Introduction In this chapter, we will discuss the complexity and fluidity of trans* identities. We contrast these with mainstream understandings of trans* lives and discuss the implications for later life care for trans* people with dementia. We will situate our discussion in the context of the increased visibility and confidence of trans* populations in the United Kingdom (UK) in the early twenty-first century. This is a time when limited legal recognition and protections have now been enacted in the UK, and when trans* issues are increasingly part of mainstream discussion. This is also a time when public health and social care systems are under increasing pressure to respond to issues of diversity in dementia care while also having to deal with constraints upon resources. We identify some core good practice guidelines in working with trans* people with dementia. Recognising the lack of UK-specific research in this field to date, we also begin a conversation which explores potential directions for future research to inform policy and practice.