Colorado ballot measure · November 3, 2026

Colorado Proposition 135, explained

Ban on gender-related surgery for minors. A ballot measure is a yes-or-no question put directly to voters — no candidate is involved, and the wording on the ballot is the wording that becomes law. This page shows that wording first, then what it actually changes.

The official wording

Shall there be a change to the Colorado Revised Statutes modifying existing law by prohibiting surgery on a minor for the purpose of altering the minor's biological sex characteristics, and, in connection therewith, prohibiting any health-care professional or other person from knowingly performing, prescribing, administering, or providing any surgery to a minor for the purpose of altering the minor's biological sex characteristics and prohibiting the use of state or federal funds, Medicaid reimbursement, or insurance coverage to pay for this type of surgery?

This is what appears on the ballot. Everything below explains it.

What it actually means

Prohibits surgery on anyone under 18 to alter biological sex characteristics as treatment in response to the minor's perception of sex or gender, and bars public money, Medicaid and private insurance from paying for it. Male circumcision, treatment of verifiable disorders of sex development, and non-surgical care such as counseling are not restricted.

If you vote YES

Health care professionals and others could not knowingly perform, prescribe or provide surgery on a minor to alter biological sex characteristics in response to the minor's perception of sex or gender.
State and federal funds, Medicaid and private insurance could not pay for these surgeries.
Exceptions would cover male circumcision and treatment of medically verifiable disorders of sex development or acquired physical or chemical abnormalities; social transition and counseling would not be affected.
The Department of Regulatory Agencies and public employers of health professionals would update rules and handle complaints, at minimal cost.

If you vote NO

Colorado law would continue to protect access to these surgeries for minors when medically necessary, with decisions made by patients, families and providers.
Private insurance and public health programs could continue to cover them.
Children's Hospital Colorado, Rocky Mountain Children's and Denver Health report they do not currently perform these surgeries on transgender patients under 18.

The numbers that matter

State and local fiscal impact: Minimal costs and possibly minimal savings
U.S. surgery rate, ages 15-17 (2019): About 2.1 per 100,000 youths

Why supporters say YES

Minors lack the maturity to make permanent, life-altering medical decisions; less invasive, non-surgical care should be used until adulthood, when a person can fully weigh the risks.
— Colorado Blue Book argument for Proposition 135 (Legislative Council Staff)
More long-term data is needed, some minors may regret irreversible procedures, and other states have limited these treatments for minors.
— Colorado Blue Book argument for Proposition 135 (Legislative Council Staff)

Why opponents say NO

A ban based on a patient's purpose is overly broad and could affect other surgeries for both transgender and non-transgender minors, as insurers limit coverage and doctors avoid care for fear of legal consequences.
— Colorado Blue Book argument against Proposition 135 (Legislative Council Staff)
The measure overrides care that parents, patients and doctors agree is necessary and may worsen mental health outcomes for transgender youth; such decisions belong with families and providers.
— Colorado Blue Book argument against Proposition 135 (Legislative Council Staff)

What’s genuinely uncertain

How many Colorado minors would be affected is unknown; a Harvard study of 2019 insurance claims found about 2.1 in 100,000 transgender or gender-diverse youths aged 15 to 17 had such surgery, and none aged 12 or younger.
The measure lists no specific procedures, so which surgeries are covered depends on interpretation of purpose.
The measure is sponsored by Protect Kids Colorado, according to Colorado Newsline; no registered opposition committee was identified in the sources reviewed.

The bottom line

Reserving irreversible gender-related surgery for adults, against the state overriding medical decisions by families and doctors, with possible effects on other care.

One neutral sentence describing the tradeoff — not a recommendation.

Sources:leg.colorado.gov coloradosos.gov coloradonewsline.com

Checking it against the official text

The Colorado Secretary of State publishes the certified measures and, in most states, an official voter guide with fiscal notes. That is the authoritative version. Everything here is an explanation of it, not a substitute for it.

Confirm this with the official source

Your ballot is determined by your election authority, not by us. Verify your registration, precinct, and sample ballot at Colorado Secretary of State.

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