This study explored results from a nationwide survey conducted with homeless youth shelter directors. The research sought to further the understanding of how policy and societal changes about gender affirming access to services have affected service delivery and accommodations at homeless youth shelters for transgender and gender non-conforming (TGNC) youth. Results from (n = 117) youth shelters indicate the majority of those surveyed are current in implementing many of the Housing and Urban Development (HUD) gender affirming policies. Among others, recommendations include a need for shelters to incorporate TGNC safety accommodations, and to update dress code policies from a universal design perspective.