---
title: "Proposition 135: Prohibit Surgery on Minors in Response to Perception of Sex or Gender | The Scoop on Colorado’s November 2026 Proposed Measures – Part 12 of 14"
description: "Colorado Proposition 135: restrictions on surgery for minors, medical exceptions, fiscal impact, and arguments for & against | Links to all 2026 Measures"
---

[What's Up Americans? | Blog](https://whatsupamericans.com/blog)

# [Proposition 135: Prohibit Surgery on Minors in Response to Perception of Sex or Gender | The Scoop on Colorado’s November 2026 Proposed Measures – Part 12 of 14](https://whatsupamericans.com/blog/proposition-135-2026-election)

 Written by [Marek Bobik](https://whatsupamericans.com/blog/author/marek-bobik) | Oct 17, 2026, 12:25:43 AM

Should Colorado prohibit certain surgeries until a person turns 18—or leave those decisions to patients, parents, and medical professionals under existing law?

That is the central question behind Proposition 135, which appears on Colorado’s November 3, 2026, ballot. The citizen initiative would change state statutes rather than the Constitution, so it requires a simple majority to pass. ([coloradosos.gov](https://www.coloradosos.gov/pubs/elections/Initiatives/ballot/contacts/2026.html))

Supporters describe it as protection against irreversible medical decisions made before adulthood. Opponents describe it as government interference in individualized medical care. The debate concerns both the proposed age restriction and how broadly its language could apply. ([cpr.org](https://www.cpr.org/2026/09/25/vg-2026-prop-135-minor-gender-affirming-surgeries/))

## What Your Vote Means

### A YES vote

A **YES vote** would prohibit surgery on anyone under 18 to alter biological sex characteristics in response to the minor’s perception of sex or gender, subject to specified exceptions. It would also prohibit government funds and insurance coverage from paying for those surgeries. ([sos.state.co.us](https://www.sos.state.co.us/pubs/elections/Initiatives/titleBoard/filings/2025-2026/110Final.pdf))

### A NO vote

A **NO vote** would reject this prohibition and preserve existing Colorado law. It would not require any doctor or hospital to offer surgery or guarantee that a particular procedure would be available or covered. ([cpr.org](https://www.cpr.org/2026/09/25/vg-2026-prop-135-minor-gender-affirming-surgeries/))

## Official Ballot Language

The official question asks whether Colorado should prohibit the covered surgeries and bar state or federal funds, Medicaid reimbursement, and insurance coverage from paying for them.

**That is a summary, not the complete ballot wording.** The full question appears in the Secretary of State’s official ballot listing. ([coloradosos.gov](https://www.coloradosos.gov/pubs/elections/Initiatives/ballot/contacts/2026.html))

## Official Proposition Language: What the Measure Actually Changes

Originally filed as **Initiative 110**, the proposal would take effect on **January 1, 2027**, and apply to violations occurring on or after that date. ([sos.state.co.us](https://www.sos.state.co.us/pubs/elections/Initiatives/titleBoard/filings/2025-2026/110Final.pdf))

### 1. The prohibition depends on the purpose of surgery

The proposal does not provide a procedure-by-procedure list. Instead, it defines the covered treatment by its relationship to a minor’s perception of sex or gender.

**The reason for an operation—not simply its name—would therefore matter.** The Blue Book warns that this approach could affect some procedures sought by non-transgender minors as well. ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2/files/blue-book))

### 2. The text contains specific exceptions

The definition excludes:

- Treatment for people born with a medically verifiable disorder of sex development.
- Treatment for acquired physical or chemical abnormalities.
- Male circumcision.

The operative prohibition does not contain a separate exception merely because a parent consents or a clinician recommends the surgery. ([sos.state.co.us](https://www.sos.state.co.us/pubs/elections/Initiatives/titleBoard/filings/2025-2026/110Final.pdf))

### 3. Paying out of pocket would not bypass the prohibition

The measure would restrict both providing the surgery and financing it. It is not simply an insurance-coverage change. ([sos.state.co.us](https://www.sos.state.co.us/pubs/elections/Initiatives/titleBoard/filings/2025-2026/110Final.pdf))

Three additional details deserve attention.

### Does it prohibit all gender-related care?

No. Its operative restriction concerns **surgery**. CPR reports that supporters distinguish the proposal from restrictions on counseling, hormone treatment, and other nonsurgical care. That does not establish whether those services are available under other applicable rules. ([cpr.org](https://www.cpr.org/2026/09/25/vg-2026-prop-135-minor-gender-affirming-surgeries/))

### How common are these surgeries?

The Blue Book says the number of minors receiving procedures that would fall under this particular prohibition is unknown. It cites research indicating that gender-affirming surgery among minors is rare.

