Access to equitable health care, including gender-affirming medical care (eg, pubertal blockers, sex hormones), continues to be a struggle for transgender and nonbinary youth, especially those who are in racial and ethnic minority groups. 1,2 Barriers to accessing comprehensive health care may contribute to the many health disparities transgender and nonbinary youth face, such as higher rates of substance misuse, burden of sexually transmitted infections, bullying, being bullied, anxiety, depression, suicidal ideation, and suicidal behaviors compared with their aged-matched cisgender peers. 3 Looking at 1 disparity, mental health, there is clear evidence that access to pubertal suppression and gender-affirming hormones can be lifesaving. 4,5 Yet, barriers to this care continue to exist, and many transgender and nonbinary people avoid accessing health care because of experiences of discrimination and/or fear of breaches in confidentiality. 2 There is good news; with the exponential increase in multidisciplinary gender clinics around the world, and in particular the US, access to gender-affirming medical care has improved. 6 However, has this been enough to provide equitable access for transgender and nonbinary youth, especially transgender and nonbinary youth of color? The answer is a resounding no. This is highlighted by the fact that we continue to see health disparities within this population, despite having more centers providing gender-related care. 3 What changes to clinical practice must be done to ensure access to gender-affirming medical care for all youth?In this issue of JAMA Pediatrics, Chong et al 7 systematically reviewed the experience and perspectives of transgender youth accessing health care globally. The authors give strategies to improve clinical practice on 6 themes: (1) provide gender-affirming care, (2) promote inclusive administrative practices, (3) address concerns about confidentiality and public harassment, (4) address psychological stressors and risktaking behavior, (5) improve accessibility to transgender health services and information, and (6) educate and empower clinicians to address systematic barriers to care. These must all be done. We posit more is required to ensure equitable access to gender-affirming medical care for all transgender and nonbinary youth. Below are 7 additional strategies we believe are necessary to improve access to care.