Despite Thailand's international reputation for transgender acceptance and medical expertise, transgender adults face systematic exclusion from the country's healthy aging initiatives. Transgender women experience heightened stigma and economic marginalization, while transgender men encounter distinct health access barriers, yet both groups remain invisible in longevity planning. This represents a critical blind spot in health equity that extends beyond Thailand's borders. As populations age globally, the intersection of gender identity and aging reveals how traditional longevity frameworks often overlook vulnerable populations. The commentary highlights a fundamental tension: societies may appear progressive on LGBTQ+ issues while simultaneously failing older transgender adults through inadequate healthcare access, social support systems, and policy recognition. For Thailand's rapidly aging demographics, this exclusion undermines the country's broader healthy longevity goals. The observation points to a broader pattern where aging research and policy frequently center on cisgender experiences, potentially missing crucial insights about diverse pathways to healthy aging. Addressing these gaps requires intentional inclusion of transgender perspectives in gerontological research, healthcare provider training, and policy development—insights relevant for any aging society grappling with health equity.