Colorado House approves pair of bills for transgender health care and protections

Republicans oppose legislation on parental rights groundsTwo bills that would strengthen protections for transgender people and gender-affirming care won preliminary approval in the Colorado House on Friday.

They come as transgender rights and protections are put on shaky ground at the federal level under the Trump administration, which has issued orders to recognize only two unchangeable genders, stop offering non-binary passport gender markers, and attempts to stop funding care for transgender minors.

“What’s happening at the federal level is casting a long shadow and we don’t know what the future holds. There is a real possibility that gender-affirming care could be at risk,” said Rep. Brianna Titone, an Arvada Democrat and the Legislature’s only transgender member. “Passing this bill is about telling Coloradans that no, we are not going to let that happen. It’s about taking control of what we can do to ensure that our friends and neighbors and family members continue to get the care they need regardless of what might happen in the future.”

As more states enact policy to restrict care, especially for minors, Colorado could further become an island of access and absorb more out-of-state patients.House Bill 25-1309, sponsored by Titone, would codify into state law existing state public health rules about gender-affirming health care coverage. It would make it illegal for health insurers to deny or limit care deemed medically necessary by a doctor, which could include hormone therapy and procedures like facial surgery, breast augmentations and genital reconstruction.

“What can be created by rules can also be undone,” said bill sponsor Rep. Kyle Brown, a Louisville Democrat. “This bill codifies existing standards into statute to provide long-term stability and clarity for patients.”

The bill would also exempt prescriptions for testosterone from the state’s Prescription Drug Use Monitoring Program, which shares data across pharmacies and providers to mitigate abuse of controlled substances.

Republicans offered a failed amendment during the chamber’s two-hour debate on the bill to limit covered care to adults only, arguing that minors are not mentally developed enough to make such medical decisions. They pointed to Colorado laws that place age restrictions on other behavior like buying firearms and getting a tattoo.You can’t even buy a betta fish until you’re 18. But we’re going to allow (doctors) to perform lifelong sterility based with no (Food and Drug Administration) approval and no systematic review,” said Rep. Brandi Bradley, a Littleton Republican.

“If you’re an adult, make your own decision. But for the love of humanity, protect the children who don’t understand that these things are not FDA approved or haven’t been reviewed by any research. Let these children go through puberty,” she said.

The FDA has approved puberty blockers for precocious puberty. The medication’s use is considered off-label for youth gender-affirming care, but it has been standard care for decades.

Democrats responded that decisions about gender-affirming health care for transgender children are made between the patient, their families and their doctor. Leading medical organizations, including the American Academy of Pediatrics, recommend that gender-diverse children have access to developmentally-appropriate care.

“I think we should consult everyone in the equation, especially the person the care is being directed to,” Titone said.The other bill, House Bill 25-1312, aims to add protections for transgender people in schools and courts. It would require courts to consider as a form of coercive control actions like deadnaming — using a transgender person’s previous name before transitioning in order to reject their identity — and misgendering in child custody decisions. It would also shield parents who help their child obtain gender-affirming care from court orders in other states that outlaw the practice.

“Supporting a child’s gender identity is indeed in the best interest of the child, and that support cannot be used against a loving and supportive parent in a dispute,” said bill sponsor Rep. Rebekah Stewart, a Lakewood Democrat.

But Republicans argued the bill’s provisions for custody decisions would be an “erosion” on parental rights.

“The idea that misgendering your own child is considered coercive control, which is another word for child abuse, because you want to get your child help instead of affirming their delusions … this is the most disgusting bill I’ve seen so far,” said Rep. Jarvis Caldwell, a Colorado Springs Republican.The bill would also label deadnaming and misgendering as discriminatory acts under the state’s anti-discrimination law.

Schools could not adopt a gender-based dress code under the bill. If a school has an adopted policy related to chosen names, that policy would have to be “inclusive of all reasons that a student might adopt a chosen name that differs from the student’s legal name.” The Legislature approved a law last year that concerns students’ chosen names in public schools

“This bill is truly the least that we can do. Frankly, I wish that we didn’t have to bring this bill, but the reality of navigating the world today as a transgender human necessitates it,” Stewart said.

Both bills still need a final recorded vote in the House before heading to the Senate. Democrats hold majorities in both chambers and do not need any Republican votes to pass legislation.