The national otolaryngology-head and neck surgery (OHNS) landscape of transgender and nonbinary/gender-nonconforming (TNG) care education and gender-affirming surgical training is variable with limited availability. However, specialized and innovative training with breadth and depth is available at select training sites focusing on facial and/or vocal gender affirmation throughout the United States. With growing trainee interest, program and fellowship director-related efforts to expand training, and progressive arcs of social change focusing on protections and promotion of TNG health, the future of OHNS training opportunities to serve TNG patients is promising.