.htm .............. 24
`
`Pan Am. Health Org., “Cures” for an Illness that Does Not Exist (2012),
`https://www3.paho.org/hq/dmdocuments/2012/Conversion-Therapies-
`EN.pdf ................................................................................................... 31
`
`
`
`vii
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`

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`
`
`
`
`Statista Rsch. Dep’t, U.S. LGBTQ Youth Who Experienced Conversion
`Therapy and Attempted Suicide 2021, Statista (May 10, 2022),
`https://www.statista.com/statistics/1053024/lgbtq-youth-in-us-
`attempted-suicide-conversion-therapy-experience/ ............................ 20
`
`Substance Abuse & Mental Health Servs. Admin., Moving Beyond
`Change Efforts: Evidence and Action to Support and Affirm
`LGBTQI+ Youth (2023),
`https://store.samhsa.gov/sites/default/files/pep22-03-12-001.pdf19, 27,
`28
`
`Sunnivie Brydum, WATCH: U.S. Surgeon General Opposes Conversion
`Therapy (Apr. 10, 2015), https://www.advocate.com/ex-gay-
`therapy/2015/04/10/watch-us-surgeon-general-opposes-conversion-
`therapy .................................................................................................. 28
`
`The Trevor Project, 2023 U.S. National Survey on the Mental Health of
`LGBTQ Young People (May 2023),
`https://www.thetrevorproject.org/survey-
`2023/assets/static/05_TREVOR05_2023survey.pdf ............9, 10, 11, 14
`
`The Trevor Project, Learn With Love: Episode 1, Youtube (Jan. 31,
`2023), https://www.youtube.com/watch?v=Yf8uH-GOQzc. ................ 17
`
`The Trevor Project, National Survey on LGBTQ Youth Mental Health
`(June 2019), https://www.thetrevorproject.org/wp-
`content/uploads/2019/06/The-Trevor-Project-National-Survey-
`Results-2019.pdf ............................................................................. 12, 13
`
`The Trevor Project, National Survey on LGBTQ Youth Mental Health
`(May 2022), https://www.thetrevorproject.org/survey-
`2022/assets/static/trevor01_2022survey_final.pdf ........................ 11, 12
`
`World Health Org., “Cures” For An Illness That Does Not Exist:
`Purported Therapies Aimed At Changing Sexual Orientation Lack
`Medical Justification And Are Ethically Unacceptable (May 17,
`2012),
`http://www.paho.org/hq/?option=com_docman&task=doc_view&gid=1
`7703&Itemid=270&lang=en ................................................................. 27
`
`
`
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`
`
`
`
`World Med. Ass’n, WMA Statement on Natural Variations of Human
`Sexuality (Oct. 2013), https://www.wma.net/policies-post/wma-
`statement-on-natural-variations-of-human-sexuality/ ....................... 31
`
`RULES
`
`Federal Rule of Appellate Procedure 29 .................................................... 3
`
`REGULATIONS
`
`87 Fed. Reg. 37189 (June 15, 2022) .......................................................... 27
`
`
`
`
`
`ix
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`
`
`
`IDENTITY AND INTEREST OF AMICI CURIAE AND SOURCE
`OF THEIR AUTHORITY TO FILE THIS BRIEF
`
`The Trevor Project, Inc. (“The Trevor Project”), the American
`
`Foundation for Suicide Prevention (“AFSP”), and The American
`
`Association of Suicidology (“AAS”) respectfully submit this brief to
`
`summarize the overwhelming evidence linking conversion therapy to a
`
`significantly heightened risk of suicidality and other serious harms.
`
`The Trevor Project is the nation’s leading lesbian, gay, bisexual,
`
`transgender, queer, and questioning (“LGBTQ”) youth crisis intervention
`
`and suicide prevention organization. The Trevor Project offers the only
`
`nationwide accredited, free, and confidential phone, instant message, and
`
`text messaging crisis intervention services for LGBTQ youth. These
`
`services are used by thousands of youth each month. Through analyzing
`
`and evaluating data obtained from these services and national surveys,
`
`The Trevor Project produces innovative research that brings new
`
`knowledge, with clinical implications, to issues affecting LGBTQ youth.
`
`AFSP is the nation’s leading suicide prevention organization
`
`dedicated to saving lives and bringing hope to those affected by suicide.
`
`In carrying out its mission, AFSP funds scientific research, educates the
`
`public about mental health and suicide prevention, advocates for public
`
`1
`
`

