Human sexuality is a labyrinthine occurrence found in human beings that reflects the fascinating interplay of such complex phenomena as biological sex, core gender identity, and gender role behavior. Research in the twenty-first century has considered intrinsic aspects of human sexuality, leading to numerous complexities and controversies in current society. In this chapter, we look at special populations that include the LGBTQIA+ classification referring to persons described as lesbian, gay, bisexual, transgender, questioning (queer), intersexed, agender, asexual, pansexual, genderqueer, and others. This group of persons can develop a variety of behavioral problems and present the clinician with numerous clinical challenges. The emphasis in this discussion is on the transgender pediatric person and the need for integrated behavioral health services to help these individuals as well as the clinicians caring for them.