For more than a decade, Rainbow Railroad has recognized “conversion therapy” as a tool of displacement — a method for making LGBTQI+ lives uninhabitable, in the body, in the home, and in the country.
“Conversion therapy,” which refers to a range of “dangerous and discredited practices” aimed at changing a person’s sexual orientation or gender identity or expression, has recently dominated headlines. On March 31, 2026, the Supreme Court of the United States (SCOTUS) issued a decision in Chiles v. Salazar, a case that considered how “conversion therapy” can be regulated.
In the 8-1 decision, SCOTUS ruled that Colorado’s state law banning such practices regulated the speech of the therapist in the case, and the lower court did not properly evaluate it. This means that “conversion therapy” can be protected speech under the First Amendment, and the case was sent back to the US Court of Appeals for reconsideration. This decision has an immediate impact on the people Rainbow Railroad works with every day; it retraumatizes survivors, threatens to upend asylum claims, and lends legitimacy to the very practices that forced them to flee home.
Rainbow Railroad's unique case data confirms that “conversion therapy” is a driver of displacement.
A Growing Crisis for LGBTQI+ People in the US
Rainbow Railroad has received nearly 80,000 requests for help since its founding. Of the 465 requests for help that specifically mentioned “conversion therapy” practices, nearly one in three came from the United States. This proportion ties in to a broader trend. In 2023, one out of eight overall requests for help came from the United States, and in 2024, one out of every five requests for help originated from the United States. In 2025, this increased to one out of every three requests. Our data is clear: LGBTQI+ people in the United States do not feel safe. The numbers reflect the reality that “conversion therapy” institutionalizes stigma and rejection, leading to worse mental and physical health outcomes for LGBTQI+ people. Survivors have nearly double the odds of lifetime suicidal ideation and an 88% increased likelihood of attempting it. The US, once a desirable destination for LGBTQI+ migrants, now tops the list of countries where citizens, and particularly trans people, are asking for help.
This Supreme Court decision may undermine the protections against “conversion therapy” in more than 23 states and the District of Columbia. The ruling also undermines protections for LGBTQI+ people seeking asylum in the US who have fled these practices in their countries of origin.
In response to the Chiles v. Salazar ruling, CEO of Rainbow Railroad, Ilana Landsberg-Lewis, stated, “This decision doesn’t just retraumatize survivors. It risks creating a barrier to asylum claims. A Supreme Court that treats ‘conversion therapy’ as protected speech could make it harder to demonstrate that being subjected to these practices abroad constitutes a ‘credible fear’ of persecution.”
Beyond the Border: Implications of the Ruling Abroad
The implications of Chiles v. Salazar extend far beyond Colorado. Its consequences displace the most vulnerable, shrink the map of safety for people fleeing persecution, and embolden the governments already working to do the same.
America’s influence on the conditions in which “conversion therapy” flourishes around the globe has been extensively documented. For instance, between 2007 and 2020, over 20 US evangelical organizations spent at least $54 million in Africa to influence law, policy, and public opinion against sexual and reproductive rights, and have been directly linked to anti-LGBTQI+ legislation in Uganda, Kenya, and Ghana. The irony is stark. The same political movement that has defunded health clinics, gutted humanitarian aid, and abandoned communities across the globe never stopped writing checks to export homophobia. For communities that lost access to American aid, the only dollars still reliably arriving are the ones financing their persecution.
Ghana illustrates where this trajectory leads. The country has repeatedly considered anti-LGBTQI+ legislation that would go beyond criminalizing same-sex intimacy and mandate that people suspected of being LGBTQI+ undergo “conversion therapy” or face up to five years in prison. It would also subject intersex individuals to forced medical intervention, at their own financial and psychological expense. This is “conversion therapy” as a tool of displacement. Submit to conversion, survive imprisonment, or flee. For many LGBTQI+ Ghanaians, these are not choices; they are the terms of their displacement.
Incremental Momentum: Global Moves to Restrict Conversion Therapy
But the fight is far from over. On May 7, 2026, the Colorado General Assembly passed revised legislation intended to address the First Amendment guidance in Chiles v. Salazar, while preserving the state’s protections against “conversion therapy.”
Federal legislation in the US has long been proposed that could curb many of the threats posed by the Chiles v. Salazar decision. First introduced in 2015, the Therapeutic Fraud Prevention Act would classify providing or advertising “conversion therapy” in exchange for monetary compensation as an unfair or deceptive act or practice under the Federal Trade Commission Act. This approach reflects the same standard that the UN Independent Forensic Expert Group has applied in declaring forced conversion practices fraud. Passing this bill would be a meaningful step toward closing the patchwork of gaps that has allowed the practice to persist and relocate across borders.
Encouragingly, the international community has increasingly moved to ban “conversion therapy.” Canada banned the practice in 2022. On April 29, 2026, the European Parliament voted in support of a ban on “conversion therapy” across the European Union. The European Commission has declined to enact an EU-wide ban, instead urging member states to enact national bans.
LGBTQI+ people are already enduring violence and fleeing persecution, and Rainbow Railroad will continue to help survivors access safety. The decision in Chiles v. Salazar demands an urgent, coordinated response from Congress, state institutions, and the international community that has long named “conversion therapy” for what it is: abusive, inhuman, and discriminatory. No court decision changes that. Justice cannot be deliberated while people are being displaced. It is time to act.