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Free Gender-Affirming Letters

Hello! I am happy you found me! I write free gender-affirming letters! :)

And I'm sorry the insurance companies still require this to gatekeep people. :(

I believe gender-affirming care should be accessible, not gatekept. That’s why I offer free gender-affirming letters for hormone therapy (HRT) and gender-affirming surgeries to clients in Washington and Florida.

Part of my commitment to advocacy is to provide these letters for free, in one evaluative session. I charge my standard session rate of $175 for the one session, and I do not charge for the cost of writing the letter, and you will get your letter the same day as your appointment.

Get my new book, Rose Colored Glasses, to heal from toxic relationships!

Frequently Asked Questions

I can bill Ambetter Coordinated Care insurance (in WA, until January 12). You are responsible for determining whether you have a deductible to meet; if you do, I will charge your card for the cost at the time of the session. ​I am not in network with any other insurance companies.

 

I accept credit card, HSA, and FSA. If you have out of network benefits, I can provide a superbill you can provide to your insurance for reimbursement. This is up to you to determine with your insurance company; I cannot guarantee reimbursement. Please note if you use your insurance, your insurance company will see your diagnosis.

Here is my process for free gender-affirming letters:

1. You would send me an email to let me know you want a gender-affirming letter, and the deadline by which you need the letter.

2. I would e-mail you back within 24 hours, Monday through Thursday, and send you some scheduling options.

3. We agree to a date and time that works for both of us.

4. I send you the standard counseling paperwork to read and sign. For the intake questionnaire, you can write as little or as much as you want. Note: Please fill out the paperwork prior to 24 hours to your appointment. If you have not filled out the paperwork before then, I will assume you are not able to make the appointment and I will cancel it. You will have one opportunity to reschedule and attend your appointment.

5. I also send you a Google calendar meeting invite for the agreed upon date and time. All times are in Pacific time, and per counseling legal rules, you must reside in Washington or Florida, where I am licensed. 

6. We meet for the session, where I ask the questions insurance requires of us, and some additional questions according to WPATH standards of care. Please have the list of questions that your specific insurance requires ready at the time of session.

7. I write the letter, sign it, and send it to you within the same day! If you want any adjustments, and/or if the insurance company requests any changes (they frequently make updates to their requirements), send me an email, and I will make the requested changes within a few days, free of charge. :)  

If this sounds good to you, please send me an email and let me know your deadline for the letter, and I will send you some available session times. :) All the session times will be during my office hours, Monday and Thursday, 10 am to 5 pm PST

Thank you! You can reach me at counselor@katemageau.com

Interested in therapy? More information here :)

Mental Health Advocacy Ideas

Updated November 2025

Offering online counseling for people in Seattle, Bellingham, Tacoma, Olympia, Spokane, and all over Washington; and Miami, Orlando, Gold Coast, Gulf Coast, First Coast, Tampa, Jacksonville, and throughout Florida. Serving the following Washington counties, online: Adams County, WA, Asotin County, WA​, Benton County, WA, Chelan County, WA​, Clallam County, WA, Clark County, WA​, Columbia County, WA, Cowlitz County, WA​, Douglas County, WA, Ferry County, WA​, Franklin County, WA, Garfield County, WA​, Grant County, WA, Grays Harbor County, WA​, Island County, WA, Jefferson County, WA​, King County, WA, Kitsap County, WA​, Kittitas County, WA, Klickitat County, WA​, Lewis County, WA, Lincoln County, WA​, Mason County, WA, Okanogan County, WA​, Pacific County, WA, Pend Oreille County, WA​, Pierce County, WA, San Juan County, WA​, Skagit County, WA, Skamania County, WA​, Snohomish County, WA, Spokane County, WA​, Stevens County, WA, Thurston County, WA​, Wahkiakum County, WA, Walla Walla County, WA​, Whatcom County, WA, Whitman County, WA​, and Yakima County, WA. 

