Research by Josiah Hesse

Content note: Language and terminology related to gender, gender identity, and transgender communities is constantly evolving. Please note that there are terms, phrases, and words used in this article that are a reflection of the time and era it was originally written.

Healthcare is rarely just a matter of clinical science. It is a complex, human arena where social values, state authority, medical ethics, and individual bodily autonomy continuously intersect. For transgender, nonbinary, and gender-diverse individuals, accessing medical care has historically meant navigating a dense maze of barriers, such as institutional gatekeeping, economic precariousness, and legal ambiguity. To seek gender-affirming treatment—whether social transition support, gender-affirming hormone therapy, or complex reconstructive surgeries—is to engage with a healthcare apparatus that has, at various times, pathologized, ignored, or actively denied the existence of transgender people.

Yet, across the United States, the story of transgender healthcare is not merely one of marginalization; it is equally a story of profound resilience, strategic policy innovation, and grassroots community organizing. Few places illustrate this dynamic more vividly than Colorado.

Over the past half-century, Colorado has undergone a dramatic transformation. Once infamously dubbed the “Hate State” following the 1992 passage of Amendment 2—a voter-approved constitutional amendment that prohibited local municipalities from enacting anti-discrimination protections for gay, lesbian, and bisexual residents—Colorado has since emerged as one of the nation’s most robust sanctuaries for transgender-affirming healthcare and civil rights. This shift was neither accidental nor inevitable. It was carefully built over decades by a network of groundbreaking clinicians, grassroots activists, policy strategists, state administrators, and community journalists who recognized that securing health equity required transforming both clinical practice and state law.

To understand the current ecosystem of gender-affirming care in Colorado, one must examine three deeply interconnected pillars: the historical record preserved in community archives, the evolution of clinical practice from a niche subspecialty to standard medicine, and the strategic policy frameworks that codified anti-discrimination protections into law.

The historical record preserved in the archives of OUT FRONT—Colorado’s premier LGBTQ+ newspaper, founded in 1976—shatters the persistent myth that transgender healthcare is a recent phenomenon. Decades before gender-affirming care became a prominent fixture in national political debates, transgender Coloradans were actively seeking, providing, and organizing around medical transition.

In 1976, OUT FRONT documented the extraordinary surgical practice of Dr. Stanley Biber at Mount San Rafael Hospital in Trinidad, Colorado. A small coal-mining town near the New Mexico border, Trinidad unexpectedly became recognized as the sex change capital of the world, where Dr. Biber performed twelve to fifteen gender-reaffirmation procedures a month for patients traveling from across the globe. Dr. Biber’s work demonstrated that gender-affirming surgical care could be safely provided within a local community hospital, setting an early historical precedent for Colorado as a destination for medical care.

Simultaneously, the archival record highlights how transgender health equity has always been deeply entwined with broader civil rights, racial justice, and freedom from state violence. In March 1978, the fatal police shooting of Irene De Soto, a transgender woman in Denver, catalyzed a landmark demonstration of over one hundred marchers who explicitly linked police brutality and transphobia. Throughout the 1980s and 1990s, OUT FRONT served as a critical watchdog—countering sensationalized mainstream media coverage of Medicaid funding for transition care, advertising specialized counseling networks, and publishing groundbreaking investigative series detailing the medical science, psychiatric gatekeeping, and surgical realities facing transgender Coloradans.

While early surgical innovators provided critical interventions, the day-to-day healthcare needs of transgender adults were long neglected by mainstream medical education. For decades, transgender individuals seeking routine preventative health exams, acute care, or hormone therapy were forced to navigate a medical system characterized by ignorance or pathologization.

In the late 1990s and early 2000s, clinicians working in this space were largely self-taught. Working across disciplines—consulting endocrinologists, psychiatrists, and primary care peers—a dedicated cohort of providers began building the clinical literature from the ground up. Among them was Dr. Rita Lee, a Professor of Internal Medicine at the University of Colorado Anschutz School of Medicine, who spearheaded a vital paradigm shift: reframing gender-affirming care not as an obscure, highly specialized practice, but as an essential component of comprehensive primary care.

Gender-affirming hormone therapy relies on the same pharmacological mechanisms and clinical safety protocols long utilized in cisgender health, such as hormone replacement therapy for menopausal women or testosterone therapy for cisgender men with hypogonadism. More importantly, when primary care environments affirm a patient’s identity, health outcomes improve dramatically across the board—leading to higher rates of preventative cancer screenings, routine vaccinations, and chronic disease management. To affirm a patient’s gender identity is, at its core, to affirm their basic humanity.

