When Mathew Shurka was a teenager, he saw therapists who performed what he now understands was conversion therapy in an attempt to change his sexual orientation.

“When I was in conversion therapy, I loved my therapist,” said Shurka. “I mean, he was my therapist. I trusted him. He’s the person I told my whole life story to. Especially as a child, it was the first encounter of talking to someone who wasn’t in my family that I can speak to.”

Shurka is now fighting the very form of therapy he says held him in thrall, as a cofounder of the National Center for Lesbians Rights’s (NCLR) Born Perfect campaign, an effort to support state-level bans on conversion therapy.

Shurka believes that violating those trusting relationships (between therapist and patient and between children and their families), with abuse aimed at changing sexual orientation and gender identity, causes long-lasting damage for LGBTQ children and adolescents.

“They don’t want to lose their family, and if they’re in conversion therapy, [they’re] in a safe and protected space,” he said. “There’s no way out, which is why suicide becomes such an available option in their eyes.”

New data from the Trevor Project, a national suicide prevent hotline for LGBTQ youth, details the psychological damage experienced by queer youth who undergo conversion therapy. The survey examined the mental health of more than 34,000 LGBTQ young people in the U.S. and found that 42% of those who have undergone conversion therapy have attempted suicide compared to just 17% of those who have not had the therapy. The numbers were even starker for trans and gender non-conforming youth who had been subjected to conversion therapy — 57% reported attempting suicide.

While just 5% of respondents reported undergoing official conversion therapy, Casey Pick, senior fellow for Advocacy and Government Affairs at the Trevor Project, notes that the survey shows this kind of intentional conversion therapy is still being practiced in areas where laws don’t effectively protect LGBTQ youth.

“There’s not a lot of people out there for conversion therapy, but in many ways the great challenge is demonstrating that this is still happening,” she said in an interview with Teen Vogue. “There are still people, including licensed professionals, who are engaging in this unethical practice. Once you demonstrate that this is still happening and that the harm is very real, then support for prohibiting this practice tends to move quicker.”

Currently, according to the Movement Advancement Project, 32 states still allow conversion therapy. Beginning with California in 2012, 18 states, D.C., and Puerto Rico have banned the practice for minors, with momentum picking up more recently for legislation. Maine governor Janet Mills, a Democrat, signed a bill into law late last month banning the practice in relation to minors, making hers the 17th state to do so. (Colorado followed suit just before this year’s LGBTQ Pride month began.)

“I think it’s important for a number of reasons. First and foremost, conversion therapy is not a legitimate practice,” Maine state representative Ryan Fecteau, who introduced the conversion therapy ban in the legislature each of the last two legislative sessions, tells Teen Vogue. “Every major medical organization across the country has indicated such and we also know that when young LGBTQ people think that there’s a possibility that they could be subjected to [conversion therapy] they are less likely to seek counseling for legitimate things.”

According to advocates, however, laws banning conversion therapy are not foolproof.