In Sweden, transgender (in short “trans”) activism is not a new phenomenon, however, it is unclear exactly how long it has been conducted, where some believe that it has existed long before its relatively new visibility. The trans activist movement has extensive knowledge of the situation for trans people and works actively to conduct knowledge-enhancing initiatives in Sweden, including training for staff in human service organizations. Previous studies show that knowledge about trans issues among social workers is limited and that the services for trans people are deficient. This study, therefore, examines personal experiences of people who have been involved in trans activism in Sweden for a long time and how they outline the challenges that social work face in the present time and in the future. The study is based on in-depth qualitative interviews with seven Swedish trans activists and the collected material was analysed using the content analysis method. The analysis is structured around three themes: (1) Trans activism: Why and How?, (2) The role of trans activist organisations: How to achieve change?, and (3) Politics and Knowledge. Implications as well as challenges for social work are suggested as identifying the own room for manoeuvre as well as a need for increased knowledge and training. Future research is recommended with a larger sample where activists that are not connected to the larger trans organisations in Sweden are to be included to a higher degree.