While transgender older adults and advocacy organizations have won important victories in health care for transgender older adults, significant barriers remain. New federal leadership in the United States has brought a bevy of backlash in federal policies that present challenges in accessing health care for transgender older adults. This article focuses on three key areas: insurance coverage for medically necessary care, discrimination, and religious-based exemptions to providing services. Social workers can play a pivotal role in supporting transgender older adults by staying informed of key policy issues and taking proactive steps to protecting the health care of this community.