(CNN) On a Wednesday evening around 7, as the late summer sun settled low on Houston's flat horizon, two men shifted uncomfortably at Sam Young's door.

They were there to deliver the news, sealed in a thin white envelope and tucked into a coat pocket, of Young's potential excommunication from The Church of Jesus Christ of Latter-day Saints.

Young invited his friends, two administrators from his local Mormon congregation, into his living room. After short pleasantries, they notified Young that a council of Mormon men would decide September 12 whether his public criticism of the church, including a 23-day hunger strike, had rendered him an apostate.

Sunday, a decision arrived: Young was officially excommunicated.

Young, who posted a copy of the excommunication edict on his blog, said he will appeal the order.

In an interview with CNN, Young said he feels "supremely disappointed" in the loss of his membership, "in the church itself and in the leadership." He also feels "sadness for the victims who the church was rejecting by this verdict."

"You are entitled to your opinion or position," the edict said. "But you cannot remain a member in good standing while attacking the Church and its leaders and trying to get others to follow you."

As a 65-year-old grandfather, Young has spent his life following Mormon cultural prescription. Born in rural Utah, he served as a church missionary in Guatemala and El Salvador, married in a church temple, and raised six Mormon daughters.

Yet recently, after discovering his daughters' experiences with bishops as Mormon youth, he has become an unlikely activist in the #MeToo era.

Young is protesting what he feels is a "physically, emotionally, and spiritually" abusive practice within the church: "worthiness interviews," in which members are asked a series of questions about their adherence to church rules, specifically its sexual code of conduct, alone in their bishop's office. These interviews are requisite for all teenagers, for worship in the church's temples, and for baptism into the faith of 16 million members.

This lifelong commitment renders Young's advocacy a complicated, nuanced form of criticism -- one embedded with apology. As a bishop in the early 1990s, Young said, he regrets inviting 12- to 18-year-olds into his small, sparse office in a Mormon meetinghouse in Houston and asking them church-mandated questions about their abstinence from premarital sex.

"It was wrong, so wrong." Young said. "I regret I ever asked."

While all bishops are required to ask whether members "obey the law of chastity," abstaining from all premarital sexual activity, Young says more than 3,000 people, including four of his daughters, have said their bishops probed for the explicit details of their sexual conduct as children.

The church now offers the opportunity for youth to be interviewed with an accompanying adult. But it has yet to condemn the practice of asking sexually explicit questions in interviews. Nor has it acknowledged the alleged trauma and, in some instances, predation that has resulted from them.

The church calls the practice of bishops' interviews a "sacred responsibility" and offers the opportunity for mentorship; critics argue it is traumatizing and creates opportunities for grooming and emotional or sexual abuse.

In the excommunication edict, the president of Young's district in Houston said, "This action was not taken because of your opinion or position on protecting children."

"The Church has a strong desire to protect children and, as you know, issued updated guidelines for interviewing youth earlier this year. Teaching standards of morality to youth and helping them follow those standards -- including in interviews with priesthood leaders -- is an important responsibility of parents and of the Church.

"The issue is not that you have concerns -- or even that you disagree with the Church's guidelines, rather it is your persistent, aggressive effort to persuade others to your point of view by repeatedly and deliberately attacking and publicly opposing the Church and its leaders," the church's excommunication edict says.

Young's advocacy is resonant in an era of #MeToo consciousness-raising and outrage regarding sexual abuse within the Catholic Church.

More than 800 people have spoken about the trauma, pain, abuse or discomfort they felt during in these interviews on the website of Young's organization, Protect LDS Children. More than 21,000 people have signed a petition, often leaving their own stories in the comments, demanding the end to "sexually explicit interviews of Mormon youth."

However, engaging in a dialogue on this topic will require the church acknowledge the messy nuance of sexuality itself, relinquish the rigidity with which it has been discussed in the past, and draw new boundaries for what can acceptably be policed and discussed within the faith.

'A searching interview'

For most of July, Sam Young subsisted only on an electrolyte mix of water, one teaspoon of salt, and one tablespoon of honey.

His 23-day hunger strike advocated for a clear, 10-word policy change within the church: "No one-on-one interviews. No sexually explicit questions, ever."

For the first two weeks, he invited senior church leaders to meet with him where he was protesting outside church headquarters in Salt Lake City. He said he would end his strike if a leader would be willing to denounce just one of the dozens of explicit questions that have allegedly been asked in interviews.

"The British Government paid attention to Gandhi," he said, noting he had fasted for two days longer than the Indian revolutionary. "But I've heard from no one."

Church spokesman Eric Hawkins told CNN, "We share a common concern for the safety and well-being of youth. We condemn any inappropriate behavior or abuse regardless of where or when it occurs. Local Church leaders are provided with instructions regarding youth interviews and are expected to review and follow them."

As volunteer clergy with no pastoral or clinical training aside from direction they receive in church manuals, bishops today are formally instructed to ask standardized questions to ascertain a member's adherence to and belief in church teachings. Over time, the questions have evolved.

