There are 1.4 million adults in the U.S. who identify as transgender. Transgender and gender non-conforming individuals may present to the otolaryngologist with general complaints of the ear, nose, and throat as well as those directly tied to gender affirmation. It is important for otolaryngologists and office staff to provide unbiased care in a safe environment for patients of all gender identities. This presentation will introduce terminology and the best clinical practices for all otolaryngology-head and neck surgeons. Panelists will then provide an overview of gender identity, gender expression, sexual preference and their associated spectrums. We will also provide updated information on creating affirming spaces for patients within the context of otolaryngology and explore challenges faced when providing gender affirming services for patients.