In early December 2020, Jay Castilow attached two pieces of paper to his bedroom door: his pronouns (he/him) and his chosen name.

“I think [being trans] is a joy that not many people are able to feel,” Jay said. “It makes me happy to think about my transness. Sometimes it’s very stressful, but, for me, it’s something that I’ve grown with. It’s been, obviously, a major, major, major part of my life, like completely life changing, but in the best way.”

In February 2021, Jay started wearing a chest-minimizing binder, and in April 2022 he began medically transitioning. He currently does hormone replacement therapy through weekly testosterone injections. Unless another equally effective and safe treatment becomes available, he will have to receive these shots every week for the rest of his life.

“When I go to school, when I go to work, I'm not a trans person, but I am,” Jay said. “But I'm not a trans person there. I’m just Jay.”

When Jay first came out, his parents—Harry and Dena Castilow—struggled to use Jay’s correct name and pronouns. Dena said she even asked her son to have his blood tested for “some kind of chemical imbalance.” After educating themselves, however, Harry and Dena have become fierce supporters of their son and the LGBTQ+ community as a whole.

“Not many people can say that they’ve had a good experience transitioning, and I’m glad that I have been able to,” Jay said.

Even before coming out, Jay was a vocal activist, fighting for the rights of LGBTQ+ individuals as well as attending Black Lives Matter, prison abolition and pro-choice rallies.

In August 2023, Senate Bill 49 went into effect, prohibiting Missouri minors, like Jay, from receiving most gender-affirming care. If the University of Missouri had not filled Jay’s final testosterone prescription, he would have been forced to stretch the leftover medication in his old vials until he turned 18 in May 2024.

Jay and his parents are prepared to flee the state if Missouri increases the age for people to access gender-affirming care from 18 to 21 years old. If the Castilows do end up leaving Missouri, Jay would be ineligible for A+ Scholarship Program benefits reducing the cost of his college tuition, despite the work he did in high school to receive this award.

Although his future remains uncertain, Jay, like countless other teenagers, is taking life one day at a time, constantly deciding with each new trial and tribulation what type of man he wants to be.