This tool describes how services can be designed and implemented to be acceptable and accessible to transgender women. To accomplish this, respectful and ongoing engagement with them is essential. This tool gives particular attention to programmes run by transgender people themselves, in contexts where this is possible. It is itself the product of collaboration among transgender people, advocates, service-providers, researchers, government officials and non-governmental organizations (NGOs) from around the world, as well as United Nations agencies, and development partners from the United States.