In the past 10 years, gender-variant (GV) children (children who do not conform to traditional gender norms) have received increased attention from scholars, mental health practitioners, and popular media. In schools, these students have been shown to be particularly vulnerable to violence and harassment, leading to myriad negative psychoeducational outcomes. School psychologists are often asked to work with GV students and to consult with families about the best therapeutic options in the clinical settings outside of schools. In light of the fact that clinical approaches to GV children are wide ranging and often contradictory in their assumptions and goals, this can be a difficult task. In this article, we begin by defining terms and definitions relevant to the discussions on GV students. We then review and summarize various clinical models of working with GV children and youth. We advocate a stance of awareness, thoughtfulness, and nonpathologizing of gender diversity when working with this student population. Finally, we discuss implications for school psychologists, framed within the structure of the National Association of School Psychologists (NASP) position statement, "Lesbian, Gay, Bisexual, Transgender, and Questioning Youth" (NASP, 2011).