This multiple-methods two-part study included a collection analysis of the holdings of trans books in 35 randomly selected public high school libraries in one state in the southeastern United States. Also, the attitudes and practices of 37 high school librarians (in the same state but not necessarily at the same schools whose collections were analyzed) about this material were surveyed and analyzed. The conclusion drawn from the collection analysis is that libraries are under-collecting trans books compared to books without LGBTQIA+ characters and themes. Some libraries in the state do have robust collections of trans material, but access to trans books varies widely across the state, and some students have poor access. This poor access amounts to inequitable service. The results of the survey revealed that participants overwhelmingly had positive views about trans books and believe that they intentionally collect this material. The positive attitudes of the school librarians do not align with the findings of the collection analysis that libraries are under-collecting material with trans themes and characters. In a time when both trans rights and trans literature are under attack across the country, what resources are freely available to youth in their schools matters. Further research is needed to know how to improve the holdings of trans materials. Additional research could also consider the perspectives of trans youth about library service.