Colorado voters ban trans youth surgeries that hospitals already don’t perform

Colorado voters have narrowly approved a measure banning gender-affirming surgery for minors, handing opponents of transgender rights a victory in a state where Democrats also swept major statewide races.The Associated Press called Proposition 135’s passage Friday. Results reported by Decision Desk HQ showed 52.03 percent supporting the measure and 47.97 percent opposing it, with more than 95 percent of the estimated vote counted.The measure prohibits healthcare professionals from performing surgery on people younger than 18 to alter their sex characteristics in response to their gender identity. It also bars state and federal funding, Medicaid reimbursements and private insurance coverage for the prohibited procedures.Proposition 135 does not ban nonsurgical gender-affirming care, including puberty blockers, hormone therapy or counseling.Related: 4 states move anti-trans ballot measures to voters for 2026 midterm electionThe measure’s reach could extend beyond transgender patients. Colorado’s official voter guide says it may restrict surgeries for cisgender minors if the treatment is interpreted as responding to their perception of sex or gender. It includes exceptions for circumcision and certain treatments for differences in sex development and acquired physical or chemical abnormalities.The vote restricts procedures that are already uncommon. Children’s Hospital Colorado, Rocky Mountain Children’s and Denver Health — the state’s three large pediatric surgical providers — reported that they do not perform gender- or sex-based surgeries on transgender patients younger than 18, according to the voter guide.A 2024 study published in JAMA Network Open examined 2019 insurance claims covering nearly 23 million minors. Researchers identified 85 gender-affirming surgical procedures associated with transgender or gender-diverse diagnoses among patients younger than 18; 82 were chest-related procedures. They found no such surgeries among children 12 or youn