The concept of identity is complex and affected by personal and cultural pressures. No more so than during adolescence, a time when we endeavour to find out who we truly are as our minds and bodies go through many changes, we start to disidentify with our families, and we are exposed to group attitudes and pressures. For many adolescents, puberty can feel like an unwanted betrayal by their own bodies. Their changing physicality seems to pull them further away from the self they imagine or wish to be and they struggle to reconcile their physical form with their sense of self. This book explores gender distress through the lens of early childhood development with a focus on and elaboration of developmental interpretations and corresponding psychotherapeutic approaches. It builds on the work of Evans’ previous book, co-authored with Susan Evans, Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults (2021). As with his first book, it is based on continuous learning gained through clinical work with different patient groups. The analyst’s role is to remain curious and help patients explore and understand themselves in every aspect of their lives. Evans uses composite cases to chart the progression of therapy and show how psychological support can help individuals. The book includes a Preface from R. D. Hinshelwood and Foreword from Ron Britton. It is essential reading for all clinicians, practising therapists and trainees, as well as any other professionals who work with adolescents and young people.