<p>Transgender youth contend with conventional stressors and traumas at higher rates than their cisgender peers, and this accumulation of stressors can result in significant health and mental health disparities. Youth with gender incongruence and/or who are impacted by trauma can have considerable overlaps in their clinical presentations (e.g., symptoms not attributed to the appropriate etiology, complications around disclosure) as well as in their strengths and protections. The likelihood of experiencing trauma, combined with these overlaps, provides rationale for an integrated approach to treatment. In this paper, we review the literature related to the interplay between conventional traumas, minority stressors, and gender incongruence. We also review existing clinical guidance for mental health clinicians treating youth experiencing both gender incongruence and traumatic stress. To date, this guidance mostly exists in separate bodies of literature and specialties. We present a rationale and call to action toward clinical models that address the needs of transgender youth and their families in an integrated way, grounded in trauma-informed, gender-affirmative care.</p>