This article explores the ethical and clinical issues that may arise when utilizing group psychotherapy to work with transgender and gender diverse (TGD) individuals. Considering the unique barriers to mental health services experienced by this community, the authors identify ethical standards that may be especially salient in this work, including: justice and respect for people's rights and dignity, competence, consent, and navigating multiple relationships. The article also explores the authors' TGD therapy group and how they have worked with and addressed such ethical considerations and concerns.