`

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`
`
`
`
`policies in mental health and suicide prevention, and supports survivors
`
`of suicide loss and those affected by suicide. To that end, as part of its
`
`overall mission of suicide prevention, AFSP funds research to better
`
`understand the experiences and suicide risk of LGBTQ people and
`
`supports public policies at the federal and state levels that improve
`
`mental health and reduce suicide risk for LGBTQ populations. AFSP is
`
`dedicated to improving access to evidence-based LGBTQ-affirming
`
`physical and mental health care that in turn reduces stigma, harm and
`
`suicide risk.
`
`AAS is the world’s largest and nation’s oldest membership-based
`
`suicide prevention organization promoting the understanding and
`
`prevention of suicide and the support for those who have been affected by
`
`it through research, education, advocacy and community programs.
`
`Amici have a special interest in this litigation as well as familiarity
`
`and knowledge of the significant harms that LGBTQ youth endure as a
`
`result of conversion therapy. Amici are deeply concerned a preliminary
`
`injunction in this case will place LGBTQ minors at an increased and
`
`substantial risk of suicidality. The Trevor Project works firsthand with
`
`LGBTQ youth who have endured these harmful practices—and
`
`
`
`2
`
`

`

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`
`
`
`
`understands the devastating impacts that these treatments inflict,
`
`including an increased risk of suicide. Due to the increased and
`
`substantial risks of suicidality, Amici advocate to end the practice of
`
`conversion therapy against minors through public policy. For these
`
`reasons, The Trevor Project, AFSP, and AAS have a substantial interest
`
`in supporting the enforcement of laws prohibiting the practice of
`
`conversion therapy against minors.1
`
`Amici have obtained consent to file this brief from both parties and
`
`therefore may file it pursuant to Federal Rule of Appellate Procedure
`
`29(a)(2).
`
`
`
`
`
`
`
`
`
` 1 No party or party’s counsel authored this brief in whole or in part or
`contributed money intended to fund preparing or submitting this brief.
`No person other than amici, its members, or its counsel contributed
`money that was intended to fund preparing or submitting the brief. See
`Fed. R. App. P. 29(a)(4)(E).
`
`
`
`3
`
`

