Gender Affirming Care in Washington State

Rights & Best Practice

A quick guide to understanding legal protections for patients and providers in Washington state. Based on the FAQ from the WA State Health Care Authority.

This guide is not a replacement for legal advice. If you need legal advice, please contact a lawyer or schedule a legal consultation through QLaw Foundation’s 2SLGBTQIA+ Legal Clinic.

Legal Protections

Gender-affirming care provided consistently with state law and clinical guidelines IS covered in Washington state. WA state-regulated commercial plans can’t deny or limit gender-affirming care. This includes youth under 19. Apple Health (WA Medicaid) covers medically necessary gender-affirming care.

You’re still covered! WA law requires coverage of gender-affirming care for public employees and school staff. Contact your plan to confirm details.

No federal changes to coverage

No federal rule changes affect Apple Health coverage. Continue using standard authorization and claims processes.

  • Protects you from out-of-state subpoenas (such as legal demands for patient info), investigations, and civil actions related to lawful gender- affirming and reproductive care.
  • Applies to all providers, staff, and those assisting in care.
  • These protections only apply to care provided in Washington state – you’re still protected if you provide care to out-of-state patients as long as you’re providing the care IN Washington state.

RCW 74.09.675

Apple Health must cover medically necessary gender-affirming care

RCW 48.43.0128

State-regulated commercial plans can’t deny or limit this care

Under RCW70.02.020, do not release patient info related to gender-affirming care without consent of patient

My Health My Data Act still applies if you work with non-clinical partners or data platforms.

If you receive any request for information from out-of-state authorities, consult your legal/compliance team and WA state Attorney General’s Office at shieldlaw@atg.wa.gov before sharing any information.

Claims for medically necessary gender- affirming care (including care for youth) are valid and reimbursable under WA law.

There are no changes to Apple Health (Medicaid) coverage or billing as of April 2025. Follow existing prior authorization, claims, and encounter submission processes.

 

Quick Links

Washington Health Care Authority

If you receive any request for information from out-of-state authorities, consult your legal/compliance team and WA state Attorney General’s Office at shieldlaw@atg.wa.gov before sharing any information.

Download the Zine

Download and print the mini zine at home!

Need Legal Help?

Free consultations, referrals and resources.