The prevalence of youth experiencing “gender dysphoria” over the last decade has exploded. More minors than ever before are identifying as a different gender than their biological sex. Yet, there is a divergence among nations regarding what care is best for minors questioning their gender identity. The United Kingdom has begun to move away from prescribing minors puberty blockers and hormone therapies, as the federal government in the United States seeks to protect and promote gender-affirming care for youth. The response among the states is far more fractured. Some states have imposed bans on gender-affirming care for minors. While there is no consensus among medical experts, emerging studies suggest gender-affirming treatments for minors may cause permanent harm. The majority of legal scholarship however, unequivocally supports minors’ ability to pursue treatment without consideration of their cognitive capacity to legally consent to such consequential decisions. Until there is a better understanding of the potential long-term costs of treating youth with gender-affirming care, courts should apply the Gillick competence standard adopted by UK courts. This paper asks courts to consider the age at which a minor can legally consent to transgender treatments while highlighting the emerging concerns associated with such care.