May Christian counselors offer Christian counsel? This is the question the Supreme Court of the United States is expected to weigh in on this week. 

If that sounds extreme, that’s because it is. If you are wondering why you have not heard about it yet, that is because the case, Tingley v. Ferguson, has been framed as a debate over “gay conversion therapy.” Brian Tingley, a licensed family counselor in Washington state, has challenged the state’s ban on conversion therapy, which extends to any conversation between a counselor and a minor client that pursues “change” of that young person’s perceived gender identity or sexual attractions. 

Tingley is challenging on free speech grounds, but the question, for many Christian counselors, cuts deeper. The phrase “conversion therapy,” connoting religious radicalism in opposition to science, has been very effective in winning the cultural battle for those in favor of banning Christians from counseling gay people. But within the framing is a more fundamental argument. Christian counsel, which by definition questions the modern belief that sexual preferences are intrinsic to selfhood, is antithetical to the modern belief in the inalienable right to self creation. 

The stakes in Tingley v. Ferguson are no less than this. USA Today called the case one of “Religion vs. LGBTQ+ Rights,” which is another way of saying the tension here is between the old religion and the new one, each of which determines the success or failure of a psychiatric treatment according to theological priors. The old religion sought the “healing of the soul” (the meaning of the word “psychiatry”) by helping an individual to conform himself to nature and nature’s God. In this older view, spiritual health and happiness stemmed from learning how to fit oneself into the existing world. The new religion seeks precisely the opposite, to affirm every person in his mental predilection, regardless of whether doing so harms or helps him, since the primary “right” in this world is the right to live unquestioned. The existing world, then, is shaped to fit the psychiatric patient. 

Naturally, the old religion must be conquered before the new one may reign. As with debates over pandemic strategies, the left has worked hard to make the question one of science versus anti-science. Thus, we are told that the rubes who practice “gay conversation therapy” (in scare quotes, because you cannot find a counselor, including Joseph Nicolosi himself, who actually advertises his services as such) are archaic Bible thumpers who think gayness can be cured with fresh air and a few tongue lashings, or perhaps a social media fast and manual labor. Any serious, licensed medical practitioner should know better, and should denounce such anti-scientific approaches, according to this line of argument. 

The Human Rights Campaign website lists “conversion therapy” or “reparative therapy” as “a range of dangerous and discredited practices that falsely claim to change a person’s sexual orientation or gender identity or expression.” Such practices, they add, have been “rejected by every mainstream medical and mental health organization for decades” and can lead to “depression, anxiety, drug use, homelessness, and suicide.”

HRC is correct about one thing: The fringe instances of electric shock therapy and public exorcisms that opponents cite are far from normative in the world of reparative therapy, especially where Christian counselors are concerned. Nevertheless, organizations like the Association of Certified Biblical Counselors, which offer, among other services, Christian counseling for those with same-sex attraction, have become the targets of such bans due to their view of same-sex attraction as sinful. 

This is the root problem for adherents of the new affirmative psychiatry. A few quacks hardly merit the American Academy of Child & Adolescent Psychiatry making policy statements on the need to end the practice of “conversion therapy.” A whole sector of counselors who question, or outright reject, their first principle that a person’s sexual self-identification is absolute and undeniable, on the other hand, demand answering. All the more so when those religious counselors are still, to the chagrin of modern man, still taken seriously in certain circles. This is what Christian counselors represent; when opponents say Tingley v. Ferguson is a case of religion versus LGBTQ+ rights, believe them. 

This split has not shaped the field of psychiatry for more than a few decades. Long before it was normal for a man to go to a therapist with his identity questions, it was normal for him to go to a priest. Indeed, a comparatively small fraction of history has seen mental problems treated by licensed technicians rather than men of the cloth. But while much has changed since a religious answer to a mental ailment was considered as serious or more so than a scientific one, the most radical shift has occurred even more recently. Freud and other early clinical psychologists sought to cure their patients of certain neuroses, of which homosexuality and transsexuality were considered two until the 1970s; the new psychiatric approach, shown in heightened terms with the practice of hormone replacement “therapy” for gender-confused youth, has replaced the implicit morality of just a few decades ago. The ailment itself is no longer even called an ailment; instead, it is celebrated. 

What has changed in the world of soul-healing is merely the substance of these moral imperatives. The new psychiatry has a new morality. It is followed with the same religious fervor as any of the older ones. It has new quacks, too, with new extreme cures that are already far more common than exorcisms and electroshock therapy. This new morality calls it right and good to help a man cut off his manhood to conform his body to the world inside his head. 

What matters, then, is not so much the purported effectiveness or failure of gay conversion therapy, which deserves its own separate discussion. What matters, for the Supreme Court and Christian counselors, is an understanding that what is really at stake is far from a simple legal affirmation of what every serious counselor already knows. It is Christian counsel which is on trial, and every sort of healthy morality which goes with it.