This public domain picture is not of a minor, nor is it of a gender-affirming surgery. But passing Prop 135 would ban gender-affirming surgery for people under 18 in Colorado.

At its simplest, passing Proposition 135 would prohibit any health care professional from performing, providing, prescribing, or administering “any surgery to a minor for the purposes of altering biological sex characteristics.” “Minor” is described as any person under the age of 18. No state or federal funds, or private insurance payments, could be used toward treatments that would be prohibited under Prop 135. With more on this point to follow, the initiative does not include specific language about what types of surgeries would be prohibited.

Prop 135 is a statutory initiative, not a Constitutional amendment, and would pass with a simple majority of 50% (plus one) of the vote.

Why Prop 135?

Prop 135 does not propose any restrictions on gender surgery for people 18 years old or older. While there will be those who question the veracity of the next statement, this sentence from Prop 135’s legislative declaration might explain some of the proponents’ reasoning for running the initiative: “Children lack the maturity to make permanent, life-altering medical decisions.”

The legislative declaration also notes that surgeries might result in result in “serious, irreversible consequences, including sterility.”

The Prop 135 designated representatives, Erin Lee and Michele Austin, launched an issue committee called “Protect Our Children,” plus they are also the designated representatives for this year’s Proposition 133 (stronger penalties for human trafficking of a minor) and 134 (basically preventing trans girls and women from competing with cisgender women in interscholastic sports).

Erin Lee has spent years in activism questioning gender fluidity. Readers might gain perspective from a Colorado Public Radio story, linked here, about Lee’s experience with a daughter who at one point told her parents she was transgender. Michele Austin is described in Colorado Times Recorder as being a “longtime Republican strategist” who owns a consulting firm called “Red Map Strategies.”

What Types of Surgeries Might Be Prohibited?

Per Prop 135 text:

“’Altering biological sex characteristics’ means treatment in response to a minor’s perception of sex or gender. It does not include treatment for persons born with a medically verifiable disorder of sex development or treatment for acquired physical or chemical abnormalities. ‘Altering biological sex characteristics’ does not include male circumcision.”

While this is definitely not meant to claim anything about how the courts might treat certain procedures should Prop 135 pass, the Journal of the American Medical Association (JAMA) has posted a study called “National Estimates of Gender-Affirming Surgery in the US.”

In this study, the authors listed procedures that they classify as gender-affirming surgery (GAS), including “breast and chest procedures, genital reconstructive procedures, and other facial and cosmetic surgical procedures.” Prop 135 does not use the term “gender-affirming surgery,” as noted in the first paragraph of this section.

To break the JAMA classifications down a little more:

  • Breast and chest surgical procedures encompassed breast reconstruction, mammoplasty and mastopexy, or nipple reconstruction.
  • Genital reconstructive procedures included any surgical intervention of the male or female genital tract.
  • Other facial and cosmetic procedures included cosmetic facial procedures and other cosmetic procedures including hair removal or transplantation, liposuction, and collagen injections.

Have Other States Passed Initiatives Like Prop 135?

Per the website mapresearch.org, at least 27 U.S. states have adopted various bans that might apply to gender-affirming surgical procedures and/or medications for minors. It should be noted that the website says some of the laws have been blocked by the courts or partially blocked.

Have Other Countries Banned These Surgeries for Minors?

The legislative declaration intro to Prop 135 includes the following statement: “European nations, including Sweden, Finland, and the United Kingdom, have halted surgery due to the serious and widespread harm resulting from that intervention.”

