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This paper describes the evolution, learning and key components of a group psychotherapy provision for adolescents experiencing gender-related distress (GRD). It suggests that this approach has much to contribute to current consideration of what help for this population could include. In the context of rapidly increasing numbers and a changing demographic of young people referred with gender incongruence over the past 15 years, the Cass Review was commissioned to make recommendations about their NHS care. Concluding in 2024, it found relevant research to be limited and emphasised the importance of gaining a much better understanding of those presenting for help, their support needs and the potential treatment options. While the diverse antecedents and manifestations of adolescent GRD indicate that no one model will fit all, this paper offers a rationale for considering group psychotherapy as a meaningful support. It describes a provision that originated as a CAMHS and third sector partnership initiative, and has been maintained in a third sector community setting across this 15-year period with a mix of NHS, local authority and charitable funding. Informed by psychoanalytic, group analytic, mentalization-based and art therapy approaches, the model used has been shaped through trial, error and collaborative endeavour with affected young people. Service developments and current research plans are outlined. Process examples as well as photographs of artwork illustrate the discussion.