In this workshop, we will apply a biopsychosocial framework to understanding mental health in middle-aged and older transgender and gender-diverse adults. Participants will learn to differentiate normative age-related cognitive changes from disease processes; identify the psychological, medical, and social risks associated with isolation, discrimination, and institutional care; and strengthen assessment, referral, and psychotherapeutic interventions tailored to this population. We will also examine intersectionality — including race, ethnicity, culture, and socioeconomic factors — and increase clinical sensitivity to sexual orientation and gender identity concerns in later life, while challenging implicit assumptions that may impact care delivery.