10/23/2026
Here’s our statement on I-638
Lavender Spectrum Health Statement on Initiative 638
Lavender Spectrum Health does not support Initiative 638 (I-638). As primary care clinicians, we believe this measure asks health care providers to do something that is not medically indicated, not part of the standard of care, and harmful to the young people it claims to protect.
Sports physicals do not include a ge***al exam. A routine sports physical focuses on what keeps a student safe to play: heart health, musculoskeletal health, and screening for conditions that could make exertion dangerous. Washington’s standard sports physical does not include a ge***al exam, and it does not ask the provider to verify s*x. For students with a p***s, a hernia check may be offered, but it is optional and done for one reason only: a hernia can cause pain or become obstructed during sports. It is a safety screening, not a s*x verification.
What I-638 actually requires. The initiative requires a student who wants to play girls’ sports to submit a statement from their personal health care provider verifying their biological s*x, based only on reproductive anatomy, genetic makeup, or naturally produced testosterone levels. Genetic and hormone testing are not medically necessary for a healthy student, and insurance will not cover tests ordered for no clinical reason. That leaves families with two choices: pay out of pocket for unnecessary lab work, or ask their child’s provider to perform a ge***al exam that has no medical purpose.
This affects every girl who plays sports, not only transgender girls. The verification requirement applies to every student who wants to compete on a girls’ team. Under this measure, a girl’s ability to join her team depends on her body being examined or tested, and on a provider being willing to certify it.
Our position as clinicians. We will not perform ge***al exams, genetic testing, or hormone testing that is not medically indicated in order to certify a patient’s s*x for athletic eligibility. Every exam we perform must have a clinical reason, informed consent, and the patient’s wellbeing at its center. Examinations done to satisfy a political requirement do not meet that standard.
We encourage our patients, families, and community to read the full text of I-638 before voting, and to talk with their own health care providers about what a sports physical actually involves.
Natalie A. Paul, MSN, FNP-C
Founder, Lavender Spectrum Health
