The Health Care Authority (HCA) has proposed changes to the medical treatment available to Washington Apple Health (Medicaid) enrollees undergoing a gender transition. These changes threaten trans individuals’ access to services they need to accomplish a successful transition. NoHLA worked with the Coalition for Inclusive Health Care to submit comments expressing our concerns that the proposed HCA regulations do not take into account individualized treatment needs for these people. Coalition members also testified about the expected impact at a public hearing in Olympia. We hope HCA makes our requested changes when adopting the final rules.