The transition from childhood to adulthood involves three key aspects: acquiring new roles for maturing youth; developing and establishing autonomy; and preparing for emotional and functional independence. During this transition period, any or all of these aspects may pose challenges and require observation, consideration, and additional support. For childhood cancer survivors, the transition from oncologist-led care to primary pediatric, adolescent, and eventually adult care is especially important due to the risks and realities of significant late effects that require lifelong follow-up care. As teen survivors mature into adulthood, they may also experience new long-term side effects or the worsening of existing chronic issues. These challenges can impact a survivor’s ability to develop independence, manage tasks associated with day-to-day Iiving, graduate from high school, and/or enter the workplace. The psychological impact of watching healthy friends and siblings complete school and pursue their adult aspirations – especially if side effects challenge their ability to do so – can erode a sense of self and the belief that they can lead an independent life. Regardless of the challenges survivors experience, each survivor should nurture self-advocacy skills. Active efforts to shift appropriate decision-making from parent to survivor will help to establish capability and success for young adult survivors.