Clinical goodwill alone, however, cannot survive in a regulatory vacuum. Without legal protections and mandatory coverage rules, insurance companies routinely denied claims for gender-affirming treatments—or used an individual’s transgender status as a pretext to deny unrelated emergency care.

The structural transformation of Colorado’s healthcare policy gained momentum in the early 2010s through a powerful synergy between public health data collection and targeted legal strategy. When public health analyst Alison Grace Bui worked at the Colorado Department of Public Health & Environment, standard general-population surveys like the Behavioral Risk Factor Surveillance System lacked the design to capture detailed data on transgender populations. Partnering directly with One Colorado, Bui lent her technical expertise in survey design to support a community-led data collection effort. This resulted in baseline data establishing that transgender Coloradans faced disproportionate poverty, insurance denials, and clinical discrimination.

Equipped with this data, policy strategists like Ashley Wheeland—then Health Policy Director at One Colorado and currently Policy and Advocacy Director for Leverage Colorado—executed a multi-pronged regulatory strategy. Rather than waiting for complex statutory overhauls in the legislature, advocates engaged directly with major private insurers, state Medicaid officials, and the Colorado Division of Insurance. In 2013, the Division of Insurance issued a historic administrative bulletin declaring that denying coverage for medically necessary gender-affirming care, or discriminating against patients based on gender identity, constituted illegal discrimination under state law. This administrative victory created a vital regulatory shield that was later codified into permanent state statute.

The narrative of transgender-affirming healthcare in Colorado is not a simple linear march toward progress. Today, healthcare providers, policy advocates, and transgender communities face an increasingly polarized national climate characterized by legal challenges, shifting regulations, and widespread misinformation surrounding gender-affirming care.

Yet, as history demonstrates, the foundation built in Colorado over the past five decades offers a resilient framework for enduring these pressures. By anchoring clinical practice in medical ethics and the sacred patient-provider relationship, by maintaining community-led baseline data, and by defending hard-won administrative non-discrimination rules, Colorado continues to chart a course for compassionate, evidence-based healthcare access. The following sections examine this legacy in depth, tracing the people, policies, and archival records that transformed the state into a sanctuary for trans-affirming medicine.

A Comprehensive Timeline of Transgender Healthcare, Activism, and Media Coverage in Colorado (1976–1995)

The history of transgender-affirming healthcare in Colorado is a complex, rich, and often paradoxical narrative. Long before modern legal protections were enacted or gender-affirming medicine achieved mainstream recognition within major hospital systems, grassroots activists, leading-edge surgical teams, community organizers, and local publications were actively documenting and shaping the landscape of gender-affirming care.

Central to this historical record is OUT FRONT, founded in 1976 as Colorado’s premier LGBTQ+ newspaper. Throughout the late 1970s, 1980s, and 1990s, OUT FRONT served as a vital community bulletin, a political watchdog, and a public square. Its archives reveal how trans Coloradans navigated a healthcare system that was simultaneously groundbreaking and deeply discriminatory. From the high-volume surgical practices in rural southern Colorado to grassroots demonstrations against state violence, from clinical seminars on gender dysphoria to nuanced four-part investigative series detailing the medical realities of transition, the pages of OUT FRONT captured history as it happened.

This comprehensive timeline reconstructs two decades of trans-affirming healthcare events, clinical debates, and political struggles as chronicled in the OUT FRONT archives and contemporary historical sources.

1976: Trinidad, Colorado, and the “Sex Change Capital of the World”

The story of trans-affirming healthcare in Colorado begins not in a major metropolis like Denver or Boulder, but in Trinidad, a small coal-mining town located in Las Animas County near the New Mexico border. In May 1976, OUT FRONT reported on a national media story that had put Trinidad on the global medical map.

In a brief report referencing coverage by The Denver Post, OUT FRONT highlighted the extraordinary surgical volume being conducted at Mount San Rafael Hospital by Dr. Stanley Biber, a general practitioner and Chief of Staff at the facility:

“The Denver Post reports that Trinidad Colorado, a small isolated town, has become the sex change capitol of the world. Dr. Stanley Biber, Chief of Staff at Mount San Rafael (the only hospital in town) is performing the changes at a rate of 12 to 15 a month.”

— “Sex Change Capital,” OUT FRONT (May 1976)

Dr. Biber, a former military surgeon who had settled in Trinidad, began performing gender-reaffirmation surgeries in 1969 after a local transgender woman asked if he could perform the procedure. Using surgical techniques adapted from Korean War reconstructive procedures, Dr. Biber established one of the very few accessible surgical centers for transgender individuals in the United States.

At a time when major academic medical centers were shuttering or strictly limiting their gender identity clinics due to institutional conservatism and social stigma, Dr. Biber’s practice at Mount San Rafael Hospital made Trinidad an international destination. His work demonstrated that gender-affirming surgical care could be safely integrated into rural hospital settings, laying an early precedent for Colorado as a beacon for gender-affirming medical travel.

