Discussions of transgender identities, affirmations, and politics typically rely on, or assume, trans individuals’ ability to self-advocate and self-direct. However, people with cognitive and intellectual disabilities do not always have the ability to self-advocate and self-direct. Cognitive disabilities present obstacles to learning or understanding; intellectual disabilities (IDs) are a subset of cognitive disabilities that involve a low intelligence quotient or limit a person’s ability to understand, reason, or adapt to new situations. These disabilities present a unique challenge for trans individuals in comprehending and communicating their own identities and in accessing the care and communities they need to thrive.