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Family mental health services, specifically group services emerged out of a tradition of family therapy aimed at prompting youth well-being by intervening on the systemic level. For example, families may reject gender expansiveness or enforce the rigidity of gender norms rather than alter the family system. When a child transitions, the entire family and system is impacted and must change as well (Malpas & Glaeser, 2018; Malpas, Pellicane & Glaeser, in press). Many strides have been made in the last half century towards an increasing multicultural competence of family therapy services, yet a one size fits all approach does not serve all families (Malpas, Pellicane & Glaeser, in press).