An appeal court has sided with California and upheld the first law in America banning psychological treatment that seeks to turn gay youths straight.
In a resounding, unanimous opinion, a three-judge panel of the 9th US Circuit Court of Appeals found the state law barring the so-called gay aversion therapy legal in every respect.
The judges said trying to change a minor's sexual orientation through intense therapy appeared dangerous, and that California politicians properly showed that the sexual orientation change efforts were outside the scientific mainstream and have been rejected for good reason.
"One could argue that children under the age of 18 are especially vulnerable with respect to sexual identity and that their parents' judgment may be clouded by this emotionally-charged issue as well," Judge Susan Graber wrote for the court panel.
The California Legislature cited reports, experts and anecdotes involving suicides, substance abuse and other behaviour by young recipients of the therapy before members voted last year to ban it for minors. "Efforts to change a young person's sexual orientation pose critical health risks, including depression, shame, decreased self-esteem, social withdrawal, substance abuse, self-harm and suicide," Lambda Legal, which defends gay rights, said after Thursday's ruling.
The activities of pastors and lay counsellors who are unlicensed but provide such therapy through church programmes are not covered by the law.
New Jersey governor Chris Christie has signed a similar law that would also outlaw the therapy in his state.
Liberty Counsel, a Christian legal aid group that represents supporters of the practice, said it would either ask a larger panel of the court to reconsider the decision or petition the US Supreme Court to take up the case. The group is also fighting the New Jersey law.
"The minors that Liberty Counsel represents do not want to act on same-sex attractions, nor do they want to engage in such behaviour," the group said in a statement. "They are greatly benefiting from this counselling."
Liberty and other backers of the therapy argue that politicians have no conclusive, scientific proof that the therapy does harm.