Utah teenager Payton Butler came out as transgender early on in high school after years of struggling with his gender identity.

Life felt “easier” when he started taking testosterone during his sophomore year, he says. But now, transgender kids in Utah are banned from receiving the same care. Utah became the first state this year to outlaw gender-affirming care for minors when Gov. Spencer Cox signed a bill into law at the end of January. The law restricts puberty blockers, hormone therapy and surgeries.

Payton Butler, an 18-year-old high schooler in South Jordan, Utah, received hormones, surgery and other gender-affirming care throughout high school. He says it was essential to his mental and physical well-being. (Courtesy of Payton Butler)

Growing up in the Church of Jesus Christ of Latter-day Saints, Butler says his family considered him a tomboy. Every Sunday, he felt uncomfortable wearing dresses to church until his mom let him start wearing pants at age 8. The family left the church that same year — and not long after, Butler started going through puberty.

“[Puberty] felt like the end of the world. I remember my mom, she talked to me about how puberty was going to happen, like the changes my body was gonna go through, and I just started bawling,” he says. “I knew that that wasn’t right. I just didn’t have the language to kind of explain how I was feeling.”

As he started crushing on girls around his pre-teen years, Butler identified as a lesbian. But as high school started, Butler concluded that he didn’t feel like a girl. He told his mom, who took him to get a haircut and different clothes.

“Just from those changes, my life got just infinitely better. It was so much easier to just wake up in the morning and look at myself in the mirror,” the 18-year-old high school senior says. “And I felt more me, like a ninth grader should.”

Butler has received hormone therapy and top surgery — the very care that minors are now banned from accessing in his state. He knew what he needed at age 14, he says, and believes high school would have been even harder for him if he didn’t receive gender-affirming care.

“It’s really not easy being trans,” he says, “especially in Utah.”

When he started taking testosterone at 14, Butler says he looked younger than his cisgender male peers and had a higher voice, which made him a target for bullying. Everyone experiences insecurities in high school, he says, but trans teens who are denied gender-affirming care fall far behind their classmates and struggle to fit in.

“No one knows you better than you know yourself,” Butler says. “I think politicians and people who don’t completely agree with allowing a 14-year-old to transition don’t fully understand what it’s like to be trans. And so they can’t really understand what it’s like.”

If Utah’s ban went into effect a few years ago, Butler says he wouldn’t know what his life would look like today. Butler spoke to Gov. Cox and state Sen. Mike Kennedy, who sponsored the bill, but felt like the lawmakers couldn’t hear him.

“Caring for our children doesn’t mean riding the latest radical wave,” Kennedy said last month. “When the discussion centers around surgical procedures and administering drugs to children, the potential long term negative outcomes cannot be ignored.”

Kennedy’s focus on the negative side of transitioning frustrates Butler. When Butler met Kennedy, the senator pointed out that males live for a shorter time on average than females and asked if Butler accepted this as part of transitioning.

“I think when [Kennedy] talks about all of these negative outcomes, he’s not really focusing on the lives he’s saving,” Butler says, “because, yeah, I could not transition and maybe live a couple of years longer because I stayed female. But I’m not really living. I’m just kind of going through life unhappy with who I am.”

The American Civil Liberties Union of Utah and the National Center for Lesbian Rights vow to sue Utah over the law. Meanwhile, a handful of other states already have restrictions, and more than a dozen others are considering them.

To young people in Utah and other states with similar bans, Butler says to keep holding on — though the wait may be “excruciating.”

“It might feel like the end of the world,” he says. “But once you’re able to start taking those hormones, once you get that surgery, once you can change your name, it just gets so much easier. You can actually live. You can step outside and take a deep breath for the first time.”

James Perkins-Mastromarino and Katherine Swartz produced and edited this interview for broadcast with Jill Ryan. Allison Hagan adapted it for the web.

This article was originally published on WBUR.org.

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