Clinics everywhere that support transgender and gender expansive children and youth are reporting an exponential growth in the numbers of new cases. A recent study revealed that 2.7 % of over 80,000 high school students identified as a gender other than the one assigned at birth (Pediatrics, 2017). Virtually all institutions dedicated to children and youth are faced with the challenge of welcoming and integrating gender diverse children and youth and deconstructing established paradigms regarding gender identity and expression. In a field plagued with controversy, certain approaches are emerging as best practices to support gender diverse children, youth, and their families.