Female-identified transgender youth (FIT youth) have a male birth sex but identify as female, placing them outside of socially acceptable standards and increasing the challenges of adolescence. They face numerous potential sources of stress and have a higher likelihood of experiencing negative mental health outcomes due to lack of support, lack of perceived safety, and limited access to resources and like peers. Fortunately, there are protective factors and intervention strategies that help buffer against negative mental health outcomes. Intervention is encouraged to build on these factors and is likely to be most effective when applied at the individual, family, and school levels.