It also reports that **Children’s Hospital Colorado, Rocky Mountain Children’s, and Denver Health do not perform gender- or sex-based surgeries on transgender patients under 18**. That is not the same as establishing that no such procedure occurs anywhere in Colorado. ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2/files/blue-book))

### Would the measure create a new criminal sentence?

The proposal does not specify a new felony classification, prison term, or standalone criminal penalty. Its potential consequences should not be described as automatic imprisonment. The official analysis anticipates regulatory complaints and possible legal costs associated with compliance. ([sos.state.co.us](https://www.sos.state.co.us/pubs/elections/Initiatives/titleBoard/filings/2025-2026/110Final.pdf))

## Sponsors and Designated Representatives

The initiative’s representatives are **Erin Lee and Michele Austin**. Supporting committees listed by the Secretary of State include **Protect Kids Colorado** and **Protect Our Children**. Listed opponents include **Families Not Politics**, **Protect Trans Kids**, and **No on 134 and 135**, among others. ([coloradosos.gov](https://www.coloradosos.gov/pubs/elections/Initiatives/ballot/contacts/2026.html))

Protect Kids Colorado promotes the proposal as protecting children from irreversible surgery. Families Not Politics argues that medical decisions should remain with families and their providers. These are campaign positions, not neutral findings. ([protectkidscolorado.org](https://www.protectkidscolorado.org/?utm_source=openai))

## The Case for Voting YES on Proposition 135

*The arguments below describe competing policy positions, not guaranteed medical outcomes.*

### Permanent decisions should wait until adulthood

Supporters argue that minors cannot adequately evaluate the lifelong consequences of these procedures. They favor a firm age boundary rather than case-by-case permission. ([cpr.org](https://www.cpr.org/2026/09/25/vg-2026-prop-135-minor-gender-affirming-surgeries/))

**Counterargument:** Opponents say an age-based prohibition overrides individualized judgment even when the patient, parents, and clinicians agree that treatment is appropriate. ([familiesnotpolitics.com](https://familiesnotpolitics.com/?utm_source=openai))

**The question to weigh:** Should the law establish an absolute boundary, or allow exceptions based on individual circumstances?

### Uncertainty warrants a cautious approach

The Blue Book summarizes supporters’ concern that longer-term evidence is needed and that some patients later regret irreversible treatment. Supporters believe waiting preserves future choices. ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2/files/blue-book))

**Counterargument:** Opponents argue that delaying recommended care also has consequences and should not automatically be treated as the safer option for every patient. ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2/files/final-draft-packet))

**The question to weigh:** Who should evaluate the competing risks of treatment and delay?

### A legal safeguard could prevent future changes in practice

The supporting campaign seeks a binding prohibition rather than relying solely on providers’ current policies. ([protectkidscolorado.org](https://www.protectkidscolorado.org/?utm_source=openai))

**Counterargument:** Opponents favor retaining medical discretion instead of replacing it with a statewide ban. ([familiesnotpolitics.com](https://familiesnotpolitics.com/?utm_source=openai))

**The question to weigh:** Is a statutory restriction necessary, or are existing clinical decision-making processes preferable?

## The Case for Voting NO on Proposition 135

*The arguments below describe competing policy positions, not guaranteed medical outcomes.*

### Families and clinicians should retain decision-making authority

Families Not Politics argues that politicians and ballot campaigns should not determine an individual child’s medical treatment. ([familiesnotpolitics.com](https://familiesnotpolitics.com/?utm_source=openai))

**Counterargument:** Supporters believe protecting minors sometimes requires legal limits that parental permission cannot override. ([cpr.org](https://www.cpr.org/2026/09/25/vg-2026-prop-135-minor-gender-affirming-surgeries/))

**The question to weigh:** Where should parental authority end and state protection begin?

### Broad wording could discourage care beyond the intended target

Opponents worry that uncertainty about a procedure’s purpose could discourage clinicians or insurers from approving otherwise appropriate care. The official analysis includes this concern among the arguments against the measure. ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2/files/final-draft-packet))

**Counterargument:** Supporters point to the proposal’s medical exceptions as evidence that it is not intended to prohibit every operation affecting sex characteristics. ([cpr.org](https://www.cpr.org/2026/09/25/vg-2026-prop-135-minor-gender-affirming-surgeries/))

**The question to weigh:** Are those exceptions clear enough for patients, providers, and insurers?

### The restriction could compound difficulties for transgender youth

Opponents argue that restricting treatment can add to the stigma and barriers transgender young people already encounter. Their campaign emphasizes protecting those students and their families from government intrusion. ([familiesnotpolitics.com](https://familiesnotpolitics.com/?utm_source=openai))

**Counterargument:** Supporters frame the proposal as delaying irreversible interventions, rather than prohibiting all support or treatment. ([cpr.org](https://www.cpr.org/2026/09/25/vg-2026-prop-135-minor-gender-affirming-surgeries/))

