Proposition 135: Prohibit Surgery on Minors in Response to Perception of Sex or Gender

What It Would Do

Proposition 135 would ban surgery on anyone under 18 performed to alter their biological sex characteristics in response to their perceived sex or gender (gender-affirming surgery). It would not ban non-surgical treatments like counseling or social transition, and it would not affect male circumcision or treatment for medically verifiable disorders of sex development or acquired physical or chemical abnormalities. It would also bar the use of state or federal funds, Medicaid, or private insurance to pay for the prohibited surgeries.

Fiscal Impact

Per the state's official Blue Book analysis, the fiscal impact is expected to be minimal: small workload and cost increases for the state health regulator (DORA) and other agencies to update policies and handle complaints, and possible small decreases in state Medicaid and employee-insurance spending from no longer covering these procedures. The Blue Book also notes that Colorado's three major pediatric surgical providers — Children's Hospital Colorado, Rocky Mountain Children's, and Denver Health — report they do not perform these surgeries on patients under 18.

Why We're Voting No

Boulder Progressives opposes Proposition 135 because it would insert politicians into private medical decisions between families and their doctors, restricting access to care that major medical associations recognize as safe and appropriate for some transgender youth.

Sources: 2026 Colorado State Ballot Information Booklet (Blue Book), Legislative Council Staff.