This issue offers guidance on sex, gender, and identity to help you navigate patient care through the societal turmoil engulfing these topics. Clinicians often skip sexual histories—we want you to feel comfortable taking a sexual history with children and teens. Some teens talk about having multiple selves or “headmates”—Dr. Paroma Mitra helps us differentiate dissociative identity disorder and plural identity. Gender affirming care (GAC) is now restricted in 20 US states and in England, while the US Supreme Court recently did not block gender dysphoria rights under the Americans with Disabilities Act (ADA)—we clarify the facts about what GAC is and talk with Dr. Peter Daniolos about how to help families connect with their gender diverse children and teens. We also provide resources on sexuality and gender diversity, including books, agencies, and quick guides on the vocabulary of gender and plurality, and we offer some tips on navigating pronouns. We expect you will have thoughts and comments, and we welcome your feedback.