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Abstract Lesbian, gay, bisexual, and transgender (LGBT) elders and long-term couples have become more visible and their special concerns about aging are being recognized by gerontologists. LGBT elders are a diverse group with regard to all characteristics. This article focuses on the characteristics, research needs and barriers, service needs and barriers, clinical implications, and suggestions for appropriate treatment to increase awareness of clinical gerontologists who may not be familiar with LGBT seniors or who wish to improve their services to this population. Gerontologists working in long-term care facilities and those working in social and home care services may be especially interested in the special concerns of transgender elders and the recent changes in public policy regarding all LGBT elders.