The gender clinic in Zaandam counsels youngsters who struggle with their gender identity. The advice of the gender clinic is considered the prelude to a change of sex in the passport, or a major medical treatment. We get acquainted with practitioners and all the dilemmas they represent. How do you give proper advice concerning irreversible choices that may mark the rest of people’s lives, while the outpatient clinic is struggling with its finances and the waiting list keeps getting longer? How do you deal with a low-IQ adolescent who wants to transition? What to do with feelings of doubt? And is there also room within the team for a conservative voice?