Despite an upward trend in research focused on trans youth, how trans youth cope with their gender identity remains relatively unknown. We aimed to gather in-depth information about how trans youth described the developmental process of coping with factors that arise when youth are exploring their gender identity, coming out to others, and navigating institutions and society. We interviewed 20 trans youth, ages 7–18, from the Northeastern, Southern, and Midwestern regions of the United States. Six coping themes, with 23 higher order categories, emerged from the grounded theory analysis: Negotiating Gender, Avoidance, Emotional Relief, Personal Solace, Support, and Active Engagement. Findings underscore the importance of understanding the nuances of coping processes, such that the same coping strategy could be either useful or harmful, depending on the purpose, timing, and context. Results indicate that youth report both subtle and explicit observations of their family members’ coping processes, especially when comparing how family members cope differently on similar issues related to gender identity. Implications for this study include the importance of researching interventions that focus on minority stress for trans youth, as well as future research directions to understand family coping processes.