Increasing visibility of transgender, nonbinary, and gender expansive (TNBGE) people in the United States and in higher education has coincided with a call for more affirming and appropriate mental health services. Group therapy has been connected to positive outcomes for college students, but appears less available to or less popular among TNBGE students. This article will summarize the history of feminist, queer, and trans theories, feminist group therapy, and therapeutic groups for TNBGE people. Recommendations for facilitating TNBGE groups will be presented, drawing from the work of three queer university counseling clinicians with collective experience in facilitating LGBTQ + and exclusively TNBGE groups using queer, trans, and multicultural feminist theories. Considerations for facilitating LGBTQ + groups for Black, Indigenous, People of Color (BIPOC) will also be included, based on relevant literature and clinical experience. Limitations of the authors’ perspectives and recommendations will be outlined, as well as future directions for research and practice.