Colorado voters approved Proposition 135, banning certain gender-related surgeries for minors statewide.

The Associated Press called the race at 9:24 a.m. on Friday, Nov. 6, according to The Colorado Sun. The measure was passing with 52% of the vote and 48% opposed, a margin of more than 104,000 votes. Opponents had already conceded defeat on Thursday, Nov. 5.

For families in the Cherry Creek and Littleton school communities, the new law changes the legal landscape around medical decisions for transgender youth. The measure prohibits health care professionals from knowingly performing "any surgery to a minor for the purpose of altering biological sex characteristics," according to the measure's text. It also bars state and federal funding, Medicaid reimbursement and insurance coverage for those procedures, CPR News reported.

The law does not restrict non-surgical treatments, including counseling and social transition.

Colorado's three largest pediatric surgical providers already do not perform gender-affirming surgeries on transgender patients under 18, CPR News reported. The measure establishes a statewide legal prohibition and funding restrictions beyond current hospital practice.

Scope remains unclear

Opponents warned the measure's language could reach beyond transgender patients. The Colorado Sun reported that hospitals declined before the election to say which surgeries they currently perform would fall under the ban. Opponents said the vague wording and exemptions would force medical professionals to guess what is and isn't prohibited.

The measure defines "altering biological sex characteristics" as "treatment in response to a minor's perception of sex or gender." It includes exceptions for male circumcision, people born with "a medically verifiable disorder of sex development" and "acquired physical or chemical abnormalities."

State officials, doctors and hospitals will have to determine exactly which procedures are now illegal, The Colorado Sun reported. It remains unclear whether lawmakers or state regulators will step in to clarify the scope.

Legislature may revisit the law

Because Proposition 135 amends state statute rather than the constitution, the legislature can change it with a simple majority vote. The Colorado Sun reported that lawmakers could make changes as early as January, when the new legislative session begins. Separately, Gov.-elect Phil Weiser, Colorado's attorney general, said he expects the legislature to examine the new law closely.

"We're going to have to take a look at these anti-trans measures and what adjustments are necessary and appropriate," Weiser said on Nov. 4, speaking to reporters after winning the governor's race, as reported by Colorado Newsline. Weiser did not offer specifics, saying it was too soon to comment on how Democrats may respond, according to The Colorado Sun. Options range from full repeal to minor alterations.

Erin Lee, a chief proponent of Proposition 135, called any legislative changes an attempt to circumvent democracy. "Weiser doesn't get to celebrate the will of the voters when it puts him in office and disregard that same will when it produces a result he doesn't like," Lee said in a text message on Nov. 5, according to The Colorado Sun.

Nadine Bridges, executive director of the LGBTQ+ advocacy group One Colorado, condemned the result in a Nov. 5 statement. "This outcome is painful, and it will have real consequences for young people and families across our state," Bridges said, according to The Colorado Sun.

Colorado joins 27 other states that have implemented restrictions on care for transgender youth.