Clinicians are increasingly called upon to work with gay, lesbian, bisexual, transgender (GLBT), and gender-variant youth. Currently, there is no formal outline regarding competent care for these youth. This Workshop reviews the key competencies necessary when treating GLBT and gender-variant youth, and provides resources to those involved in training, supervision, and clinical care. Participants have the opportunity to develop clinical competence through knowledge of the evidence-base, ethics, controversies, and biases with respect to psychiatric practice with GLBT and gender-variant youth. The challenges and opportunities involved in training child and adolescent psychiatry fellows about GLBT issues are covered and participants gain knowledge about creating a model for curriculum development, with actual examples from three institutions.