1978: Protesting State Violence and Medical Discrimination: The Irene De Soto March

Healthcare equity cannot be separated from broader systemic discrimination and state violence. In the spring of 1978, the Denver transgender community faced a tragedy that mobilized grassroots political power across sexual orientation and gender identity lines.

In late March 1978, Irene De Soto, a  transgender woman, was shot and killed by Denver Police Department vice-squad officer Lawrence R. Subia. The killing sparked outrage across the city’s LGBTQ+ community. On March 31, an ad-hoc committee assembled at the Gay Community Center of Denver to coordinate a direct response.

In April 1978, OUT FRONT reported on the massive protest march that followed:

“About 100 people marched through the streets of Denver last Sunday to protest the fatal shooting of preoperative transsexual Irene De Soto by vice-squad officer Lawrence R. Subia. The protest of the shooting came as a result of an ad-hoc committee meeting held at the Gay Community Center March 31 which was attended by gays from all segments of the community. The focus of the march was to spotlight the discriminatory attitudes and actions of the Denver Police Department against sexual and racial minorities.”

— “Protest March Follows Shooting,” OUT FRONT (April 1978)

The Irene De Soto demonstration marked a crucial moment in Colorado’s civil rights history. It explicitly linked police brutality, racial bias, and transphobia, demonstrating that the fight for trans liberation involved physical safety and equal protection under the law. The march established an early coalition between gay, lesbian, and trans activists in Denver, asserting that trans women—particularly those navigating preoperative medical transitions—were an integral part of the broader civil rights movement.

1979: National Clinical Context: The Honolulu Surgical Protocol Reports

As local activism grew, OUT FRONT kept its readers informed about national and international developments in gender-affirming medicine. In 1979, the paper reported on a clinical presentation delivered at the Nurses Association of the American College of Obstetricians and Gynecologists conference at the Hyatt Regency Hotel in Honolulu, Hawaii.

The report detailed the work of a multidisciplinary surgical and psychiatric team—comprising Dr. Flowers, urologist Dr. John Edwards, and gynecologist/psychiatrist Dr. Edwin Gramlich:

“In the past ten years, a team of doctors here has performed between 20 and 50 sex change operations to transform genetic men—typically, people who truly think of themselves as ‘females trapped in male bodies’—into anatomical females, three doctors here said recently. Among our patients are nurses, airline stewardesses, teachers and social workers.”

— “Sex Change Operations Detailed,” OUT FRONT (1979)

The doctors emphasized the rigorous psychological preparation required under early clinical protocols:

“Our patients were well prepared psychologically for the change of sex. We require that they live as females for as long as two years before the operation.”

— “Sex Change Operations Detailed,” OUT FRONT (1979)

Publishing these national reports provided transgender Coloradans with crucial information about emerging standards of care. The reference to the “real-life experience”—requiring patients to live publicly in their affirmed gender for up to two years prior to surgery—reflected the gatekeeping protocols of the era, which were codified under early Harry Benjamin International Gender Dysphoria Association guidelines.

1980: Professional Education, Clinical Gatekeeping, and National Religious Debates

The year 1980 represented a major turning point in the documentation of transgender healthcare within OUT FRONT. The publication covered clinical education seminars, institutional gatekeeping, religious debates, and legal battles over public healthcare funding.

Clinical Seminars in Denver: Dr. Paul A. Walker and HBIGDA

In late 1980, the Professional Counseling and Training Center, Inc. organized a two-day educational conference in Denver featuring Dr. Paul A. Walker, one of the foremost national figures in transgender health care.

OUT FRONT carried advertisements and detailed event summaries for the seminar, titled “Transsexualism, Hermaphrodites and the Rest of Us”:

“Walker, a specialist in gender identity, holds a Ph.D. in Psychology from the University of Rochester and formerly served on the faculty of the Johns Hopkins University School of Medicine and has been the director of the Gender Identity Clinic of the University of Texas Medical Branch in Galveston, Texas. A certified sex therapist and educator, Walker is currently in private practice in San Francisco and holds positions as the director of the Janus Information Facility and is President of the Harry Benjamin International Gender Dysphoria Association, Inc.”

— “Event Announcement,” OUT FRONT (November 1980)

A companion news report in OUT FRONT detailed the specific focus of the Denver lectures:

“Through the efforts of the Professional Counseling and Training Center, Inc., Dr. Paul Walker, a specialist in gender identity will speak in Denver for two education sessions in November. ‘Gender Identity as Mental Health Specialty’ will be a two day seminar for mental health and general health care specialists featuring lecture and discussion on the therapeutic needs of people desiring sex change operations.”

