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When I was in school (and granted this was 20 years ago), the nurse couldn't give me Tylenol without informing my parents.

Have things really changed this much? and if so, how are the laws/rules/whatever written that might allow cross-sex hormones or surgical treatment, but not Tylenol?

I don't understand how these things could possibly actually be as this makes them seem, but I'm many layers removed from any public school system, much less one in Seattle.

I’m on the north east and calling home for Tylenol is still a thing. Since I don’t have direct knowledge of the area I skimmed the article and question exactly how far it goes. Specifically “Two health centers at the largest school district in Washington State are operated by a nonprofit which provides, among other things, gender transition medications and referrals for gender transition surgeries” - the health center is operated by another entity? So the school nurse is replaced and outsourced ? Or is this something entirely different where students can get a referral to an outside? Later in the article they say they don’t provide puberty blockers. I’m not sure but this sounds more like something where the reality is a bit different.