“We’ve gone from kind of a trickle to what seems to be more of a stream,” said Scott McCoy, senior policy counsel at the Southern Poverty Law Center. SPLC filed the suit against JONAH, or Jews Offering New Alternatives for Healing, the conversion-therapy group involved with Unger’s treatment. The widely covered case was the first consumer-fraud case heard against the use of conversion therapy in the U.S.

A number of professional organizations have spoken out on the lack of evidence for the practice’s efficacy, as well as the deep psychological toll it has taken on those subjected to it. In his attempts to alter his clients’ orientation, Alan Downing—a JONAH-affiliated “life coach”—had two people re-enact experiences of childhood sexual abuse. During a session that reportedly cost $100, he made another client fully undress in front of a mirror. After sessions with Downing, Unger fell into a deep depression, and began praying that he would die in his sleep. Chaim Levin, another plaintiff in the JONAH case, attempted to kill himself.

While one can imagine a clear moral argument against this practice, the ruling in the JONAH case stemmed from the simple fact that it does not work. Research supports this point. A decade after the psychiatrist Robert Spitzer published a controversial and refuted study in 2003 of 200 men and women who claimed to have changed their sexual orientation to “predominantly heterosexual” after some form of “reparative therapy,” he apologized, saying there was no way to verify his participants’ responses.

Jack Drescher, a psychiatrist who has chaired the American Psychiatric Association’s Committee on Sexual Orientation and Gender Diversity and helped write the guidelines on sexuality and gender disorders for the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, tells me that there is no standardization of the practice, and what little research exists around it is poorly done and not subject to peer review. “It’s like the Wild, Wild West,” he said.

During his presidency, Barack Obama called for an end to “therapies” that aim to change sexual orientation or gender identity, but a bill introduced to ban conversion therapy at the federal level stalled in Congress last year. The 2016 GOP platform drew the ire of activists as well as the Log Cabin Republicans, a gay conservative group, for including “the right of parents to consent to medical treatment for their minor children,” which some both in and outside of the party interpreted as a tacit endorsement of “conversion therapy.” And, according to McCoy, the understanding of conversion therapy as a threat to children has helped marshal Republican support for these bills at a state level.

In a contentious year when other LGBTQ-rights issues have become the center of debate—including North Carolina’s HB2 bill, the decision to continue to exclude questions about sexual orientation and gender from the national census, the State Department’s denial of visas to gay and bisexual Chechens fleeing state-sanctioned violence, and the Supreme Court’s upcoming hearing of the appeal of a baker who refused to bake a wedding cake for a same-sex couple—McCoy maintains that the movements to ban so-called conversion therapy have their own “independent momentum.”