There are now deep debates within psychoanalytics regarding approaches of care for an adolescent presenting as non-binary or transgender. These debates are vastly split. While some view the child’s demand to transition as a matter of self-knowledge that calls for “affirmation,” others raise concerns over the child or adolescent’s capacity to discern between “need and wish” and warn against affirmation of a young person’s gendered assertions. In this paper, I focus on the question of care through a close reading of Eve Watson paper “Transitioning and Variance in Children and Adolescents: Some Temporal and Ethical Considerations.” Watson’s robust critique of the affirmative model and the “watchful waiting model” centers on a number of ethical concerns that bear on the question of the child and adolescent’s desire and its saturation. Her critique, however, leaves us with a question. What do we imagine affirmation to be? I use Watson’s critique of affirmations to address the instabilities of the term and its implication in considering the clinical encounter with the trans child.