Sexual and relationship health is a critical component of clinical practice with transgender and gender nonconforming (TGNC) clients. TGNC people face significant challenges in accessing trans-affirmative sexual health care and often lack safe spaces to explore their sexual concerns. In the rare instances that sexuality-specific health care is available to transgender people, it tends to utilize a disease prevention approach, focusing particularly on HIV/AIDS. Though this is a critical need, such a disease focus overlooks numerous aspects of sex and sexuality. As such, little is known about the sexual experiences of TGNC people and what their potential needs may be for overall sexual and relationship health. Working collaboratively with members of the local transgender community, we developed a sexual health therapy group specifically for transfeminine spectrum adults that is pleasure-based and sex positive in nature. The current article focuses on this curriculum, which is grounded in the Gender Affirmative Lifespan Approach (GALA) and includes 8 distinct group psychotherapy modules covering a range of transfeminine-specific sexual health topics. We present the therapeutic themes and interventions included within each module of the group therapy curriculum and provide a detailed example of 1 such module. This group therapy curriculum provides a much-needed foundation for developing more sexuality-related resources for TGNC people, as well as a clinical training resource for mental and sexual health providers. Recommendations for competent and effective utilization of the curriculum are discussed.