The healthcare needs of transgender and gender-diverse (TGD) patients, particularly in the perioperative setting, require specialized knowledge and sensitivity. It is estimated there are approximately 25 million people who identify as TGD worldwide, with 1-1.4 million residing in the US. As acceptance and recognition of these patients increase, the likelihood of encountering them in the perioperative setting increases. This article discusses perioperative guidelines for healthcare teams to ensure equitable, respectful, and competent patient-centered care for TGD patients. Key topics addressed include affirmative patient identification and terminology, unique challenges that TGD patients face, and other supportive guidelines for all phases of perioperative care.