Colorado voters to decide on ban of gender-related surgeries for minors

Colorado voters will consider Proposition 135 in the upcoming November election, a proposal that would outlaw any surgical procedure performed on a person under 18 for the purpose of altering biological sex characteristics, and would bar Medicaid, private insurance or federal funds from covering such care. The bill defines the prohibited purpose as treatment in response to a minor’s perception of sex or gender, but includes exemptions for male circumcision, verified disorders of sex development and acquired abnormalities, leaving interpretation to medical providers and regulators.

While the initiative does not affect hormone therapy, puberty blockers, or counseling, supporters such as Protect Kids Colorado and activist Erin Lee claim it prevents irreversible decisions by children, whereas opponents—including LGBTQ groups, the American Society of Plastic Surgeons, and the American Civil Liberties Union—argue existing parental consent laws already safeguard care and that regret rates are low. Data indicate gender-affirming surgeries for minors are extremely uncommon, with a 2024 Harvard study reporting roughly 2.1 procedures per 100,000 teens aged 15-17.

The measure could modestly lower state expenditures on these surgeries but might increase costs related to enforcement. The outcome will add Colorado to a growing list of states restricting gender-related medical interventions for youth.