School-based nurse practitioners (NPs) can reduce health disparities for transgender and gender nonconforming (TGNC) adolescents. However, research is limited regarding their understanding of TGNC health. This study aimed to explore school-based NPs' perceptions of the health needs of TGNC adolescents. A qualitative, descriptive analysis utilizing a demographic survey and semi-structured interview questionnaire was conducted. School-based NPs (N = 6) were recruited via the New York School-Based Health Alliance listserv and through clinical networking. An essentialist, reflexive approach utilizing inductive thematic analysis was utilized. Four key themes and an overarching theme were identified. The overarching theme was the following: School-based NPs are primary resources--or "point people"--for TGNC adolescents seeking support, safety, and accessibility to health care. Findings identified the need for improvements in the areas of TGNC advocacy and education.