Using an ecological framework, the existing literature and research, and the authors' combined 60 years of clinical practice with children, youth, and families, this article examines gender variant childhood development from a holistic viewpoint where children, youth, and environments are understood as a unit in the context of their relationship to one another. The focus is limited to a discussion about the recognition of gender identity; an examination of the adaptation process through which gender variant children and youth go through to deal with the stress of an environment where there is not a "goodness of fit"; and a discussion of the overall developmental tasks of a transgender childhood and adolescence. Recommendations for social work practice with gender variant young people are presented in the conclusion of the paper.