The number of older LGBTQ+ adults is growing worldwide. Yet few studies outside of the United States have examined their experiences of aging. Drawing on the Health Equity Promotion Model and contextualized in Canada’s unique socio-political history, our study used multiple, in-depth, qualitative interviews to examine 30 older Canadian LGBTQ+ adults’ (aged 65–83) perceptions and experiences of growing older. Our descriptive thematic analysis identified three overarching categories: “Losses,” “gains,” and “needs.” Losses referred to the changes in the participants’ health, autonomy, and relationships that had occurred with age. Gains entailed positive later life changes, including increased wisdom, flexibility, and social connections. Finally, needs referred to those things that the participants deemed essential for aging well, namely, inclusive health care, meaningful activities, and supportive networks. We discuss the policy and practice implications of our findings for the fostering of health, well-being, and social inclusion amongst this often-marginalized population.