Coloradans pass Proposition 135, banning certain surgeries for transgender kids

Proposition 135 passed in Colorado with 52% of the vote. The proposition will ban certain surgeries for transgender kids.

Under the proposition, kids under 18 years old can no longer undergo surgeries that alter biological sex characteristics if the surgeries are in response to their gender identity. It also bans the government and private insurance companies from paying for the surgeries.

The Colorado Department of Health Care Policy and Financing, which administers Medicaid, says it spent $2.7 million on gender-affirming care for kids between 2023 and 2025. It didn't have a breakdown of how much of that went to cover surgeries.

Opponents say Proposition 135 - like Prop 134 - would take decision-making away from parents as well as doctors. They say it could lead to insurers refusing coverage for other gender affirming care and even prevent surgeries for non-transgender kids who have features different from their biological sex, like boys with large breasts.

Supporters note the measure makes exceptions for circumcisions, "medically verifiable disorders of sex development" and "acquired physical or chemical abnormalities." But it's unclear what disorders and abnormalities qualify.

Treatments like hormone therapy and puberty-blocking drugs are exempt.  

Supporters say gender-affirming operations shouldn't happen until kids have the maturity to make decisions that will impact them the rest of their lives.

The American Society of Plastic Surgeons recommends waiting until age 19 for sex change operations.

The Academy of Pediatrics says decisions about gender-affirming care should be made by patients and physicians, not government mandates.

Twenty-seven other states have laws in place similar to Propositions 134 and 135.

The measure is statutory, not constitutional, so it takes a simple majority to pass it, and state lawmakers can change or repeal it.