By 1971, bishops were asked to conduct "a searching interview" to determine "worthiness" for temple worship, ascertaining whether a member "is morally clean -- free from adultery, fornication, homosexuality."

However, one factor has remained constant: Mormon bishops are considered conduits for God's forgiveness. To fully repent of transgression requires admitting sin to a bishop, rendering the confessional stakes high.

Mica McGriggs, a postdoctoral fellow in intersectional trauma at Columbia University who is Mormon, argues that "when you have a white patriarchal hierarchy as the setup of the organization," youth, particularly young women, feel there "is no alternative, no choice" to say no to a bishop who probes beyond the church's prescribed questions.

McGriggs argues that it is "negligent" for the church to allow bishops to undertake an explicit line of questioning to determine the nature of sexual activity.

McGriggs says she believes the majority of bishops are well-intentioned. But she said their lack of professional training makes their efforts to offer pastoral care potentially dangerous. That's particularly so in situations of childhood abuse or sexual assault in which sexual questioning is likely to result in re-traumatizing, victim-blaming and internalized shame.

"This is setting people up to really struggle with their mental health, from depression to anxiety and even full-blown PTSD," she said.

The church did not respond to a request for comment on the potential connection between the interviews and mental health. Instead, Hawkins referenced a statement from earlier this summer in which the church's president and prophet, Russell M. Nelson, affirmed the need for interviews.

"Bishops have a sacred responsibility to lead, teach, and inspire youth," Nelson said in a statement to all bishops. "Effective personal interviews are one important way they do this. These interviews provide opportunities to help youth become disciples of the Savior, repent of transgressions, and live the gospel of Jesus Christ."

In June, the church released "new guidelines" for interviewing young Mormons, including a list of 13 questions that could be used. One of the recommended questions asks young Mormons whether they "live the law of chastity." Another asks about "any sins or misdeeds in your life that should have been resolved with priesthood authorities but have not been."

The guidelines also allow young Mormons to ask another adult to be present during the interview. And they instruct Mormon leaders to have a parent or another adult close by when interviewing young people.

"As representatives of the Savior, bishops are divinely appointed judges in Israel. In this role, they conduct interviews to determine worthiness and to help youth repent of transgressions," the guidelines say.

600 testimonies

Earlier this year, Young marched across Salt Lake City with more than 1,000 protesters, including eight of his grandchildren. He delivered three books of victims' testimonies to Mormon church headquarters.

Collectively, the testimonies read like an ethnography of trauma, revealing patterns of self-harm while enumerating the many ways religious shame and scrupulosity can scar the bodies of believers.

Printed and bound, the testimonies contain two accounts of suicide that relatives claim were a direct result of mental health complications from interviews; 97 accounts of suicidal ideation and attempted suicide; and accounts from dozens of women who said they were blamed by their bishops when reporting rape or assault.

Hundreds more recorded in detail the explicit questions regarding masturbation, sexual intimacy and sexual orientation they were asked by bishops. Childhood abuse victims said the shame they felt from these interviews resulted in a perverse sense of responsibility for their abuse. One man reported his attempts of self-castration at the age of 13, then again at 14. Many wrote of how they, as children, prayed for sensory impairment, that their "temptation to sin" might be taken from them.

"These interviews were torturous and left me feeling anything but worthy, loved or deserving of belonging in my community," said Drew Stelter, a 28-year-old gay man from Salt Lake City who said he was subjected to attempts to "cast out" his homosexuality as a young Mormon, after speaking to his bishop.

"Rather than receiving the support and gentle encouragement I was seeking, I received instead a heaping of shame, blame and punishment that resulted in immense self-loathing, suicidality and re-traumatization of prior abuse."

Katie Langston, now 36, said she was 12 when her aging bishop, staring intently at her from across his desk, asked her whether she masturbated.

Under the glow of the church's standard-issue fluorescent lights, Langston wondered what counted as sexual sin, particularly at her age. Was it wrong to try to understand her own body, morphing in pubescence, and to begin to come to terms with her nascent sexuality? Yes, Langston recalls her bishop telling her.

"Disorienting is too soft a word," Langston said. "It was horrifying. It was humiliating. It was degrading. It was embarrassing."

Langston, who undertook years of theological study after her experience as a youth with her bishops, is now a candidate for ordination in a Lutheran seminary. She challenges the Mormon church's claim that worthiness interviews are a doctrinal necessity. She said the church's reliance on bishop-mediated repentance "reflects a deep misunderstanding" of the Christian theology of grace.

"You can't have a good and loving and gracious God at the same time as you have a 'worthiness' construct that is enforced by a systematic, regular, personal inquisition. They are fundamentally incompatible," she said.

Yet beyond its theological relevance, Langston is more concerned with the psychological effects of this practice.

"I believe you have people who have been traumatized on a wide scale, spiritually traumatized. People are submitting themselves to this practice, and they can't speak up about it because there is so much on the line."

