Trans advocate Jazz Jennings on life before, after gender confirmation surgery

Arguably the most famous transgender teen in the world, Jennings catches up with "Nightline," which has been documenting her inspiring journey for a decade.
6:10 | 01/10/19

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Transcript for Trans advocate Jazz Jennings on life before, after gender confirmation surgery
I didn't necessarily choose this path. This path chose me. Reporter: Jazz Jennings is the most famous transgender teen. She shares the most personal details of her life. From the time I've been 6 years old I've been sharing my story. At first I thought okay, this will all come to an end and I'll be able to live my life. But more and more I realize I was given this platform for a reason. I always like people to look past your physical anatomy to see who you are. Reporter: Now in the fifth season of her award-winning tlc show "I am jazz", she's more candid than ever, sharing intimate milestone moments of adolescence. Have you kissed him yet? Yes, I've kissed him a lot. Reporter: On the verge of leading to the final gender confirmation surgery. I do have to weigh you. If you are one pound short we're going to have to push surgery back. Let's just do the damn thing. Let's do it. Reporter: A life changing procedure that for years was just a dream. I asked my mom, when is the good fairy going to come with her magic wand and turn my penis into a vagina. Reporter: You were 2. Yeah. Reporter: When we met up with jazz last year she was days away from undergoing her final transition surgery. I would say this is the final step of transitioning. Reporter: A procedure that in her case essentially refashions male genitalia into the female equivalent. This is really the last thing that will validate my identity as a woman. I can live my life as just jazz. Reporter: It's been a long and winding road, one we've documented for more than a decade. Hi. Can I come in your house? Yeah. Reporter: The Jennings first opened up to Barbara Walters back in 2007. Your child was born a boy, and now you call him a girl. Yes? Yes. Reporter: At the time, jazz was just 6 years old, one of the youngest documented cases of a child transitioning from male to female. If people say to you, are you a boy or a girl, what do you say? A girl. Mm-hm. Reporter: You've had to put up with a lot of withering criticism, what, after all these years, do you say to people who still have those doubts? I'd rather have a living daughter than a dead son. And I know that if I didn't let this child B who she wanted to be, there's a good chance she wouldn't be with us today. Reporter: Over the years, we've checked in with jazz, that precocious little girl who grew into a teen, navigating the awkward middle school years. I don't care what he thinks about me. Reporter: But with adolescence looming, jazz along with her parents, decided to use blockers to block male puberty. Then the female hormone. This is the pill I take. I start getting breasts, softer features. Everything more feminine. It's what I've always wanted. Reporter: She calls it a life-saving pill. But years later, reaching the operating room would come with obstacles. That surgery impeded by the hormones. I didn't have enough growth down below. It was very challenging to find a doctor, a surgeon who was willing to perform the operation on me, just because I'm such a difficult case. What we're really doing right now is break through in terms of the surgery in this peritoneal lining. Jazz as a medical case is a conundrum. Her puberty was blocked so well that she didn't get genitals in a way to allow us to use the approach. They're using the tissue I have, the peritoneal, I call did a break through. As long as it's functional. Reporter: As jazz made her way into that life-saving surgery, she hopes if successful it would pave the way for the next generation of trans girls seeking to have the same surgery. With a team of three sur jgeons, the surger lasti Almos five hours. W haveews. We have it's a girl! Reporter: Her parents right there throughout. It's girl.I lov you so much. Repor weollowed up with jazz after her surgery. The recovery was not easy. ? There was a complication, I had to go in for another procedure. It was all part of the journey. The good thing was it was only cosmetic and external, so it wasn't too dramatic. Reporter: Your life was never in danger. No, my life wasn't in danger. Reporter: In many ways, she's still that girl we met a decade ago. But now at 18, the trans child advocate is transitioning to adult, tackling the hard realities in her community, discrimination in the work place, unemployment, homelesses, even higher rates of murder. Reporter: Do you see yourself continuing to carry the banner for trans rights? More and more I'm thinking about continuing my advocatesy. If we can embrace the variety of who we are and all of our differences and come together world can be a beautiful place. Our thanks to jazz and the entire Jennings family. "I am jazz" airs Tuesday night on tlc.

This transcript has been automatically generated and may not be 100% accurate.

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