Laura Edwards-Leeper, a clinical psychologist who established the first youth gender clinic in the U.S., and Joe Olson-Kennedy, a physician advocating for gender-affirming care, delve into the evolution of treatment for transgender youth. They discuss the adaptation of the Dutch model to U.S. contexts, the increasing demand for care, and the rise of non-binary identities. Their insights touch on the complexities of assessing gender identity, the importance of trust in self-identification, and the need for thoughtful, child-led approaches in a rapidly evolving landscape.