Max Brandt was welcomed into the world as a baby girl, but as a young child was repelled by “girly girls” and feminine things. And after puberty arrived, Brandt suffered through a mental breakdown every menstrual cycle.

Eventually, gender dysphoria —  the psychological distress brought on by a mismatch between one’s sex assigned at birth and gender identity — made Brandt suicidal and prone to self-harm.

“It was a very palpable, almost physical pain for me,’’ recalled Brandt, who grew up in Santa Cruz.  “It affected almost everything I did.”

Brandt is now 23 and thriving as a college student studying psychology in Minneapolis. And he feels fortunate to have been raised in California, where access to hormonal treatment, surgery and other transgender health care as a minor was critical to stabilizing his mental health and helping him live a joyful life as a teenage boy.

Contending that all transgender youths in the country should have the same choices as Brandt and others like him, California legislators have made the state a refuge for trans youths and their families as a growing number of states attempt to restrict or ban transgender care to people under 18.

Over the summer, California became the first state in the nation to pass such a sanctuary law. Senate Bill 107, which takes effect on New Year’s Day, aims to protect out-of-state patients and their parents from legal retaliation by other states if they travel here for gender-affirming care.

“It has sent a very loud message to the rest of the country that we stand with trans kids and their families,” said the law’s primary sponsor, state Sen. Scott Wiener, D-San Francisco.

The measure, however, has been met with intense opposition in the midst of an acrimonious national debate centering on transgender youth and their rights — creating a direct clash between the states.

The new law restricts California authorities from enforcing the laws of other states that restrict or outright ban gender-affirming care that is legal in the Golden State. Such care includes mental health care, hormone blockers, surgeries and other medical interventions that combat gender dysphoria.

Specifically, the measure prohibits California law enforcement from participating in the arrest or extradition of a person accused of a crime related to transgender care in a state where such care is criminalized. It also prevents California health care providers from releasing medical information to out-of-state authorities investigating families for allowing children to receive transgender care.

More than 58,000 youth in 15 states were at risk of losing access to gender-affirming care as of last March because of state laws and policies, according to a report by the Williams Institute at UCLA’s School of Law.

Over the past two years, at least 306 bills targeted transgender people — the overwhelming majority focusing on trans youth — and about 15 percent are now law, a recent NPR analysis found.

Four states — Alabama, Arkansas, Arizona and Tennessee — have totally or partially banned access to gender-affirming care for minors, though much of the new legislation is now blocked in court as the legal dust settles.

Before California Gov. Gavin Newsom signed SB 107, about 50 conservative, religious and parental rights groups from across the country urged him in a letter to veto the measure, warning Newsom that it would entice “minor children nationwide to leave their families and run away in pursuit of harmful drugs and sterilizing surgeries.”

Greg Burt of the Fresno-based California Family Council, a religious organization that fiercely opposes the law, said in an interview that he’s concerned that a clause regarding child custody cases in the measure could result in children being kidnapped and taken to California to receive care and then removed from their parents’ custody.

“It’s a nightmare for the parent to think that someone could convince my kid they’re transgender, and the kids are taken from me and sterilized, and their bodies are mutilated permanently,” Burt said.

Proponents of the law, however, counter that it clearly does not give California new powers to take children from their parents. They say it simply prevents California from aiding another state’s attempts to remove custody from parents who allow their child to receive gender-affirming care.

The law’s supporters say the clause Burt is referring to was written in response to Texas Gov. Greg Abbott’s decision last February to direct the state’s child welfare agency to investigate parents of transgender kids for child abuse if they allow their children to receive gender-affirming care.

“This is not about kids getting access without parent consent, or anything along those lines,” said Kathie Moehlig, executive director of TransFamily Support Services in San Diego.  “We are going to be a safe place if you need to travel here for this care.”

Moehlig’s organization recently helped a family with a transgender child move from Texas to San Diego in response to Abbott’s directive.

The child’s mother, who didn’t want her name used to protect the family’s privacy, told the Bay Area News Group in an email that she feels fortunate to now live in a state that is supportive of her child. But she said she’s still concerned about the nation’s increasing number of legal mandates intruding on gender-affirming care decisions.

“I worry about my child’s safety and future every day,” she said. “The current political climate dictating medical and family decisions and laws being enacted that take away bodily autonomy are very frightening.”

Burt and other opponents of allowing hormone treatment and surgery for minors with gender dysphoria say they worry that many youth may later regret their choice. “Your goal as a parent is to protect your child from making mistakes when they’re young,” he said.

According to a groundbreaking Princeton University study released in July, only 2.5 percent of 317 children in the U.S. and Canada who began social transitioning between ages 3 and 12 had changed their minds five years later.

The U.S. Food and Drug Administration and the National Institutes of Health say there’s limited data on the long-term effects of medical interventions such as puberty blockers and hormone treatment. But many parents of transgender children are often willing to take those risks in light of the high suicide rates of transgender youth.

Data shows that the number of adolescents seeking medical interventions for gender dysphoria is growing. Statistics compiled by Reuters with the help of the health technology company Komodo showed that the number of 6- to 17-year-olds diagnosed nationally nearly tripled to at least 42,000 from 2017 to 2021.

The American Academy of Pediatrics recommends that youth have access to comprehensive, gender-affirming and developmentally appropriate health care “that is provided in a safe and inclusive clinical space.”

Brandt, the college student from Santa Cruz, began receiving puberty blockers at age 14, testosterone treatment at 15 and had surgery to remove breast tissue to attain a masculine chest at 16.

“For me,” he said, “every single little thing that changed was such a joyous experience for me — even getting extra acne.”

After the surgery, Brandt said, he returned home feeling jazzed. “To be able to look in the mirror and be able to touch my chest and not have something there was really a joyous experience,” he said, “as was seeing the way that T-shirts fit me afterwards.”

It’s important for other youths, no matter where they live, to have access to the same quality care that he did, Brandt said.

“I think that every parent wants their kid to be happy and healthy,” he said. “Being able to medically transition has in some ways saved my life.”