Colorado voters will decide Initiative 110 in November 2026, which would bar healthcare providers from performing surgeries on minors to alter biological sex characteristics in response to gender perception and block public or insurance funding for such procedures. The measure qualified for the ballot after Protect Kids Colorado submitted well over the required signatures, joining parallel efforts on youth sports participation. Colorado’s Democratic lean and history of protecting gender-affirming access create headwinds, while national trends toward restrictions in other states and organized signature drives signal countervailing support. Competing interpretations of the measure’s scope, including potential overlap with broader reproductive health services, and the absence of detailed polling this far from election day keep the contest near even odds. Late-cycle campaign spending, turnout among suburban and independent voters, and any shifts in national messaging on youth medical interventions could move probabilities in either direction before November.