Individuals who thrive outside the confines of the two-box gender binary system have always been a part of the human family, and have held a place of honor in many world cultures across time. As the 21st century US begins to crack open rigid gender roles into more expansive identities, many nonbinary individuals have found the language and courage to express the fullness of who they are. However, nonbinary identities are still poorly understood by many service providers, leading to damaging care experiences and medical mistrust. This session will explore the colonial legacy of the gender binary, damaging impacts of assumption and erasure, techniques to engage nonbinary people respectfully, and examples of vibrant lives thriving outside the confinement of those boxes.