No. Anywhere in Washington works. Licensing follows where you are sitting during the session, not where you live, so the whole state is open to us.

We don't, and it's a deliberate choice rather than a missing office lease. Soma Roots Therapy is fully telehealth, so every session happens over secure video — whether you're in Seattle, Tacoma, Bellingham, Spokane, or on a ferry with surprisingly decent signal.

That means there's no waiting room, no downtown parking origami, and no white-knuckling I-5 to make it to a 5:00 appointment on time. You meet with us from wherever you already feel most yourself. For a lot of folks — especially anyone navigating chronic illness, disability, caregiving, or the simple reality of Washington geography — that's not a compromise. It's the entire point of care that comes to you.

For Washington clients, we're in-network with:

• Aetna

• Blue Cross Blue Shield (BCBS)

• Cigna

• First Choice Health Network — which in Washington includes Kaiser WA (Access PPO, Elect PPO, Summit PPO), PacificSource (Navigator, Voyager), and several Providence networks (Choice, Extend PPO, Signature)

• Moda

• Optum

• Providence

• United

The obligatory-but-loving reminder: insurance was clearly designed by people who've never actually filed a claim, so please confirm with your plan that we're covered before our first session. A surprise bill is exactly the kind of nervous-system whiplash we're trying to help you avoid.

Don't see your plan? You've still got options. We provide superbills for out-of-network reimbursement, and we hold a limited number of sliding-scale spots based on need and life circumstances — because cost shouldn't be the gate that keeps you from care. Self-pay rates are $270 for the intake and $245 for a 55-minute session, HSA/FSA welcome.

And a straight answer so nobody's guessing: we are not credentialed with Medicaid (including Apple Health) or Medicare, and don't plan to be.

Yes. If you're in Washington and pursuing gender-affirming surgery, we provide WPATH-informed assessments and write the letters your surgeon or provider needs without gatekeeping.

You are the authority on your own gender. Our role isn't to interrogate you or hand out permission slips; it's to understand your goals, make sure you have the information you need, and write an honest, thorough letter that moves you forward. No proving yourself, no "are you sure?", no hoops that exist only to make a system comfortable at your expense.

If you're reaching out specifically for an assessment, let us know and we'll walk you through the process, timelines, and cost (sliding scale is available for these, too).

Far more common than you'd think, and absolutely not a dealbreaker. Between roommates, family, thin walls, and small people with excellent hearing, "a quiet room with a door that closes" is a luxury a lot of people just don't have.

A few things that work well: joining from your parked car, taking the session on a walk with earbuds, running a fan or white-noise app outside the door, or tucking into a corner with headphones in. Some folks book from a private spot at work on a break. And if you ever need to type instead of talk during a hard moment that's completely fine. The work bends to fit your life, not the other way around.

If privacy is a genuine barrier for you, tell us. We'll problem-solve it together before it gets in the way.