Decline in Support for Gender-Affirming Care in Colorado Among Transgender Youth Families

Colorado, once recognized as a safe haven for gender-affirming healthcare, is experiencing a shift that has left many families of transgender youth feeling uncertain and distressed. Historically, the state has been a destination for those seeking legally protected gender-affirming treatments, including hormone therapy and surgeries, which are considered essential health benefits. In the past, some individuals even moved to Colorado specifically to access such care.

The roots of Colorado’s reputation as a hub for gender-affirming services trace back to the 1970s, particularly in the town of Trinidad, which gained fame as "the sex-change capital of the world," due to pioneering work by surgeon Stanley Biber performing gender surgeries for adults.

However, recent federal policy shifts under the Trump administration aimed to restrict gender-affirming care for minors. Executive orders labeled such treatments as harmful and mutilative, and directed federal agencies to limit funding and restrict access. In response, several Colorado healthcare organizations, including Children's Hospital Colorado, Denver Health, and UCHealth, initially suspended new prescriptions of puberty blockers and hormones for patients under 19, and halted surgical procedures.

Following legal challenges, notably a U.S. District Court ruling that deemed the federal orders discriminatory, some of these institutions, such as Children's Hospital Colorado and Denver Health, resumed offering puberty blockers and hormone treatments in February 2025. Nonetheless, gender-affirming surgeries remain on hold, with providers citing safety concerns and legal uncertainties.

The court decision has not fully alleviated the distress among transgender youth and their families. Many have begun stockpiling prescriptions, seeking private providers with appropriate expertise, or considering relocating to other states or countries with more supportive policies.

Meanwhile, the federal government has continued to threaten funding cuts and review processes aimed at medical education programs related to transgender healthcare. Despite these challenges, the provision of gender-affirming care remains a critical issue, with researchers highlighting that access to such treatments is limited even among insured youth. The ongoing legal and political landscape creates a complex and uncertain future for transgender minors seeking gender-affirming medical interventions in Colorado and beyond.