DENVER, COLORADO — Colorado voters approved Proposition 135, creating a statewide prohibition on certain surgeries for people under 18 when performed to alter biological sex characteristics in response to a minor’s perception of sex or gender.
The measure passed with roughly 52% support to 48% opposition, according to current election results.
Proposition 135 prohibits health professionals from knowingly performing or providing covered surgeries and bars state or federal funds, Medicaid reimbursement and private insurance coverage from paying for them. It includes exceptions for certain disorders of sex development and other specified medical conditions and does not apply to male circumcision.
The measure does not prohibit counseling, social transition or nonsurgical gender-related treatment.
Its practical effect may initially be limited because Colorado’s three largest pediatric surgical providers already did not perform gender-affirming surgeries on transgender patients under 18. However, the proposition turns that practice into a statewide legal restriction and limits insurance coverage for procedures falling within its definition.
Supporters argued minors should not undergo irreversible procedures before adulthood. Opponents said medical decisions should remain between families and health professionals and warned the measure’s language could potentially affect some procedures involving non-transgender minors.
The law is scheduled to take effect Jan. 1, 2027. State regulatory boards will be responsible for handling complaints and determining how the prohibition is applied in individual cases.
The result is notable because Colorado voters approved the restriction while simultaneously electing Democrats to dominant control of state government.
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