It has become increasingly common for school-age children and adolescents to express what is commonly known as gender nonconformity. School officials across the country are being called upon to implement systems and programs that are inclusive of gender nonconforming youth. It is important that children have access to a learning environment that is, at a minimum, safe, and ideally, that accepts and celebrates the diversity students bring to school. School psychologists play a critical role in creating a school environment that is inclusive of all students. To do so, school psychologists must be aware of the clinical concerns that gender nonconforming students may have. "DSM-5" has moved away from pathologizing a person's identity and toward recognizing the stress that may exist for those people whose birth sex and gender are not in alignment. This article discusses three major changes in the diagnosis from "DSM-IV-TR" to "DSM-5," possible consequences of "DSM-5" changes, and implications for school psychologists.