`

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`
`
`
`INTRODUCTION
`
`Substantial evidence shows LGBTQ youth subjected to conversion
`
`therapy are at risk of great harm, including a significantly increased risk
`
`of depression, anxiety, and suicidality, which has resulted in an
`
`overwhelming medical consensus that minor patients must not be
`
`subjected to conversion therapy under the imprimatur of the mental
`
`health profession. Every mainstream medical and mental health
`
`organization has uniformly rejected the practice as harmful and
`
`ineffective. Conversion therapy providers exploit and exacerbate the
`
`fears of concerned parents while simultaneously deceiving them about
`
`the likelihood that their purported remedies will lead to the results they
`
`promise. Patients experience shame, anger, and depression and some
`
`engage in self-harm and even suicide.2
`
`In view of this well-established medical consensus, the Colorado
`
`legislature, like the legislatures of 21 other states plus the District of
`
`Columbia, enacted the bipartisan Minor Conversion Therapy Law
`
`
` 2 See infra pp. 16–17.
`
`
`
`4
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`
`
`
`prohibiting the practice.3 Its authority to regulate unsafe medical
`
`treatments and protect minor children from medical treatments that put
`
`them at an increased risk of suicidality and other serious harms is well
`
`settled.4 Ms. Chiles’ arguments not only contravene decades of binding
`
`case law, her position that scientific evidence supports her claims, Br. of
`
`Appellant/Cross-Appellee at 11–12, is contrary to every major medical
`
`and mental health organization’s rejection of conversion therapy as
`
`unsafe, unsound, and ineffective.5 That medical consensus rests on
`
`extensive evidence-based and rigorous, peer-reviewed studies. The relief
`
`Ms. Chiles seeks would place minors in Colorado at risk of well-
`
`documented, serious and potentially life-threatening harms. As one
`
`survivor of conversion therapy explained to The Trevor Project,
`
`
` 3 Colo.
`§§ 12-245-202(3.5), 12-224(1)(t)(V), 12-240-
`Rev.
`Stat.
`104(5.5)(a), 12-240-121(1)(ee) (2022).
` 4 See, e.g., Nat’l Inst. of Family & Life Advocates v. Becerra, 138 S. Ct.
`2361 (2018) (“NIFLA”); Tingley v. Ferguson, 47 F.4th 1055 (9th Cir.
`2022); Evergreen Ass’n v. City of New York, 740 F.3d 233 (2d Cir. 2014);
`Sammon v. N.J. Bd. of Med. Examiners, 66 F.3d 639 (3d Cir. 1995).
` 5 Tingley, 47 F.4th at 1078 (“Every major medical and mental health
`organization’ has uniformly rejected aversive and non-aversive
`conversion therapy as unsafe and inefficacious.”).
`
`
`
`5
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`
`
`
`conversion therapy “didn’t change anything about me. The only thing it
`
`did was make me ashamed of who I was and what I wanted.”6
`
`Amici urge this Court to affirm the district court’s decision and
`
`recognize the state’s authority—indeed, responsibility—to protect
`
`children from being subjected to this dangerous abuse by state-licensed
`
`mental health professionals.
`
`
`
`
` 6 See infra p. 16.
`
`
`
`6
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`
`
`
`ARGUMENT
`
`I. Colorado’s Statute Redresses Significant Harms to the Health
`and Safety of Minors.
`
`The statute challenged by Ms. Chiles, Colorado’s Minor Conversion
`
`Therapy Law, prohibits the practice of conversion therapy—a practice by
`
`which professional therapists seek to impose a predetermined outcome
`
`regarding a person’s sexual orientation or gender identity under color of
`
`a Colorado-issued license to practice—for minors.7 The balance of
`
`equities weighs heavily in favor of the Colorado statute as it seeks to
`
`protect minors from the severe harms of conversion therapy, which can
`
`be a matter of life and death. See Winter v. Nat. Res. Def. Council, Inc.,
`
`555 U.S. 7, 20, 26, 32 (2008).
`
`An ever-growing body of rigorous, peer-reviewed studies spanning
`
`decades uniformly shows that conversion therapy is closely correlated
`
`
` 7 See Colo. Rev. Stat. § 12-240-104(5.5)(a) (defining conversion therapy
`as “any practice or treatment . . . that attempts or purports to change
`an individual’s sexual orientation or gender identity, including efforts
`to change behaviors or gender expressions or to eliminate or reduce
`sexual or romantic attraction or feelings toward individuals of the same
`sex); id. § 12-245-202(3.5)(a) (same); see also id. § 12-245-224(1)(t)(V)
`(prohibiting conversion therapy for minors); id. § 12-240-121(1)(ee)
`(designating the practice of conversion therapy for minors as
`unprofessional conduct).
`
`7
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`