— “Walker to Speak in Denver,” OUT FRONT (November 1980)

As the founding president of the Harry Benjamin International Gender Dysphoria Association (HBIGDA)—which later evolved into the World Professional Association for Transgender Health (WPATH)—Dr. Walker’s visit to Denver represented an effort to professionalize and standardize gender-affirming medical and psychological care in Colorado.

Institutional Inclusion and Legal Struggles: The Catholic Church and Medicaid

While clinical protocols were being established, institutions struggled with gender transition. In 1980, OUT FRONT reported on a Catholic priest who had undergone female-to-male transition, sparking a theological debate within the Vatican over whether a transgender man could validly serve as a priest.

Simultaneously, OUT FRONT monitored legal challenges regarding public healthcare funding for gender-affirming surgeries. In 1980, the paper covered a landmark lawsuit brought by a New York City woman against Medicaid after the agency refused to cover her gender-reaffirmation surgery. The suit argued that denying medically necessary surgical care to low-income transgender patients constituted illegal discrimination under federal public assistance programs.

1986: Media Backlash and the Fight for Public Funding: The Medicaid Debates

By the mid-1980s, public funding for gender-affirming healthcare had become a heated political battlefield in Colorado. Major mainstream outlets, including the Rocky Mountain News, published sensationalized coverage regarding public expenditure for transition-related procedures.

In 1986, after the Rocky Mountain News ran prominent stories titled “Medicaid to pay for half of sex change bill” and “Politicos blast Medicaid payment in sex change,” public backlash erupted among conservative lawmakers and media figures.

In response, OUT FRONT published sharp letters to the editor pointing out the hypocrisy and double standards of mainstream coverage regarding transgender health needs.

The 1986 Medicaid debates presaged the long regulatory struggles that would persist for the next three decades in Colorado. Public health agencies routinely attempted to categorize gender-affirming care as “experimental” or “elective” to justify funding exclusions—a hurdle that advocates like Ashley Wheeland and One Colorado would finally dismantle decades later through the 2013 Division of Insurance bulletin.

1994: Professional Support Systems and Community Resources

By the early 1990s, community-based professional services for gender identity had grown across the Front Range. Classified advertisements and directory listings in OUT FRONT reflected a growing network of licensed therapists, medical consultants, and support groups specializing in gender transition.

In 1994, OUT FRONT regularly featured advertisements for specialized mental health services, including listings for “Transsexual Reassignment Counseling.” These listings marked a shift toward accessible, community-vetted mental health providers who could assist clients in navigating the complex medical prerequisites—such as recommendation letters for hormone therapy and surgery—mandated by the HBIGDA Standards of Care.

1995: “Transgendered” — The Historic Four-Part Investigative Series

In 1995, OUT FRONT published a groundbreaking four-part investigative series titled “Transgendered.” Written at a time when deep, empathetic, and scientifically accurate reporting on transgender lives was virtually non-existent in mainstream media, the series offered an exhaustive examination of the medical, psychological, legal, and surgical realities of transition.

Part 1: Medical Science, DES, and the Urgency of Transition

The first installment of the series, published in early 1995, framed gender transition not as a lifestyle choice or cosmetic preference, but as an urgent medical necessity linked to biological and physiological factors.

The article profiled Pennington, a transgender woman whose medical history highlighted the complex intersections between endocrine exposure and gender identity:

“She began experiencing a series of debilitating health problems. For no obvious medical reasons, she began losing her eyesight. Then she started losing the feeling in her hands … Prior to Pennington’s birth in 1948, her mother was given DES, a synthetic female hormone, to keep her from miscarrying.”

— “Transgendered: Part I,” OUT FRONT (1995)

By examining Diethylstilbestrol (DES)—a synthetic estrogen widely prescribed to pregnant women between 1938 and 1971—The article explored contemporary scientific theories regarding prenatal hormone exposure and neurological gender differentiation. The reporting emphasized that suppressing one’s gender identity caused severe psychological distress and physical health crises, positioning gender-affirming medical intervention as life-saving healthcare.

Part 2: Psychiatric Gatekeeping, Cross-Dressing, and the DSM

The second installment tackled the psychiatric classifications that governed transgender existence in the 1990s, specifically scrutinizing the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

The article analyzed how clinical pathologization created unequal gender dynamics and arbitrary diagnostic boundaries:

“Psychologists could diagnose him as having ‘transvestic fetishism,’ which is described in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a ‘heterosexual male’ who, over a period of at least six months, dresses regularly in women’s clothing. There is, however, no such diagnosis for a female of any orientation who dresses in men’s clothing … These men are referred to as female impersonators or drag entertainers and, as of 1993, are no longer mentioned in the DSM solely because of their taste in clothes.”

