Transgender and nonbinary children and adolescents bear a disproportionate level of poor health, and adverse developmental and academic outcomes compared to their cisgender peers. In this article, I review evidence from recent research on minority stress and resilience among trans youth and advocate for two additional domains to be included when studying the experiences of trans youth from a minority stress perspective. I describe the variability across sexual-minority and gender-minority youth in experiences of minority stress across and within contexts. I advocate for explicit attention in minority stress models with gender-minority youth to the domains of (a) intrapersonal and interpersonal gender dysphoria, and (b) access and use of affirmative and comprehensive health care.