Transgender and gender diverse youth (TGD youth; i.e., children and adolescents who do not identify with their birth-assigned sex) face a variety of traumas and adversities, including those explicit to their gender identity and/or expression (hereafter “gender”; e.g., gender-related victimization, caregiver rejection). However, few studies or clinical assessment measures capture the full spectrum of adversities TGD youth experience. A comprehensive examination of gender- and non-gender-related adversities faced by TGD youth is critical to understand their high risk for mental health problems and to inform best practices for clinical assessment and care. The present study sought to qualitatively examine gender- and non-gender-related adversities using clinical interview data from a sample of TGD youth (N = 49; ages 11–20; 76% White) seeking services at a pediatric gender center. Interview data were analyzed using deductive content analysis. To support future measure development, existing measures of adversity and gender minority stress informed the analysis. Results highlighted the saliency of gender-related adversities among TGD youth, the themes of which included verbal abuse, threats or acts of physical and sexual assault, discrimination, nonaffirmation, and rejection. Implications for clinical assessment with TGD youth and future avenues in measure development are discussed.