The United States Supreme Court has ruled against Colorado’s ban on conversion therapy in a landmark decision with massive repercussions on not only LGBTQ2S+ rights but medical care in America as a whole.

Notably the court ruled 8-1, meaning two liberal justices—Elena Kagan and Sonia Sotomayor—joined the conservatives in opposing the conversion therapy ban. Justice Ketanji Brown Jackson was the lone dissenter, and in her dissent argued that the fallout from this ruling could be “catastrophic” for American healthcare.

“So, to put it bluntly, the Court could be ushering in an era of unprofessional and unsafe medical care administered by effectively unsupervised healthcare providers,” she wrote.

The case, Chiles v. Salazar, challenged Colorado’s ban on conversion therapy—in this case, referring to talk therapy aimed at changing a young person’s gender or sexual identity.

The law was introduced in 2019, and prohibits licensed counsellors from engaging in conversion therapy with minors in Colorado. Any Coloradan who thinks a licensed counsellor is engaging in conversion therapy could file a complaint with a regulatory board, which could then trigger a disciplinary review process that can yield a fine for the therapist in question.

The plaintiff in this case, Kaley Chiles, is a religious talk therapist who basically argued that the law restricts her free speech rights by forbidding her from saying anything that attempts to change a client’s sexual orientation or gender identity. She was represented by the right-wing legal group Alliance Defending Freedom, which has claimed responsibility for a host of anti-LGBTQ2S+ laws across America.

We break down what you need to know.