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Based on her clinical experience, the author first discusses gender dysphoria in the non-pubescent child, which is usually resolved before adolescence.Gender dysphoria in adolescents is quite different and poses major problems. Indeed, the intense suffering of these young people is undeniable. The DSM-5 diagnostic criteria are precise, but remain based on the individual’s subjective desire, experience, and conviction to belong to a gender other than the one assigned at birth.Use of the “Dutch protocol” to bring them to transition to the perceived gender is a typical treatment. However, the heated controversies that have long existed on this subject have been heightened in the last three years by the rapid increase in the frequency of requests from adolescents, mainly girls, often with significant psychiatric comorbidities, but who are reluctant to receive any psychiatric or psychological treatment. Some approaches to treatment are proposed.