This article summarizes key findings from a strengths and needs assessment of media work by Lesbian, Gay, Bisexual, Trans*, Queer (LGBTQ) and Two-Spirit organizations in the United States, conducted in 2014–2015. This mixed-methods participatory research included a nationwide organizational survey with 231 respondents, 19 expert interviews, and a series of workshops with project partners and advisers. We found that despite scarce resources, many LGBTQ and Two-Spirit organizations have an intersectional analysis of linked systems of race, class, gender, sexual orientation, and other axes of identity and structural inequality. Many seek to do media work that develops the critical consciousness and leadership of their communities, create media in ways that are deeply accountable to their social base, use participatory approaches to media making, are strategic and cross-platform in their approach, and root their work in community action. We call this combination of characteristics transformative media organizing, and we believe it describes an emerging paradigm for social movement media practices in the current media landscape.