Nepal is the site of many national and international human rights development measures focused on the country’s gender and sexual minorities (SGM). Given the significant impact those development efforts have on SGM and Nepali society, national and international development actors need to understand the identities and experiences of the populations they attempt to help. Performed in Kathmandu and Bharatpur, this study attempts to understand the identities used by third gender women and if those identities are reflected in development discourse. Over the course of this research, self-identified third gender women and members of organizations that work with SGM were interviewed. Observations were also conducted in a Bharatpur SGM-advocacy organization. This research questions the homogeneity of SGM described by some development organizations and their critics. Identity should be understood as context-specific, and SGM identities as intertwined and mutually-informing. Understanding the framework for gender and sexuality that underlies Nepali sexual and gender identity terms is important in order to supplement and contextualize the identities that, otherwise, may be misrepresented and misunderstood. Furthermore, development organizations should be cognizant of the impacts donor sources may have on development projects and on sexual and gender minorities. The national government should focus on successful implementation of measures already executed, and interested parties should hold the government accountable for following through with these SGM-focused human rights measures.