With the introduction of the topic of "transidentity" into the consciousness of a broad public, the treatment wishes of young people with gender dysphoria and transident experiences are increasing in child and adolescent psychotherapeutic practices. The factors influencing identity formation are diverse and accompanying the everyday trials of trans * young people of the perceived gender poses a special challenge for therapists. Heiko Dietrich uses case studies to show essential aspects of therapeutic work with this clientele. He discusses the examination of the transident experience as well as the influence of mental disorders on the self-image of adolescents, in order to gain security for the practitioner in order to make good decisions about the indications for medical measures.