Appearance-related peer victimization has been shown to have strong social, health, and economic consequences on victims. Low body satisfaction has also been associated with higher appearance-related peer victimization prevalence. Preadolescent children are particularly vulnerable to the exposure and effects of appearance-related peer victimization. Research shows gender minorities have been particularly at risk for peer victimization. More studies are needed to adequately capture the appearance-related peer victimization experiences of gender minorities within this vulnerable age group. The current study aimed to explore the prevalence rate of appearance-related peer victimization and associated variables across gender certain and uncertain preadolescents residing in the United States. 5354 children between the ages of 8 and 13 participated in this cross-sectional study. Gender groups were categorized as certain (children reported identifying as boy or girl) and uncertain (children reported being unsure of their gender or other). The sample was racially and ethnically diverse. A two-tailed independent samples t-test was performed for each variable to examine mean differences across gender certain and uncertain groups. Key findings revealed significant mean differences in appearance-related peer victimization [t(139) = 3.21, p < .001, d =.36], body satisfaction [t(211) = 6.32, p <.001, d = .55], body esteem [ t(5352) = 10.77, p = <.001, d = .71], and self-esteem [t(231) = 9.25, p = <.001, d = .73] such that gender uncertain children reported higher mean levels of appearance-related peer victimization; gender uncertain children also reported lower levels of body satisfaction, body esteem, and self-esteem. A correlational analysis indicated that as peer victimization frequency increased all children reported lower body satisfaction, body esteem, and general self-esteem. Body satisfaction and general self-esteem were more strongly positively correlated among gender uncertain children versus gender certain children. However, gender certain children reported stronger positive associations between body esteem and general self-esteem in comparison with gender uncertain children. Gender uncertain children report higher rates of appearance-related peer victimization and lower body satisfaction. Additional studies are needed to replicate and expand research on the appearance-related peer victimization experiences of preadolescent gender minority children and the related effects to body satisfaction.