Serving the following counties in Florida, online: Alachua County, FL​, Baker County, FL, Bay County, FL​, Bradford County, FL, Brevard County, FL​, Broward County, FL, Calhoun County, FL​, Charlotte County, FL, Citrus County, FL​, Clay County, FL, Collier County, FL​, Columbia County, FL, DeSoto County, FL​, Dixie County, FL, Duval County, FL​, Escambia County, FL, Flagler County, FL​, Franklin County, FL, Gadsden County, FL​, Gilchrist County, FL, Glades County, FL​, Gulf County, FL, Hamilton County, FL​, Hardee County, FL, Hendry County, FL​, Hernando County, FL, Highlands County, FL​, Hillsborough County, FL, Holmes County, FL​, Indian River County, FL, Jackson County, FL​, Jefferson County, FL, Lafayette County, FL​, Lake County, FL, Lee County, FL​, Leon County, FL, Levy County, FL​, Liberty County, FL, Madison County, FL​, Manatee County, FL, Marion County, FL​, Martin County, FL, Miami-Dade County, FL​, Monroe County, FL, Nassau County, FL​, Okaloosa County, FL, Okeechobee County, FL​, Orange County, FL, Osceola County, FL​, Palm Beach County, FL, Pasco County, FL, Pinellas County, FL​, Polk County, FL, Putnam County, FL​, Saint Johns County, FL, Saint Lucie County, FL​, Santa Rosa County, FL, Sarasota County, FL​, Seminole County, FL, Sumter County, FL​, Suwannee County, FL, Taylor County, FL​, Union County, FL, Volusia County, FL​, Wakulla County, FL, Walton County, FL​, and Washington County, FL.

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Counselor@katemageau.com

@Kate.therapist.author

I am a Licensed Mental Health Counselor, LMHC, in Washington state, #LH61597675.

I am registered as an out-of-state Telehealth counselor provider in Florida, #TPIH84: https://flhealthsource.gov/telehealth/

Land Acknowledgment

”I would like to acknowledge that we are on the traditional land of the first people of Seattle, the Duwamish People past and present and honor with gratitude the land itself and the Duwamish Tribe.”

Offering virtual, Telehealth, online ADHD Assessments and Autism Assessments for people in Seattle, Bellingham, Tacoma, Olympia, Spokane, and all over Washington; and Miami, Orlando, Gold Coast, Gulf Coast, First Coast, Tampa, Jacksonville, and throughout Florida. 

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Online therapy for people in Seattle, Bellingham, Tacoma, Olympia, Spokane, and all over Washington; and Miami, Orlando, Gold Coast, Gulf Coast, First Coast, Tampa, Jacksonville, and throughout Florida. Serving the following Washington counties, online: Adams County, WA, Asotin County, WA​, Benton County, WA, Chelan County, WA​, Clallam County, WA, Clark County, WA​, Columbia County, WA, Cowlitz County, WA​, Douglas County, WA, Ferry County, WA​, Franklin County, WA, Garfield County, WA​, Grant County, WA, Grays Harbor County, WA​, Island County, WA, Jefferson County, WA​, King County, WA, Kitsap County, WA​, Kittitas County, WA, Klickitat County, WA​, Lewis County, WA, Lincoln County, WA​, Mason County, WA, Okanogan County, WA​, Pacific County, WA, Pend Oreille County, WA​, Pierce County, WA, San Juan County, WA​, Skagit County, WA, Skamania County, WA​, Snohomish County, WA, Spokane County, WA​, Stevens County, WA, Thurston County, WA​, Wahkiakum County, WA, Walla Walla County, WA​, Whatcom County, WA, Whitman County, WA​, and Yakima County, WA. 
Online therapy for counties in Florida, online: Alachua County, FL​, Baker County, FL, Bay County, FL​, Bradford County, FL, Brevard County, FL​, Broward County, FL, Calhoun County, FL​, Charlotte County, FL, Citrus County, FL​, Clay County, FL, Collier County, FL​, Columbia County, FL, DeSoto County, FL​, Dixie County, FL, Duval County, FL​, Escambia County, FL, Flagler County, FL​, Franklin County, FL, Gadsden County, FL​, Gilchrist County, FL, Glades County, FL​, Gulf County, FL, Hamilton County, FL​, Hardee County, FL, Hendry County, FL​, Hernando County, FL, Highlands County, FL​, Hillsborough County, FL, Holmes County, FL​, Indian River County, FL, Jackson County, FL​, Jefferson County, FL, Lafayette County, FL​, Lake County, FL, Lee County, FL​, Leon County, FL, Levy County, FL​, Liberty County, FL, Madison County, FL​, Manatee County, FL, Marion County, FL​, Martin County, FL, Miami-Dade County, FL​, Monroe County, FL, Nassau County, FL​, Okaloosa County, FL, Okeechobee County, FL​, Orange County, FL, Osceola County, FL​, Palm Beach County, FL, Pasco County, FL, Pinellas County, FL​, Polk County, FL, Putnam County, FL​, Saint Johns County, FL, Saint Lucie County, FL​, Santa Rosa County, FL, Sarasota County, FL​, Seminole County, FL, Sumter County, FL​, Suwannee County, FL, Taylor County, FL​, Union County, FL, Volusia County, FL​, Wakulla County, FL, Walton County, FL​, and Washington County, FL.

© 2025 Kate Mageau

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