Trans Resource Navigator

Gender-affirming care in Washington

Change detected, under review. An official source this page relies on changed recently. Part of this page may be out of date until we review it.

  • Page changed: Transhealth program (2026-10-05) · #193
  • Page changed: File a complaint or check your complaint status (2026-10-05) · #192
  • Page changed: HB 1469 (2023), ch. 193, Laws of 2023 (2026-09-28) · #81
Care for adults
Allowed
Care for people under 18
Allowed
Apple Health (Washington Medicaid) pays for hormones
Covered
Apple Health (Washington Medicaid) pays for surgery
Covered
Private plans must cover care
Yes, by law

Gender-affirming care is legal and protected for adults and minors in Washington. Apple Health (Medicaid) covers hormones, puberty blockers, surgery, and related care; state-regulated insurance may not exclude it; and a shield law protects patients, families, and providers from other states' actions. A new federal rule stops federal Medicaid money for some care for minors from October 13, 2026; the state says it will use state funds to keep covering it.

Draft from official sources, September 24, 2026. Not yet checked by a person. How we verify

On this page
  1. Health centers near you
  2. Hormones by telehealth
  3. Clinics, programs, and funds
  4. Paying for care
  5. Rules for adults
  6. Rules for under 18
  7. Laws and court cases
  8. Sources

Community health centers near you

These federally funded centers must see you whether or not you have insurance, and charge based on income. Many, but not all, prescribe hormone therapy. Call and ask for "gender-affirming care" or "hormone therapy."

Sorting by distance uses your location only on this device. It is never sent anywhere.

Hormones by telehealth

These services prescribe hormones through video visits for people in this state. Point of Pride pays for a year and a half of care with several of them each spring.

  • Plume

    PaidNo Medicaid18+

    Trans-led telehealth service providing informed-consent hormone therapy, lab orders, prescriptions, and letters for surgery and documents, by app and video visit. Self-pay only since January 2026. A Point of Pride HRT Access Fund partner.

    About $99 per month ($90 in NY and NJ), which includes visits, messaging, prescriptions, and document letters. Labs and medications are billed separately and are often cheap with GoodRx or at a community pharmacy. Free for 18 months if you win a Point of Pride HRT Access Fund grant.

  • FOLX Health

    InsuranceTakes insuranceNo Medicaid18+

    LGBTQ-focused telehealth offering hormone therapy, PrEP, primary care, and mental health visits. Accepts major commercial insurance (Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare) but not Medicaid or Medicare. A Point of Pride HRT Access Fund partner.

    In-network with many commercial plans; self-pay membership about $69 to $98 per month all-inclusive.

  • QueerDoc

    Sliding scale

    Small telehealth practice offering informed-consent hormone therapy with transparent sliding-scale pricing. Does not bill insurance for visits, but labs and prescriptions can go through your insurance. A Point of Pride HRT Access Fund partner.

    Sliding scale by income; check the current pricing page.

  • Planned Parenthood

    Sliding scaleTakes insurance

    Many Planned Parenthood affiliates provide informed-consent gender-affirming hormone therapy alongside sexual and reproductive health care, on a sliding scale and with Medicaid. Most affiliates see adults 18 and older; a few see 16- and 17-year-olds with parental consent and a readiness letter. Many start hormone care by telehealth. Self-pay initial consults typically run about $120 to $250 before sliding-scale discounts.

Clinics, programs, and funds

  • Apple Health Transhealth program (Health Care Authority)[1]

    State Medicaid program office for gender-affirming coverage questions and prior authorization. Email applehealth.transhealth@hca.wa.gov.

    • Free
    • Accepts Medicaid

  • Seattle Children's Gender Clinic[10]

    Gender-affirming care for children and adolescents; medical care for patients who have started puberty, with parent or guardian consent. 206-987-2028.

    • Insurance
    • Accepts Medicaid
    206-987-2028

  • Planned Parenthood health centers in Washington[11]

    Planned Parenthood affiliates in Washington offer gender-affirming hormone therapy at some health centers, with Apple Health accepted and sliding-scale fees. Minimum age and participating centers were not confirmed; use the health center finder and call ahead.

    • Sliding scale
    • Accepts Medicaid
    • Sees uninsured patients
    • Unverified

  • Ingersoll Gender Center, healthcare provider database[12]

    Trans-led Seattle organization with free peer support groups and a searchable directory of trans-friendly health care providers in Washington.

    • Free
    206-849-7859911 E Pike St, Suite 221, Seattle, WA 98122

  • Find a community health center (HRSA)[13]

    Official locator for federally qualified health centers, which must see you regardless of insurance or ability to pay and charge on a sliding scale. Call and ask for "gender-affirming care".

    • Sliding scale
    • Accepts Medicaid
    • Sees uninsured patients

  • Point of Pride funds[14]

    National funds for people who cannot afford care, including the HRT Access Fund (free telehealth hormone therapy), an annual surgery fund, and free binders and shapewear.

    • Free
    • Unverified

  • Genderbands grants[15]

    Small grants for surgery and other transition costs; 18 and older.

    • Free
    • Unverified

  • Trans Health Project (Advocates for Trans Equality)[16]

    Free templates and guides for appealing insurance denials of gender-affirming care, including self-funded employer plans.

