(The Lion) — Does the government belong in the counseling room?

That’s the question a Colorado counselor is asking the U.S. Supreme Court as she challenges a state law that dictates conversations she can have with clients – allowing her to affirm gender transitions but restricting her from helping minors to embrace their biological sex.

The court will hear arguments in the case, Chiles v. Salazar, on Tuesday, in a case that could have ripple effects on First Amendment rights in healthcare.

The case was brought by Christian counselor Kaley Chiles, who views her work “as an outgrowth of her Christian faith” and has fellow Christian clients who seek her assistance “because of their shared religious beliefs,” a legal brief for Chiles reads.

Many of her clients believe that “God determines their identity according to what He has revealed in the Bible rather than their attractions or perceptions determining their identity,” the brief notes, and Chiles provides faith-informed counseling to those who seek it.

But Colorado is one of more than 20 states restricting what counselors can say when it comes to helping minors deal with gender dysphoria. A state law allows counselors to express “acceptance,” “support” and “understanding” when it comes to pushing a patient towards a gender identity different from their biological sex, but prohibits conversations to help patients accept their biological sex – even if the client explicitly asks for help in that area.

“When a teen comes to me and they state that they’re struggling with their sex or sexuality, the state has dictated to me that I’m only allowed to help them go through the process of change in one way,” Chiles said in a video message, noting that such one-way therapy often leads to medicalization. “If they were a minor who were to come to me and say, ‘I actually don’t want to go down that path, I would like to grow in greater alignment in my body and become comfortable,’ then that’s something I actually cannot engage those clients in conversations about.”

Chiles could face severe consequences for helping clients achieve one of the state’s “forbidden goals,” her brief notes, including fines of up to $5,000 per violation and losing her license. “Those penalties are strong incentives not to speak messages that Colorado disapproves,” the filing notes. “Chiles doesn’t want the State to strip away her ability to do the work she loves.”

The state, for its part, argues the government has long regulated healthcare to protect patients, and “the First Amendment has never barred states’ ability to prohibit substandard care, regardless of whether it is carried out through words.” The state defends its law as prohibiting “conversion therapy” on minors and said Chiles’ position, if the court agrees, “would gut states’ power to ensure mental healthcare professionals comply with the standard of care.”

The Lion has reached out to the state agency named in the lawsuit, the Colorado Department of Regulatory Agencies, for comment.

Chiles is represented by Alliance Defending Freedom, which told The Lion that the government “has no business censoring private conversations between clients and counselors.”

“There is a growing consensus around the world that adolescents experiencing gender dysphoria need love and an opportunity to talk through their struggles and feelings,” ADF Chief Legal Counsel Jim Campbell said. “Colorado’s law harms these young people by depriving them of caring and compassionate conversations with a counselor who helps them pursue the goals they desire.”