'They told me I was an apostate'

Sam Young first discovered what was on the line for his advocacy in January, when he met with his local bishop and stake president, similar to the leader of a diocese.

"Incensed" after discovering his daughters' experiences, Young confronted local and regional leaders about the practice, urging them to stop. In the meantime, he reached out to media outlets to raise his concerns.

"They told me I was an apostate," Young said, referring to his bishop Mike Kennington and stake president David Hruska. A stake is a regional Mormon body, like a Catholic diocese.

"They said, 'Sam, if you keep speaking out publicly, we are going to have to take action to protect the good name of the church.'"

Church leaders in Salt Lake City have a different characterization of these interactions. They said in a statement that local leaders "met with him to express love, to listen and to counsel with him." Neither Hruska nor Kennington responded to a request for comment.

Additionally, while the church said Young has spoken to the church leadership on "every level," Young said he has not spoken to the church's most senior leadership -- the president or senior "12 apostles."

He said, however, that he did receive a message from apostle David Todd Christofferson, delivered through Hruska, that he had read all of the victims' testimonies and considered them "tragic."

The church has not responded publicly to the victims' testimonies, amid increased scrutiny resulting from the advocacy of Protect LDS Children. But the church changed some of its policies regarding one-on-one interviews, releasing the new guidelines in June.

Young believes the church has made "reasonable changes." But he said they are largely cosmetic and that the majority of interviews are "still one-on-one," as youth often do not want to answer sexual questions in front of their parents.

One bishop, who declined to be identified, said some youth he interviews now elect to be joined by their parent at the insistence of the parents, not the child.

Still, some say the practice is beneficial as it stands.

Amanda Lopez, 20, from Provo, Utah, said she has had only positive experiences with bishops. She said they were "extremely considerate and respectful where matters of chastity were concerned."

Lopez said she believes interviews offer accountability to teenagers in following the church's teachings and that meeting with a bishop "brings peace and it also brings a means of guidance when difficulties arise."

Both Young and McGriggs also agree that bishops pastorally can offer positive opportunities for mentorship. But they believe the systemic practice of sexually explicit questioning is incompatible with the purported goals of caring for youth.

'Total silence'

The church seeks to emphasize the best-case scenario outcomes of bishop interviews: the potential for mentorship, the opportunity for ministry, and extension of divine mercy to repentant members.

But even when interviews are founded on mutual respect, critics say, they socialize youth to blurred sexual boundaries with men in authority positions.

"It is dangerous for such a broad community to just think this is normative. I'm here to say this is not normal and this is not healthy," McGriggs said.

"My biggest concern is the way that people are internalizing these messages and the desensitization around appropriate behavior that is happening. But what is so unfortunate is that the church does not see the ways in which these lines of questioning are potentially sexually abusive and traumatic."

This potential can be seen in cases where bishops have used their authority for grooming and predation.

In the past decade, three bishops have been convicted for the sexual abuse of children in their congregations. Many more allegations have been raised. The most recent came from McKenna Denson, a former missionary for the church, who said her mission's leader used mandatory interviews to push boundaries and later assault her.

Denson's case was dismissed because of an expired statute of limitations. But her alleged perpetrator, Joseph Bishop, admitted on tape to being "too frisky" with young girls he interviewed, according to Religion News Service

Bishop added that he was "the last person who should have been" interviewing these women alone, as he is a self-described sex addict.

The church has been muted in response to the Denson case, seeking to dismiss her claims in court while affirming "great faith in the judicial system to determine the truth."

In the meantime, on its web page dedicated to abuse prevention, the church states: "We are continually looking for ways to strengthen our proactive program to combat abuse. ... As we see or learn of ways to more effectively decrease the potential for abuse, we implement them."

Recommendations for preventative reform abound, including a gendered approach in which women would interview girls. But for the Mormon church to engage with the possibility of reform could require an acknowledgment of the allegedly explicit nature of this practice. This would represent a fundamental departure from the church's current systemic approach to policing sexual behavior and offering sexual prescription.

Young's advocacy, reduced to a simple 10-word demand, is reflective of the rigidity with which the church prescribes interview policy. Young, alongside thousands of other Mormons, has asked for: "No one-on-one interviews. No sexually explicit questions, ever."

Embedded in this request is a call for a more nuanced engagement with the varied experiences of those who are subject to interviews. McGriggs calls for a semantic distinction that would reflect this change. "We need to redefine how we are talking about worthiness, because these messages become very internalized — the idea that I'm not good enough, or God is disappointed in me. That creates shame and is not helpful for someone's spiritual growth."

While committed Mormons like Young and McGriggs are seeking an expansion of how church leadership engages with its members, the church has responded with Young's summons to a disciplinary council.

In response to whether he could be considered an apostate, Young said: "I am not speaking in opposition to the doctrine. I am speaking in open and clear opposition to a policy. One which can change."