Jazz Jennings has been in the spotlight since 2007, when she was 6 and appeared on the ABC News program “20/20.” Wearing a dress, she opened up to Barbara Walters about being a transgender child, at a time when mainstream audiences didn’t often hear from those voices.

Thirteen years later, Ms. Jennings, now 19, continues to be an advocate for L.G.B.T. youth. She has had a doll modeled after her, written a children’s book and a memoir, and, with her family, started the TransKids Purple Rainbow Foundation. And she’s the star of the TLC reality show “I Am Jazz,” which returned for its sixth season this week.

TV viewers have followed many firsts in Ms. Jennings’s daily life, from going to prom to having a boyfriend. They tuned in when she had her gender confirmation surgery in New York City last season, surrounded by her parents and three older siblings. (There were complications after the surgery, and several follow-up procedures and visits with doctors were also chronicled on the show.)

Around the country, children and teenagers have watched Ms. Jennings go about her life at a time when some states are pushing back on transgender youth seeking the kinds of medical treatments the TV star and her friends have received. In South Dakota, young transgender people fear a bill that would restrict access to hormone treatments and surgeries on anyone under the age of 16. Similar bills have been introduced in other states including Colorado, Florida and South Carolina. (And despite the growing presence of transgender people in popular culture, the community faces elevated levels of homelessness, poverty and violence, especially for transgender women of color.)

Ms. Jennings talked to The New York Times about the new season, which features her third surgery, one she described as “a cosmetic operation for aesthetic reasons.” As Ms. Jennings recovers, she and her family have to contend with another complication and a possible fourth surgery. Ms. Jennings also helps raise money for a transgender friend who says that her mother’s insurance doesn’t cover her gender confirmation surgery.

The following is an edited and condensed version of the conversation.

You’ve talked about having body and mind alignment. Can you explain the importance of this?

Finally undergoing bottom surgery has allowed me to confidently flourish in my new body and dismantle any remaining gender dysphoria. For the first time, my body fully reflected my soul — how I felt on the inside. The surgery didn’t solve all of my issues, but it did offer a sense of peace and comfort that wasn’t otherwise there.

You seemed excited last year about being accepted to Harvard. Why did you decide to delay college?

I decided to delay college so that I could focus on taking a deep breath with all of the recent events of my life. I just needed a year to focus on my mental well-being and get in the right head space. I’m very glad I took a gap year and plan on starting school at Harvard in the fall.

You had complications after your surgery. Given those, do you regret having it done at an early age?

I have no regrets when it comes to the surgery. Even though I was young, I knew what I wanted and got the surgery right when I was meant to. Yes, experiencing the complications sucked, but it all worked out in the end.

You have described the surgery as a lifesaving operation that was covered by insurance. Do you think most health insurance should cover the costs of such surgeries?

This is a controversial question because some consider this specific procedure as an “elective” surgery undergone by choice rather than necessity. However, I disagree wholeheartedly. Gender dysphoria is a real condition and this surgery saves lives. It IS a necessity for so many transgender people and should absolutely be covered by insurance. So many trans people are suicidal due to the insecurities they feel being stuck in the wrong body.

You have shared so much of your life on camera since the show debuted in 2015. How do you balance what you share with viewers and what you keep private?

There is so much of my life that isn’t featured on the show. Even though most of the monumental events of my life are recorded, I still have so many private moments that aren’t shared. There is definitely a good balance and I feel like, even with a TV show about my life, I still have a great deal of privacy.

You recently shared your surgical scars on social media. What do you hope people take away from seeing them?

I hope that people appreciate the strength and perseverance it took to complete my transition and have the courage to be body confident. We all have bodies — some are bigger, some are smaller, some have scars.

What message do you hope that viewers take away from your show?

I hope they understand the importance of unconditional love. That’s always been the core of my family’s message. You just have to love and appreciate all people for who they are, including our differences. We’re all beautiful and unique and we just have to learn to embrace that.