The purpose of this study was to describe the common psychological concerns of the first group of transgender youth to seek medical interventions in the first U.S. interdisciplinary pediatric gender clinic. The data reported were obtained during the psychological evaluations required by the clinic’s protocol. Participants included 56 gender dysphoric youth, aged 8.9 to 17.9, who were largely Caucasian. Data were obtained via archival chart review. Standard descriptive statistics were used to characterize the distribution of each measure. Student t tests were used to compare mean levels between genders, and Pearson correlation coefficients were used to assess the association of each measure with age, parent and child agreement, and the correlation between measures. Findings revealed that most mean scores fell in the “average” range; however, the percentage of patients with scores in the clinical range was notable for several variables. In terms of gender differences, transgender girls revealed more “worry” than transgender boys. Further, older youth experienced poorer self-competence, higher levels of anxiety, and decreased happiness and satisfaction than the younger patients. The results provide further evidence of the resiliency of a significant number of transgender youth, as well as the severity of mental health concerns for others. New to the existing literature are the results showing older transgender teenagers as more distressed, supporting the clinical recommendation to consider earlier medical intervention for appropriate youth, and to always incorporate mental health support and assessment.