When Julian Klein was growing up in Ocean Township, N.J., as a member of a family that attended synagogue on a regular basis, questions about his identity were constant.

Klein, a 31-year-old transgender man who uses he/him pronouns, said he has had to “come out” twice in his life: First, at 17 years old, as a female-identifying person attracted to women, and then, at 22 years old, as a trans man.

For Klein, who grew up attending classes three days a week at his local synagogue, the initial reaction from his religious family was "a very negative experience."

The notion that one could purge "sinful thoughts" through intense religious exercise was never far from Klein's mind. 

"You try to 'conversion therapy' yourself," Klein said, as he recollected memories of feeling “guilty, broken and wrong” while being part of a religion religious community that “ostracized and demonized” people like him.

Conversion therapy — any attempt to change a person's sexual orientation, gender identity or gender expression — was already on the radar of advocates who wanted to protect LGBTQ youths by the time Klein came out in 2013. California enacted the first law to protect residents from the practice in 2012, and since then, 18 other states and more than 100 local governments around the country have taken similar measures. 

But nearly a decade later, the practice persists thanks to loopholes that allow religious groups to continue conversion therapy and a belief among some therapists that the issue has become politicized. 

To many advocates, the practice still represents a threat in the life of many Americans who battle with gender identity and sexual orientation issues — especially LGBTQ youth.

“Family acceptance is what we should strive for moving forward. We want LGBTQ kids to grow with their families and stay together,” said Mathew Shurka, co-founder of "Born Perfect," a program dedicated to ending the practice through legislation and litigation. 

“We want parents to love their kids, we want political leaders and religious leaders to embrace that, but it is all being jeopardized by anti-trans bills.”

Nearly 700,000 LGBTQ adults in the United States have received or experienced conversion therapy, and 350,000 of them received it as adolescents, according to The Williams Institute School of Law at UCLA.

That number could continue to grow. 

Last year, a federal appeals court, with a district that encompasses Alabama, Georgia and Florida, issued a ruling based on First Amendment grounds that barred an injunction against conversion therapy.

"People have intense moral, religious, and spiritual views about these matters — on all sides. And that is exactly why the First Amendment does not allow communities to determine how their neighbors may be counseled about matters of sexual orientation or gender," the majority of Eleventh Circuit Court judges wrote in the decision.

More than 10% of the LGBTQ population lives in states in with a preliminary injunction currently preventing enforcement of laws protecting residents from conversion therapy, according to the Movement Advancement Project, with at least five federal lawsuits challenging the laws. 

As always, geography is a defining factor in the fight: A federal judge in Washington state recently rejected an attempt by a family counselor to block the state's law prohibiting conversion therapy on minors.

"The biggest issue is not only that conversion therapy is not banned completely, but the large increase of prevention bills popping up all over the country," Shurka said. 

"Some of these bills aim to make it impossible to ban conversion therapy in some states," he said. 

Christopher Doyle, a licensed psychotherapist and executive director of the Institute for Healthy Families, a nonprofit Judeo-Christian therapeutic organization in Manassas, Virginia, says he does not support a ban on the therapeutic method.

If the case involves a minor, Doyle says that through his work, he "deals with families and children to improve their relationship and reduce chances of harm" and that "it is up to every therapist to balance out their approaches to serve their patients better and uphold the 'do no harm' principles."

“There is great hypocrisy,” Doyle says of activists that support a conversion therapy ban. He believes “the issue is about a political agenda for them based on their political motivation.” 

Harm is the prevailing concern for LGBTQ advocates. A global study from the UN Human Rights Council that included responses from 8,000 people across 100 countries showed 98% of people who have undergone conversion therapy suffered damage that included suicidal thoughts, physical harm, depression, anxiety, shame, self-hatred and loss of faith. 

The responsibility to provide safety and security often falls in the hands of public officials who can enact the laws most LGBTQ people still need, said James Guay, a survivor of conversion therapy who now works as a marriage and family therapist in California. And while a nationwide ban is still not a reality, advocates think that continuous pressure will get the message across to the government.

“Making it illegal for anyone to profit off of harming others is part of the role of governments in terms of protecting its citizens from harm, malpractice, and abuse,” Guay said. Click here to read this article on USAToday.com.