— “Transgendered: Part II,” OUT FRONT (1995)

This installment critiqued the double standards built into psychiatric diagnostic manuals, pointing out that male-to-female cross-dressing was heavily pathologized while female cross-dressing was largely ignored. By unpacking these diagnostic distinctions, OUT FRONT educated its readership on how psychiatric gatekeeping was weaponized to control access to medical transition.

Part 4: The Surgical and Endocrine Realities of Female-to-Male (FTM) Transition

The final installment of the 1995 series offered one of the most comprehensive and candid comparative analyses of male-to-female (MTF) and female-to-male (FTM) transition protocols ever published in a community newspaper.

The article addressed the relative invisibility of transgender men within both mainstream culture and the LGBTQ+ movement, attributing it in part to the historical disparities in surgical technology:

“Also taking away from the visibility of FTMs may be that, until recently, protocols for helping people medically transition from female to male were far less developed than protocols for male to female patients. One of those that is not as advanced for FTMs but has become more widely available is the surgical process of becoming anatomically male. Whereas MTF surgery consists primarily of splitting the skin of the penis and making it into a vagina (the testicles are used to make the outer lips), there is no one set surgery (referred to as a phalloplasty) for creating a penis.”

— “Transgendered: Part IV,” OUT FRONT (1995)

The article detailed the complex, multi-stage nature of phalloplasty procedures available in the mid-1990s:

“Using almost everything from the outer lips to the implants, surgeons can create ‘as elaborate a penis as they want’ complete with testicles and the ability to get erect, according to Herrin. Even with implants, pumps and surgical alterations, however, the end result is often incomplete. To date, there is no procedure for creating a penis that can be used for urination. Further, a successful surgery based on currently available methodologies is, in the end, as many as seven to 10 surgeries (depending on how far the patient wants to go) that can total over $100,000.”

— “Transgendered: Part IV,” OUT FRONT (1995)

The article contrasted these high costs and surgical limitations with MTF procedures, noting the emotional toll on trans men:

“And unlike surgeries for MTFs whereby a fully functioning vagina (sans other body parts of females) can be achieved, ‘their (FTMs) disadvantage is that they can never have the kind of genital structure they want.’ Still, according to Herrin, available estimates indicate that half of all sex reassignment surgeries performed in the U.S. are female-to-male.”

— “Transgendered: Part IV,” OUT FRONT (1995)

Finally, the article highlighted how transgender men frequently navigated medical transition through androgen therapy and social adaptation without undergoing full phalloplasty procedures, quoting Holly Cross of Tapestry magazine:

“Yet even without any surgeries, FTMs can often get by just by using hormones and working with the body hair, facial hair and muscles they develop. ‘One reason we know so little about them [FTMs] is that they can do most of what they want to do without any surgeon or psychiatrist,’ according to Holly Cross of Tapestry magazine, a nationwide quarterly publication for the gender community.”

— “Transgendered: Part IV,” OUT FRONT (1995)

The historical record preserved in the OUT FRONT archives demonstrates that transgender-affirming healthcare in Colorado was not a recent invention, nor was it imported from external political movements. It was built over decades through the courage of transgender patients, the dedication of clinical innovators, and the vigilance of community journalists.

From Dr. Biber’s operating room in Trinidad in 1976 to the investigative series of 1995, Colorado’s transgender community has continually asserted its right to health, autonomy, and dignified medical care. Understanding this archival history is essential for contextualizing the modern victories—and ongoing challenges—surrounding gender-affirming healthcare in Colorado today.

Modern Sanctuary: The Transformation of Transgender Healthcare in Colorado (1996–Present)

The period between 1996 and the present day marks a historic realignment in Colorado’s social, legal, and clinical landscape. In 1992, Colorado earned national infamy as the “Hate State” following the voter approval of Amendment 2, a constitutional amendment designed to ban state and local governments from enacting anti-discrimination protections for sexual orientation. In the decades that followed, the state underwent a complete structural inversion—evolving into one of the nation’s most explicit legal sanctuaries for transgender healthcare, bodily autonomy, and civil rights.

This modern transformation was forged through coordinated legal strategy, grassroots advocacy, public health survey research, legislative codification, and clinical integration. As documented across local archives, regional news reporting, and Out Front magazine—Colorado’s premier LGBTQ+ publication—the fight for transgender health equity moved from basic survival and peripheral advocacy into state statute, insurance regulations, major hospital systems, and sanctuary shield laws.

