Offered services include referrals for hormone therapy and sex change surgeries.

The largest public school district in Washington State is referring students in the district to free "gender-affirming care."

The Nova Wellness Center and the Meany Health Center offer "gender reaffirming care," including hormone-blocking medications and referrals for sex change surgeries, which are available to middle and high school students in Seattle Public Schools (SPS).

According to documents obtained by Parents Defending Education (PDE), the health centers are operated by Country Doctor Community Health Centers (CDCHC) which offers "no cost comprehensive, trauma-informed, and gender-affirming care, conveniently at the school."

As stated on its website, CDCHC provides services to "transgender, non-binary, and gender diverse patients."

Services include "gender-affirming medications (estrogen, androgen blockers, testosterone, etc.) and injection techniques," "hormone therapy for adolescents and specialty referrals for younger patients as needed," and "referrals for gender-affirming surgeries."

However, the center currently "does not provide puberty blockers" for "younger patients." That requires "specialty referrals."