**The question to weigh:** Does the proposed delay provide protection proportionate to its consequences?

## Fiscal Impact

The official analysis expects **minimal overall state and local fiscal effects**, assuming compliance. It identifies potential costs and savings rather than a major budget change. ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2/files/final-draft-packet))

| Area | Expected effect |
| --- | --- |
| Professional and insurance regulation | Additional work to revise rules and materials and handle complaints |
| Government health providers | Policy updates and compliance work |
| Legal services | Possible costs responding to allegations of noncompliance |
| Public health programs and employee insurance | Potential small savings from no longer paying for covered procedures |

The projected savings are limited and conditional. The analysis does not establish a substantial financial benefit for taxpayers. ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2/files/final-draft-packet))

## Conclusion

The strongest case for **YES** is that irreversible surgical decisions should wait until adulthood. The strongest case for **NO** is that a blanket prohibition can override individualized medical judgment and create uncertainty about other care. Those are the competing positions—not settled conclusions about every patient. ([cpr.org](https://www.cpr.org/2026/09/25/vg-2026-prop-135-minor-gender-affirming-surgeries/))

My takeaway is that voters should separate three questions:

1. Should these surgical decisions always wait until age 18?
2. Does this particular wording clearly identify what would be prohibited?
3. Who should resolve difficult cases: lawmakers, regulators, or families and clinicians?

A voter can support safeguards for minors while questioning a categorical ban. Another can respect parental decision-making while believing some interventions require an adult age threshold.

## [Share & Engage](https://leg.colorado.gov/explorebudget)

 

 

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## The Scoop on Colorado’s November 2026 Proposed Measures Series

Links to blog posts on all Colorado Amendments and Measures

1. [Amendment 81: Law Enforcement Communication with Federal Immigration Authorities](https://whatsupamericans.com/blog/colorado-amendment-81-2026-election)
2. [Amendment 82: Constitutional Right to Purchase and Sell Natural Gas](https://whatsupamericans.com/blog/colorado-amendment-82-2026-election)
3. <https://whatsupamericans.com/blog/colorado-amendment-82-2026-election>[Amendment 83: Constitutional Right to Hunt and Fish](https://whatsupamericans.com/blog/colorado-amendment-83-2026-election)
4. [Amendment 84: Mail Ballot Voter Identification](https://whatsupamericans.com/blog/colorado-amendment-84-2026-election)
5. [Amendment 85: Plain Language Ballot Titles](https://whatsupamericans.com/blog/htcolorado-amendment-85-2026-election)
6. [Amendment 86: Requirements for Off-Cycle Congressional Redistricting](https://whatsupamericans.com/blog/colorado-amendment-86-2026-election)
7. [Amendment 87: Graduated Income Tax](https://whatsupamericans.com/blog/colorado-amendment-87-2026-election)
8. [Proposition NN](https://whatsupamericans.com/blog/proposition-nn-2026-election): Keep and Spend Money for Education and Other Purposes
9. [Proposition 132](https://whatsupamericans.com/blog/proposition-132-2026-election): Increase Penalties for Fentanyl Crimes
10. [Proposition 133](https://whatsupamericans.com/blog/proposition-133-2026-election): Penalties for Human Trafficking of a Minor
11. [Proposition 134](https://whatsupamericans.com/blog/proposition-134-2026-election): Male and Female Participation in School and Collegiate Sports
12. [Proposition 135](https://whatsupamericans.com/blog/proposition-135-2026-election): Prohibit Surgery on Minors in Response to Perception of Sex or Gender
13. [Proposition 136](https://whatsupamericans.com/blog/proposition-136-2026-election): Income Tax Limit
14. [Proposition 137](https://whatsupamericans.com/blog/proposition-137-2026-election): Direct Sporting Goods Sales Tax Revenue for Conservation

 

## Learn More

### Official wording and analysis

- **Colorado General Assembly — Proposition 135 measure page.** ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2))
- **Secretary of State — Initiative 110 final text.** ([sos.state.co.us](https://www.sos.state.co.us/pubs/elections/Initiatives/titleBoard/filings/2025-2026/110Final.pdf))
- **2026 Blue Book — Proposition 135 analysis and fiscal impact.** ([leg.colorado.gov](https://leg.colorado.gov/ballots/prohibit-surgery-on-minors-in-response-to-perception-of-sex-or-gender-2/files/blue-book))
- **Secretary of State — Ballot wording and registered committees.** ([coloradosos.gov](https://www.coloradosos.gov/pubs/elections/Initiatives/ballot/contacts/2026.html))

### Opinion and advocacy

- **Protect Kids Colorado — Supporting campaign.** ([protectkidscolorado.org](https://www.protectkidscolorado.org/?utm_source=openai))
- **Families Not Politics — Opposing campaign.** ([familiesnotpolitics.com](https://familiesnotpolitics.com/?utm_source=openai))

[View full post](https://whatsupamericans.com/blog/proposition-135-2026-election)

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