    • Free
    • Unverified

Paying for care

Medicaid (Apple Health (Washington Medicaid))[1][2][3][4]

Apple Health's Transhealth program covers hormone therapy, puberty suppression, speech and voice therapy, behavioral health, labs, surgical consults, gender-affirming surgery and related hospital care, and medically necessary hair removal. Hormones and routine care go through your managed care plan; surgery and hair removal need prior authorization through HCA. For most surgeries HCA generally expects 12 months of hormone therapy and 12 months living in your gender (with exceptions, including for chest surgery), and letters from your providers. By law (RCW 74.09.675) HCA and its plans cannot apply blanket exclusions, and a provider experienced in gender-affirming care must review any denial.

Apply at Washington Healthplanfinder (wahealthplanfinder.org). Questions about gender-affirming coverage can go to applehealth.transhealth@hca.wa.gov.

Apply for coverage

Private insurance[5][2][9][16]

RCW 48.43.0128 bars state-regulated health plans from denying or limiting medically necessary gender-affirming treatment, and from calling procedures like facial feminization, tracheal shave, electrolysis, or chest surgery "cosmetic" as a blanket exclusion. A denial must be reviewed by a provider experienced in gender-affirming care. State employee and school employee plans (PEBB/SEBB) have the same protection (RCW 41.05.017). If your plan denies care, appeal to the plan, then contact the Office of the Insurance Commissioner's consumer advocates (800-562-6900). Self-funded employer plans are federally regulated and may not be covered; the Trans Health Project has appeal templates.

File an insurance complaint

The rules in detail

Rules for adultsNo state restriction. Many community clinics and Planned Parenthood health centers prescribe hormones on an informed consent basis (no therapist…

No state restriction. Many community clinics and Planned Parenthood health centers prescribe hormones on an informed consent basis (no therapist letter). Telehealth prescribing is legal statewide. RCW 18.130.450 says providing medically necessary gender-affirming care within a provider's scope of practice is not unprofessional conduct.

If you have no insurance and little money, in rough order:

  1. Apply for Apple Health at wahealthplanfinder.org. It covers hormones, labs, and surgery.
  2. Go to a community health center (FQHC). They charge on a sliding scale and must see you regardless of ability to pay. Find one at findahealthcenter.hrsa.gov and ask whether they offer gender-affirming hormone therapy.
  3. Planned Parenthood health centers offer sliding-scale hormone care in several Washington cities.
  4. Point of Pride's HRT Access Fund pays for telehealth hormone care (applications open once a year).
  5. Ingersoll Gender Center keeps a directory of trans-friendly providers.
[2][6][13][14][12]
Rules for under 18Legal. Care for minors follows clinical guidelines and requires a parent's or guardian's consent; Seattle Children's Gender Clinic offers medical…

Legal. Care for minors follows clinical guidelines and requires a parent's or guardian's consent; Seattle Children's Gender Clinic offers medical care to adolescents who have started puberty, with parental consent (206-987-2028). Washington's shield law (chapter 7.115 RCW, HB 1469, 2023) bars state agencies and courts from cooperating with other states' investigations, subpoenas, or lawsuits over care that is lawful in Washington, lets people sue over such interference, and protects parents and providers who help a young person get care.

Federal change: a Centers for Medicare & Medicaid Services rule prohibits using federal Medicaid and CHIP money for certain gender-affirming care for minors starting October 13, 2026. The Health Care Authority says that if federal funds are unavailable it will use state funds to keep covering medically necessary care for eligible Apple Health clients, and will issue detailed guidance. HCA also notes that state law may not override federal enforcement in every case; families with legal concerns should talk to a lawyer.

[10][7][8][1][2]
Laws and court cases5 laws

Sources

16 sources. Numbers in the text, like [1], point here.Show all
  1. Transhealth programWashington State Health Care Authority, Official page. accessed
    “If federal funds are not available, then state funds will be used to maintain coverage of medically necessary gender-affirming care for eligible Apple Health clients.”
  2. FAQ, Apple Health coverage and state law protections for gender-affirming care (April 24, 2025)Washington State Health Care Authority, Official page. accessed
  3. RCW 74.09.675Washington State Legislature, Law. accessed
  4. WAC 182-531-1675Washington State Legislature, Regulation. accessed
  5. RCW 48.43.0128, Gender-affirming treatment coverageWashington State Legislature, Law. accessed
    “A health carrier may not apply categorical cosmetic or blanket exclusions to gender-affirming treatment.”
  6. RCW 18.130.450Washington State Legislature, Law. accessed
  7. Chapter 7.115 RCW, Protected health care servicesWashington State Legislature, Law. accessed
  8. HB 1469 (2023), ch. 193, Laws of 2023Washington State Legislature, Law. accessed
  9. File a complaint or check your complaint statusWashington State Office of the Insurance Commissioner, Official page. accessed
  10. Gender ClinicSeattle Children's, Organization. accessed
    “Gender-affirming medical care is only available for patients who have started puberty and requires consent from parents or guardians.”
  11. Find a health centerPlanned Parenthood, Organization. accessed
  12. Ingersoll Gender CenterOrganization. accessed
  13. Find a Health CenterHealth Resources and Services Administration, Official page. accessed
  14. HRT Access FundPoint of Pride, Organization. accessed
  15. GenderbandsOrganization. accessed
  16. Trans Health ProjectAdvocates for Trans Equality, Organization. accessed