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Trans Lifeline 877-565-8860

The Trevor Project

Trans Lifeline

Counseling: Medical Care/Mental Health Care


Finding a counselor can be challenging.  Before you get started, take a moment to read this article.

Since we have gone through two years of online activities, more people are considering online therapy.  If you live in a rural area, it is sometimes your only choice.  But even if you live in an urban area, it can still make sense.  There is a high demand for therapy right now as we come out of the pandemic (have we really?), and as a result, there can be a wait list for a therapist that you choose.  Find more than one possibility, and get yourself on a few waitlists.  That can help.  

We are reluctant to recommend individual therapists, as this process is individual and not a “one size fits all”.  Therapy groups that have therapists who are LGBTQ+ and/or affirming are listed below.  Don’t be afraid to ask to interview a therapist before you commit.  Inquire if the therapist is LGBTQ+ knowledgeable and affirming.  If you are dealing with a trans child, make sure the therapist has worked with families with trans children before.  When the therapist calls to set up an appointment, ask about their training, experience and approach to working with LGBTQ+ clients.  Ask enough questions until you get a feel for the person.  Once you meet that person, you still can change your mind and walk away. This is your therapy. Be a wise consumer!!!

Many people in our community have had bad experiences with mental health and medical providers.  Going back out there can feel traumatic.  Ask a friend to sit with you as you make phone calls. Ask a friend to go with you for the first meeting. That person can wait in the waiting room. Your health is important, so support yourself however you can as you start this process.

Local Therapy Groups

Various individual therapists have their own offices in the area.  Word of mouth is a great way to find a therapist.  Otherwise, ask questions.  The good news is that most clinics have people who are comfortable and skilled at working with the GLB part of our community, but you can’t be sure, so ask questions.  

For Transgender adults (over 18)

Check out Washington Gender Alliance. Come to a support group meeting. They are held every Wednesday evening online from 7:30-9:00 pm.  It doesn’t matter where you live as these are Zoom meetings.  There is a wealth of knowledge in the group, so try them out.  If you want an invitation, write to us at  For security reasons, they make sure they screen people who attend. That protects you and them.  

Families with Children/Adolescents who Identify as Trans or Gender Diverse

We are so fortunate to live in Western Washington.  The Seattle Gender Care Clinic at Children’s Hospital is one of the best in the country.  They have a multidisciplinary approach that includes mental and physical health.  Their experts are top of the line.  You can talk with them at 206-987-2028.


People who identify as Transgender or Gender Non-Conforming have regular needs for medical care.  Our community has suffered many harms from efforts to secure competent care.  Things are getting better, but it pays to be cautious and do as much screening as possible.  If you are looking for a new primary care doctor, ask questions about their competence working with transgender and non-conforming patients.  It matters.  There are now doctors at Skagit Regional Health, at Sea Mar Clinic and at the Family Care Network (formerly North Cascades Physicians) who are competent.  Skagit Pediatrics provides care to families with trans and gender non-conforming children and will be adding more services in the near future.  

Gender Affirming Care

There are a few medical doctors in Skagit County who will provide HRT for people in transition.  It is important to call the particular medical group and ask specifically if they provide HRT for Transgender or Gender Diverse patients.  Some physician groups have been slower to adopt gender inclusive forms than others.  Ask when you call if they provide intake forms that allow for more genders than male/female.  If they don’t, go elsewhere.  That is a big warning sign that they are not trans affirmative.  Ask trans people who they go to.  You can reach out to us at our email to ask who we would suggest.  

Gender Affirming Surgical Care

There are precious few providers who do bottom surgeries.  Dr. Geoffrey Stiller at Stiller Aesthetics in Spokane has been the only Washington State Provider who provides trans fem surgeries.  There is no one that offers trans male bottom surgeries.  This is changing as the University of Washington is adding Gender Affirming Surgeries to their offerings.  They are not currently fully operational, but they do offer some services.  You can contact them to see where they are in the process.  Oregon also offers services at the Meltzer Clinic in Portland and at OSHU facilities.   

Other gender affirming surgeries (top surgeries for trans masc and trans femme), breast augmentation, facial feminization surgeries, orchiectomies, hysterectomies, etc.) are offered at various hospitals and clinics.  Ask questions.  Talk to others who have had these surgeries.  

Another resource for finding these services is Ingersoll Gender Center.  They provide a comprehensive list of resources for care throughout the state.


In this confusing and ever changing environment right now for Gender Affirming Care, it is important to protect yourself and your clients. Please review this recently released overview of national laws and guidelines for providing care. It is complicated and fraught with many dangers professionally and personally in some areas. Be advised.

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