1996–2005: Dismantling Amendment 2 and Early Legal Recognitions

The turning point for civil rights policy in Colorado arrived on May 20, 1996, when the United States Supreme Court delivered its landmark decision in Romer v. Evans. By a 6–3 vote, the Court struck down Amendment 2 as unconstitutional under the Equal Protection Clause of the Fourteenth Amendment. Writing for the majority, Justice Anthony Kennedy noted that Amendment 2 imposed a broad disability upon a specific group, declaring that “a state cannot deem a class of persons a stranger to its laws.”

The invalidation of Amendment 2 removed a constitutional barrier that had chilled municipal and state non-discrimination initiatives. With the threat of state constitutional preemption lifted, community advocates shifted their focus toward establishing explicit statutory protections for sexual orientation and gender identity.

In 2001, following national outrage over bias-motivated violence, the Colorado General Assembly passed updated hate crimes legislation that explicitly included both sexual orientation and gender identity as protected classifications. This marked one of the state’s earliest statutory acknowledgments that gender expression required specific legal protection.

Concurrently, local grassroots organizations—such as the Gender Identity Center of Colorado (GIC), the Colorado Anti-Violence Program (CAVP), and the newly formed One Colorado—expanded community-based peer support networks, clinical referral directories, and sensitivity training for local medical and mental health providers across the Front Range.

2006–2012: The Colorado Anti-Discrimination Act and Data-Driven Advocacy

In 2008, Colorado enacted a major civil rights milestone with the passage of Senate Bill 08-200, expanding the Colorado Anti-Discrimination Act (CADA). The legislation added sexual orientation and gender identity to state non-discrimination protections across employment, housing, public accommodations, and commercial facilities.

While CADA established a broad prohibition against discrimination, health insurance carriers continued to exploit regulatory ambiguity. Insurers routinely included blanket “transgender exclusions” in policy contracts, denying claims for gender-affirming hormone therapy (GAHT), surgical care, and mental health counseling. In many instances, private carriers cited a patient’s transgender identity as a pretext to deny coverage for routine, unrelated medical care, such as acute emergency treatment or preventative screenings.

To confront these systemic exclusions, LGBTQ+ advocacy organizations pivoted toward empirical, data-driven strategy. Beginning in 2011, One Colorado partnered with public health analysts, community researchers, and state representatives—including statistical analyst Alison Grace Bui at the Colorado Department of Public Health & Environment (CDPHE)—to conduct statewide surveys examining LGBTQ+ health experiences.

Published in seminal reports like The Invisible OF/BY/FOR, the survey data documented severe structural disparities:

• Over 40% of transgender Coloradans reported being refused medical care or experiencing clinical discrimination due to their gender identity.
• Transgender residents experienced disproportionate rates of poverty, lack of insurance coverage, and delay of necessary medical care due to cost.
• A vast majority of respondents reported that their primary care physicians lacked basic clinical knowledge regarding transgender medicine and hormone protocols.

This baseline data transformed state policy discussions. Advocates no longer relied solely on anecdotal claims; they possessed empirical evidence proving that commercial insurance exclusions perpetuated systematic health inequities across Colorado.

2013–2020: The Division of Insurance Bulletin, Jude’s Law, and Clinical Integration

Armed with survey data, policy directors like Ashley Wheeland at One Colorado joined forces with medical professionals—including Dr. Rita Lee, MD, of the University of Colorado Anschutz School of Medicine, and Dr. Dan Reardon of Children’s Hospital Colorado—to target state regulatory bodies.

Rather than pursuing a lengthy legislative battle to amend insurance statutes, advocates petitioned the Colorado Division of Insurance (DOI) directly. In March 2013, the DOI issued a historic administrative bulletin. The bulletin formally instructed all private health insurance plans regulated by the state that:

1. Denying coverage for medically necessary gender-affirming procedures violated state non-discrimination laws.
2. Denying routine, non-transition-related medical services based on an individual’s gender identity or expression constituted illegal discrimination.

Following the 2013 Division of Insurance bulletin, Colorado Medicaid (the Department of Health Care Policy & Financing) updated its coverage policies to explicitly include gender-affirming hormone therapy, surgical interventions, and behavioral health support for low-income residents.

Concurrently, major academic and safety-net health systems across Colorado moved to integrate transgender-affirming care into routine practice:

• UCHealth Anschutz Medical Center: Under the leadership of clinicians like Dr. Rita Lee, the institution expanded internal medicine residency curricula to include gender-affirming hormone care, primary health maintenance, and culturally responsive communication, reframing gender care as routine primary care rather than an isolated subspecialty.
• Denver Health: Established the Integrated Transgender Program, offering comprehensive, multidisciplinary services under one roof—combining adult and pediatric primary care, endocrinology, surgical procedures, voice therapy, and psychiatric support.

