The U.S. Court of Appeals for the Ninth Circuit voted against reconsidering a panel decision that upheld Washington’s ban on conversion therapy for minors, though several GOP-appointed judges opposed to the decision accused the majority of disregarding First Amendment protections in the regulation of medical professionals.

Washington’s legislation—one of more than a dozen similar laws across the country—was challenged by Christian family and marriage therapist Brian Tingley who argued it violated his free speech rights. A panel of three judges affirmed the case’s dismissal last year, and Tingley asked for an en banc rehearing that was denied by a majority of the court’s active judges on Monday.