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`
`
`
`with an elevated risk of suicide in minors, as well as other serious harms.
`
`The Trevor Project’s own data echoes the overwhelming medical
`
`consensus that licensed mental health providers should not subject minor
`
`patients to conversion therapy under any circumstance. AFSP likewise
`
`“stands with the research, clinical expertise, and expert consensus of
`
`every major professional health organization in opposing the practice of
`
`conversion therapy” and “urges states to . . . protect LGBTQ youth by
`
`banning the discredited practice.”8 The baseline scientific principle that
`
`a treatment “is unsafe if its potential for inflicting death or physical
`
`injury is not offset by the possibility of therapeutic benefit,” United States
`
`v. Rutherford, 442 U.S. 544, 556 (1979), deems conversion therapy
`
`unsafe. Indeed, this is why the Colorado legislature enacted this statute,9
`
`and why every leading medical and mental health organization over the
`
`past 20 years has warned that conversion therapy is unsafe and should
`
`
`8 AFSP,
`Individuals
`LGBTQ
`https://afsp.org/conversion-therapy-bans.
` 9 Governor Jared Polis explained, upon signing the bill, that it “will help
`so many people in Colorado to make sure that no one can be forced to
`attend a torturous conversion therapy pseudoscience practice.” Bente
`Birkeland, Colorado’s Statewide Conversion Therapy Ban Is Now In
`Effect, Colo. Pub. Radio (May 31, 2019) (quoting Gov. Polis),
`https://bit.ly/3KLwLgT.
`
`populations,
`
`&
`
`- 8 -
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`

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`
`
`
`not be performed on minors.
`
`A. The Trevor Project’s Data Confirms That Conversion
`Therapy Causes Significant Harm to LGBTQ Youth.
`
`The Trevor Project is uniquely positioned to understand the
`
`significant dangers of conversion therapy. It has communicated with
`
`many individuals specifically about their experiences undergoing
`
`conversion therapy or their credible fear of being subjected to it. In the
`
`last year alone, youth from 49 states or territories, and more than 500
`
`different cities and towns, raised the issue of conversion therapy in over
`
`1,200 conversations with The Trevor Project.10
`
`In May 2023, The Trevor Project released the results of a
`
`nationwide cross-sectional survey of over 28,000 LGBTQ individuals
`
`between the ages of 13 and 24 with representation from all 50 states and
`
`the District of Columbia.11 The survey demonstrates that exposure to
`
`
` 10 This information is derived from anonymized data that The Trevor
`Project has collected, compiled, and reviewed on its telephone, text, and
`chat platforms pertaining to conversion therapy in 2022. In order to
`protect the privacy of the youth using its services, The Trevor Project
`does not make this data publicly available.
` 11 The Trevor Project, 2023 U.S. National Survey on the Mental Health
`People,
`3
`(May
`2023),
`of
`LGBTQ
`Young
`https://www.thetrevorproject.org/survey-2023/assets/static/05_
`TREVOR05_2023survey.pdf [hereinafter “2023 National Survey”].
`
`- 9 -
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`

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`
`
`
`conversion therapy is a significant risk factor for suicidality. Five percent
`
`of LGBTQ youth reported having undergone conversion therapy and ten
`
`percent reported being threatened with conversion therapy.12 Among
`
`those subjected to or threatened with conversion therapy, 28% reported
`
`a suicide attempt in the past year.13 These individuals reported
`
`attempting suicide in the past 12 months at more than twice the rate of
`
`their LGBTQ peers who did not report undergoing or being threatened
`
`with conversion therapy (28% and 28% vs. 11%).14
`
`Other key findings from The Trevor Project’s report are:
`
`•
`
`•
`
`41% of LGBTQ youth seriously considered attempting suicide
`in the past year, with about half of transgender and nonbinary
`youth having seriously considered suicide in the past year.15
`14% of LGBTQ youth attempted suicide within the past
`year.16
`
`67% of LGBTQ youth reported experiencing symptoms of
`anxiety, and 54% of LGBTQ youth reported experiencing
`
`
` 12 Id. at 18.
` 13 Id. at 20.
` 14 Id.
` 15 Id. at 5.
` 16 Id.
`
`- 10 -
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`
`
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`•
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`•
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`symptoms of depression.17 Symptoms of both were higher
`among transgender and nonbinary youth.18
`
`LGBTQ youth reported negative experiences at school,
`including being harassed because p