A direct comparison between Prop 135 and a very large number of laws in European nations might not be easy to establish. But for fairness and perspective, the website European Union Agency for Fundamental Rights released the following brief recap regarding “access to sex reassignment surgery”:

  • In this context, the age requirement for access to medical treatment without the consent of the parents or of a public authority is 18 years in Bulgaria, Cyprus, Greece, France, Hungary, Romania and Slovakia, and 15 years in Slovenia. In the United Kingdom the age requirement ranges from 16 in Scotland to 17 in England and 18 in Wales. In Belgium, Estonia, Germany and Luxembourg the child’s maturity is assessed.
  • In Austria, Czechia, Croatia, Denmark, Finland, Italy, Latvia, Lithuania, the Netherlands, Poland, Portugal, Spain and Sweden the minimum age requirement to request sex reassignment surgery is explicitly set at the age of 18.
  • Overall, twenty Member States (and Wales) only allow sex reassignment surgeries in individuals over the age of 18. Out of these, twelve Member States also set 18 as the age requirement for transgender hormone therapy, while in the case of sex reassignment surgery, eight countries (Czechia, Denmark, Finland, the Netherlands, Latvia, Poland, Spain and Sweden) ask for a higher age than for transgender hormone therapy.
  • In Ireland and Malta, the age requirement for sex reassignment surgery is 16 years.
  • Croatia allows children to have sex reassignment surgery before the age of 18 if they have parental consent, without laying down any specific minimum age requirement.

Proponents: The committees “Protect Kids Colorado – Issue Committee” and “Protect Our Children” have registered to support Prop 134.

  • Protect Kids Colorado had reported $116,450.84 in total contributions, while
  • Protect Our Children had not reported any contributions.

Opponents: Five committees have registered to oppose Prop 134.

  • Families Not Politics had reported $1,656,364.98 in total contributions as of Oct. 6, including ACLU for $297,601.98, COBALT for $224,000, One Colorado Education Fund for $134,500.84, Brighter Future for Colorado for $110,000, ACLU Foundation for $98,664.46, and Planned Parenthood Action Fund for $100,000.00. Both the ACLU and Planned Parenthood funds had New York City addresses.
  • Vote Common Sense is opposing 134, but also 132, 133, 135, and 136 along with Amendments 81, 82, 84, and 85. It’s reported $646,500 in total contributions as of Oct. 6, including $200,000 from Washington, DC-based Green Advocacy Project, $100,000 from Merle Chambers of Denver, $65,0000 from Colorado Fund for Children & Public Education, $50,000 from Coloradans for Real Safety Solutions, $50,000 from Colorado Immigration Rights Coalition, $50,000 from Colorado WINS, and $35,000 from COBALT.
  • The People’s No opposes 134, but also 132, 135, and Amendment 81. It’s reported $200,000 in monetary contributions as of Oct. 6, and $51,246.11 non-monetary, including $246,346 from ACLU of Colorado, and $103,332 from COLOR Action Fund.
  • No on 109 and 110 had reported $10,787.68 in contributions.
  • Protect Trans Kids had not reported any contributions yet.

Links to More Information:

Richard’s Take

I will vote “no” on Prop 135, with no ambivalence and just a few top reasons.

There’s a technical issue for me in that Prop 135 language does not specifically define types of procedures that might be prohibited. Without clear definition, it’s possible that 135 might ban procedures that don’t have anything to do with genitalia or even gender status, which to me is enough reason by itself to oppose putting the entirety of 135 into state law.

On the human rights side, Prop 135 would amount to a blanket ban on gender-affirming surgeries for anyone under 18, no matter what. While there are many, many laws in Colorado that involve being 18 or not, not all of these laws are created equal. A 17-year-old might be making a perfectly logical decision, but under this law they might need to live for a year or so with the discomfort of not being allowed to be who they believe they need to be. It’s their identity on which they’re deciding, and to compare this type of a situation with drinking or smoking – as Prop 135 notes in its legislative declaration – is specious at best.

While I do seriously hope that minors would take great time to consult with families and physicians and counselors before making their decisions, it’s ultimately extremely personal. In my opinion, it shouldn’t be a decision for millions of voters who have never met the person weighing that decision, possibly aren’t comfortable with transgender people of any age in the first place, and have no idea about why a person wants to go ahead with a procedure.

By no means am I suggesting that people should take the possibility of minors having gender-affirming surgery lightly. But I am saying that it seems to me like a situation for education and interpersonal conversations, as opposed to a blunt and what seems to me like a poorly-defined law. We’ll more than likely see the issue come up again in the legislature or at the ballot box if Prop 135 fails, but I don’t think this proposal is a good or fair solution and I do hope it is defeated.