The author, a child and adolescent psychiatrist, discusses his experience working with minority transgender youth in Los Angeles. He describes two cases of adolescents he has treated in Los Angeles at a clinic which serves sexual minority youth who are often wards of the foster care and criminal justice systems and who often have chaotic and traumatic family histories. Unlike the classic descriptions of transsexuals, these youth are often varied and fluid in terms of their gender identities, expression, and sexual identities and orientation.