GEOFF BENNETT: The political battles over# the rights of transgender Americans have## led to difficult decisions for# a number of families, especially## those living in states with restrictions on# transition-related medical care for minors.

Laura Barron-Lopez has the story of one# family's journey to access that care.

RHYAN, 14 Years Old: When are we leaving?

MIA, Mother: Twenty minutes, 20, 10 minutes.

LAURA BARRON-LOPEZ: Fourteen-year-old# Rhyan (ph) and his single mom,## Mia (ph), have waited over a year for this day.# They're getting ready for a doctor's appointment.

MIA: Yes.

Can you put that away?

LAURA BARRON-LOPEZ: But that appointment is in# Albuquerque, New Mexico, more .. from their home here in Austin, Texas.

It is a# journey they are making because Rhyan is trans.

This is something that you didn't just decide# one day.

You felt this for a long time?

RHYAN: Yes.

I was really young.

I was -- like, I# was 6, and I knew for sure that I was not a girl.

MIA: He was always a dude.

He was# always a little dude.

And then,## right before he came out, he cut his# hair, and looking back on it now, like,## cutting all those curls off and everything, like,# I can see how his -- he was starting to align.

And it just in hindsight makes it way# more clear than it was at the time.

But,## yes, he's always been who he's been.

LAURA BARRON-LOPEZ: Rhyan saw doctors# and therapists for years before## starting medication around the age of 10 to# temporarily pause the effects of puberty.

A few years later, he began testosterone# treatments, which can lead to things like hair## growth and a deeper voice.

All those steps fall# within guidelines for gender-affirming care, which## is supported by major U.S. medical associations,# including the American Academy of Pediatrics.

But around the globe, medical experts and# government health officials haven't been## in complete agreement.

Gender-affirming medical# care for minors has come under increased scrutiny.

STATE SEN. BEN ADAMS (R-ID): If they really feel# that their best choice is to mutilate themselves,## they better wait until they are an adult.

LAURA BARRON-LOPEZ: As conservatives,# from local lawmakers to the Republican## presidential nominee, have# used it to mobilize their base.

DONALD TRUMP, Former President of#the United States (R) ... and you say, Jimmy, I love you so# much, go have a good day in school,## and your son comes back with a brutal# operation?

Can you even imagine this?

LAURA BARRON-LOPEZ: Lies spread by former# President Donald Trump and others in## his party about things like surgeries on minors# have helped fuel a wave of state legislation.

In 2021, Arkansas became the first# state to ban transition-related## medical care for those under 18.

Since then,# restrictions have passed in 25 more states,## home to 40 percent of the nation's trans youth,# including Texas.

It's law went into effect last## September.

It revokes the licenses of# doctors who provide gender-affirming## medical care to minors and requires# anyone on treatment to be weaned off.

MIA: It was terrifying.

Like it# was, immobilizing, immobilizing.

I pounded the pavement.

I knocked on doors.

Like,# I did my best as, like, a mom and as a constituent## to the plea my to plea my case and plead our# family's case.

I watched experts get disregarded## and dismissed.

I watched facts and evidence# be ignored.

And they voted for it anyways.

LAURA BARRON-LOPEZ: What's your message# to those lawmakers who passed that ban?

RHYAN: You don't know the people you're# affecting.

You don't know how much of a,## like, impact it has on them, how dangerous it is.

LAURA BARRON-LOPEZ: As the measure# moved through the Texas legislature,## Rhyan and Mia were told his doctor# couldn't see him anymore.

They lost## access to his prescriptions and had to stretch# the medicine they did have as long as possible.

Mia started looking for care in# other states.

But between the## cost of travel, the appointment, and# the medicine, they couldn't afford it.

MIA: There's no way.

I'm already, like, barely,# barely scraping by.

I don't have -- actually,## if my car breaks down, I don't have extra# funds.

And there's days where I have to -- like,## I had to choose between, like, gas or food.

And# there's days I went hungry so my kid could eat.

LAURA BARRON-LOPEZ: Mia ultimately connected# with the Campaign for Southern Equality,## a nonprofit focused on LGBTQ rights.# Its Trans Youth Emergency Project## helps families cover the costs of# travel for out-of-state treatment.

Mia got Rhyan an appointment at a University# of New Mexico clinic in Albuquerque.

But she## still didn't have enough money to cover the# entire cost of the trip.

Enter Elevated Access,## whose volunteer pilots fly# patients living in places with## abortion or gender-affirming care bans# to out-of-state appointments for free.

A pilot we're just calling Clyde to# protect his identity volunteered to## fly Rhyan and Mia from Austin# to Albuquerque in his Cessna.

CLYDE, Pilot: The biggest surprise for# me is how I reacted emotionally to this## need.

It just seems so political, so# ridiculous because it was political.

RHYAN: I think it's stupid.

We shouldn't# have to take a private plane to go to a## fully different state for some little# vials of medicine, a shot.

And I don't## think old men should be making laws about# something that doesn't affect them at all.

MIA: Our pilot, the people that go out of their# way to risk it, that are risking their livelihoods## or putting themselves at risk for no reason,# they're just -- they're kind, and they understand## what's at stake.

And that's the part that --# it gets to me.

It gets me in my heartstrings.

CLYDE: And I will see you tomorrow maybe.

MIA: Oh, thank you.

Oh, yes, for sure.# Thank you very much.

really appreciate it.

CLYDE: Rhyan, give you a hug.

RHYAN: Thank you.

MIA: You're our hero.. LAURA BARRON-LOPEZ: The next morning, Rhyan# and Mia arrived for their appointment with Dr.## Michele Hutchison, a pediatric endocrinologist.# About half her patients are now from Texas.

DR. MICHELE HUTCHISON, University of New# Mexico Health: I hate that this is happening## to my families.

Being transgender is hard.# Transition.. all of this in the background of# everybody coming at you and telling## you that it's wrong.

How would you not have# anxiety?

How would you not have depression?

This is -- it's just a mountain to overcome.

LAURA BARRON-LOPEZ: And there are new# obstacles.

Texas' attorney general has## tried to access medical records of trans# patients getting care out of state.

Trans## Texans can no longer change their gender# on birth certificates or driver's licenses.

Meanwhile, the U.S. Supreme Court is set to## decide whether bans like the# one in Texas are constitutional.

DONALD TRUMP: Transgender insanity# the hell out of our schools.

LAURA BARRON-LOPEZ: And Mia says# that, if Trump is reelected,## she will move her family out of the country.

MIA: The stakes are high.

It is# that scary.

I want to -- yes.

No,## I wouldn't stay.

How -- how could I do# that in good faith and be a good parent?

LAURA BARRON-LOPEZ: But, for now, Rhyan's# care moves forward.

Dr. Hutchison said## Rhyan was handling his treatment well,# gave him a new testosterone prescription,## and scheduled a follow-up# appointment for six months.

RHYAN: I'm excited.

And now we# have, like, plans set in place,## and like, resources available.

I'm happy.

MIA: I love you.

Yes, today's a good day.# I have been emotional all morning.

But## it's a good day.

This is happy tears.

I'm# just -- I'm overwhelmed with gratitude.

LAURA BARRON-LOPEZ: They went to a# pharmacy nearby to fill the prescription.

MIA: Thank you very much.

LAURA BARRON-LOPEZ: A moment of# relief amid near-constant struggle.

For the "PBS News Hour," I'm Laura Barron-Lopez.