Twisted real structures are well-motivated as a way to implement the conformal transformation of a Dirac operator for a real spectral triple without needing to twist the noncommutative one-forms. We study the coupling of spectral triples with twisted real structures to gauge fields, adopting Morita equivalence via modules and bimodules as a guiding principle and paying special attention to modifications to the inner fluctuations of the Dirac operator. In particular, we analyze the twisted first-order condition as a possible alternative to abandoning the first-order condition in order to go beyond the standard model and elaborate upon the special case of gauge transformations accordingly. Applying the formalism to a toy model, we argue that under certain physically motivated assumptions, the spectral triple based on the left–right symmetric algebra should reduce to that of the standard model of fundamental particles and interactions, as in the untwisted case.