In 2019, the state achieved another major legislative victory with the passage of Senate Bill 19-042, known as Jude’s Law. Named after Jude, a transgender youth from Boulder, the legislation streamlined the legal process for updating gender markers on birth certificates and state identification documents. Jude’s Law eliminated outdated prerequisites—such as mandatory surgery, court orders, or published newspaper notices—allowing transgender Coloradans to update state records through a simple self-attestation form, including the option for a non-binary “X” marker.

2021–Present: Sanctuary Shield Laws, Privacy Protections, and Modern Challenges

As state legislatures across the United States introduced sweeping restrictions on gender-affirming healthcare between 2021 and 2026, Colorado established itself as an explicit legal haven and shield state for patients and clinicians.

In April 2023, Governor Jared Polis signed Senate Bill 23-188, officially titled the Protecting Health Care in Colorado Act. Introduced by legislative leaders and championed by health equity coalitions, the shield law established robust legal defenses:

• Protections for Out-of-State Patients: Prohibits state courts, law enforcement, and administrative agencies from assisting out-of-state investigations, extraditions, or subpoenas related to legally protected gender-affirming care or reproductive healthcare received in Colorado.
• Provider Sanctions Shield: Protects licensed Colorado healthcare providers from professional discipline, medical malpractice insurance surcharges, or license revocation resulting from out-of-state legal actions targeting gender-affirming care.

In 2025, the General Assembly passed House Bill 25-1309 (Protect Access to Gender-Affirming Health Care). The law addressed dynamic data-privacy concerns by exempting prescriptions for testosterone—a controlled substance—from public and out-of-state data queries within the state’s Prescription Drug Monitoring Program (PDMP), protecting transgender men and non-binary patients from external digital surveillance. In early 2026, House Bill 26-1322 further updated enforcement standards regarding conversion therapy bans, protecting youth while navigating evolving judicial standards.

Despite these statutory protections, the contemporary landscape remains actively contested. As reported by Out Front magazine, anti-trans advocacy groups submitted signatures for citizen-led ballot measures—such as Proposition 135—seeking to restrict healthcare access for transgender minors and limit school accommodation policies. Simultaneously, health institutions face evolving federal executive policies, judicial rulings, and national media scrutiny.

From the striking down of Amendment 2 in 1996 to the protective shield laws of the present day, Colorado’s modern history demonstrates that health equity is sustained through continuous vigilance. By combining public health research, regulatory enforcement, legislative shield protections, and inclusive clinical practice, Colorado continues to serve as a vital beacon for transgender healthcare in the American West.

Building the Baseline: How Alison Grace Bui and Community-Led Data Collection Transformed Transgender Healthcare in Colorado

When public health institutions assess community needs, standard data collection methods often leave marginalized populations invisible. General population surveys reliant on random sampling frequently fail to capture the specific health outcomes and lived experiences of transgender and gender-diverse individuals. Around 2012, long before gender-affirming care and LGBTQ+ health data became widespread topics of public discourse, a pivotal collaboration in Colorado set out to change that trajectory.

Alison Grace Bui, a statistical analyst and coordinator for the Behavioral Risk Factor Surveillance System (BRFSS) at the Colorado Department of Public Health & Environment (CDPHE), found herself at the center of this movement. When One Colorado—the state’s leading LGBTQ+ advocacy organization—approached Bui seeking data on transgender health outcomes within public health systems, the existing surveillance tools proved insufficient for such detailed community-specific research.

“It’s a general population survey, and it’s randomly sampled,” Bui explains, referring to standard surveillance systems like BRFSS. “To identify any specific identity in our data is tricky, and it’s not designed to identify specific communities and be able to dig deep into that data.”

Rather than exhausting public resources on general surveys that could not yield the needed level of detail, Bui recognized a distinct opportunity to bridge institutional expertise with grassroots outreach. One Colorado had already cultivated an extensive network and direct lines of communication within the local transgender community.

Bui stepped forward to offer technical mentorship, partnering her expertise in survey design and methodology with the advocacy group’s trusted community reach. “For me, it was really about partnering with the community,” Bui says. “It’s really important to have people who work with this community be the ones to ask these questions and to be the voice collecting the data instead of some external entity.”

At the time, existing models for LGBTQ+ public health research were virtually nonexistent. “Anytime I design a survey or design questions for a survey, it always starts with what’s already been done, and we couldn’t find anything,” Bui recalled. “We definitely had a sense that not a lot of other places were collecting this information.”

The resulting initiative established a vital baseline where none previously existed. Designed with intentional longevity in mind, the survey focused on broad indicators of overall health and wellness, ensuring the data could serve as a benchmark for future research. This foresight paid off when the survey was repeated two years later in collaboration with university researchers, allowing experts and advocates to track health outcomes, systemic barriers, and patient experiences over time.

