This month’s Ethics Rounds presents a case of an adolescent and her parent who object to the presence of a transgender adolescent in an established sexual trauma support group. To what extent do clinicians have a duty to consider the most beneficial therapeutic setting for all attendees? To what extent should the religious beliefs of a cisgender adolescent or the identity of a transgender attendee impact the group attendance of others? The case raised an opportunity for ethicists, therapists, an adolescent medicine physician, a social worker, a chaplain, an attorney and conflict mediator, and a palliative physician to consider gender identity and religious nondiscrimination as an ethics stance while also noting respect for persons, dignity, religious freedom, and therapeutic benefit ratios. It is important to foster ethically aligned and equitable care models in a nation increasingly polarized by different “bedrock beliefs.”