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In 2020, Britain’s High Court passed a landmark ruling stating that persons under the age of 16 could not provide informed consent to receive puberty blocker treatment. This historically marked the resurgence of a long-standing and arduous struggle between trans-affirming organizations in the UK and the state. The clinical aspect of this political struggle played out at Tavistock and Portman, a foundation trust of the NHS that has long provided mental health services and gender-affirming care. In this article, by analyzing the medical concept of “Gillick competence,” I criticize the normative clinical and political reasons pressed into service in the lawsuit and in the institutional denial of gender- and trans-affirming psychotherapeutic care. I draw upon the work of Jacques Lacan, Jules Gill-Peterson, Paul Verhaeghe, Patricia Gherovici, and the late Mari Ruti to offer a different conception of psychoanalytic practice, one more avowedly friendly to trans desire. When practiced with sufficient theoretical rigor and playful open-endedness, I contend that psychoanalysis is a practice uniquely situated for learning to listen to and countenance trans desire.