“We tried to design it understanding it wasn’t just a moment in time, but it was the beginning of collecting this data and having important information to inform the health outcomes and experiences of this population,” Bui notes.

By prioritizing community autonomy and robust methodological design, this groundbreaking  effort laid the foundational cornerstone for transgender-affirming healthcare policy in Colorado. The collaborative model proved that effective public health advocacy relies not only on gathering statistics, but on empowering communities to hold the mic—and the clipboard—in telling their own health stories.

Architectural Protections: How Ashley Wheeland and Colorado Built a Shield for Transgender Health Rights

In the evolving landscape of civil rights in the United States, policy changes rarely occur by accident or through sudden shifts in public sentiment. They are built through deliberate, incremental strategy—a process of establishing legal definitions, leveraging regulatory bodies, and securing early administrative victories that create lasting protections.

Long before transgender healthcare became a central focus of national political discourse, Colorado was quietly laying the groundwork for some of the most comprehensive transgender-affirming healthcare protections in the country. At the core of this policy shift was Ashley Wheeland, currently the Policy and Advocacy Director for Leverage Colorado.

Starting in the early 2010s, Wheeland worked alongside civil rights leaders, healthcare advocates, and grassroots organizations to dismantle structural barriers to medical care for transgender Coloradans. Her career—spanning roles at the Colorado Consumer Health Initiative (CCHI), One Colorado, Planned Parenthood of the Rocky Mountains, and Congress, as well as authoring statewide ballot initiatives—offers a masterclass in how targeted public policy can turn civil rights principles into enforceable legal realities.

Identifying the Gap: From General Health Reform to Anti-Discrimination

Wheeland’s entry into LGBTQ+ health advocacy began around 2012 while she was working at the Colorado Consumer Health Initiative (CCHI). CCHI, a nonprofit dedicated to reforming health insurance systems and implementing the Affordable Care Act (ACA) at the state level, was operating under a grant to examine consumer rights and insurance access across Colorado.

When One Colorado—the state’s primary LGBTQ+ advocacy organization—approached CCHI to collaborate on transgender health rights, Wheeland encountered an insurance landscape rife with systemic exclusions. Insurers routinely denied coverage for gender-affirming procedures, deeming them cosmetic or unnecessary. Worse, insurers often used an individual’s transgender identity as a broad rationale to deny routine, unrelated medical care.

“I just learned about how insurers were refusing to provide that care, but also how sometimes they would use that someone’s transgender status to deny other care, like a broken leg or something like that, because it had to do with the hormones they were taking, or something like that was the argument,” Wheeland recalls. “I just saw how problematic that was. First off, transgender healthcare is a healthcare need that is specific to transgender health, but also to see discrimination happening just because of who you are in getting any health service—It just kind of aligned with what I saw as the issue with healthcare generally. Any way to not pay for it, insurers would do it. But this was clear discrimination based on your transgender status.”

At the time, Colorado’s anti-discrimination statutes subsumed transgender protections under the broader category of “sexual orientation.” From a legal and policy standpoint, Wheeland recognized that this structure created significant hurdles. Disproving discrimination required complex legal maneuvers to fit gender identity into sexual orientation definitions, leaving transgender individuals vulnerable to regulatory loopholes.

Furthermore, medical coverage models at the time frequently misclassified transgender-related care under mental health definitions rather than physical health or medically necessary procedures.

“We had put together a plan to push for healthcare services to be covered for transgender folks—specific transgender healthcare services too—so that it’s not just saying that they’re discriminated against, but also that there are services folks need that are defined as medically necessary,” Wheeland explains. “I still think the medical world was behind, and that it was put into the mental health area … We were working with provider leaders in the LGBTQ movement to do education on transgender health for providers and push back on how it’s classified. Transgender healthcare should be like discrimination law versus ‘you should provide it because they have some mental health need.'”

The Civil Rights Reality of Healthcare Access

As Wheeland deepened her work with One Colorado—eventually transitioning to become the organization’s Health Policy Director under then-Executive Director Brad Clark—the socio-economic realities facing the transgender community became increasingly evident.

Inaccessible healthcare was not merely an administrative inconvenience; it was a civil rights issue with direct ties to economic security and physical safety.

“I just learned so much about the issue and how dangerous it is for transgender folks to not have healthcare,” Wheeland says. “It’s not just not having healthcare, but if you can’t get those services and you need them to be able to live who you are, then people will discriminate against you for being transgender. If you couldn’t get top surgery, or other surgeries, or hormone access and insurance wouldn’t pay for it, you had to pay for it out of pocket, which people could not afford—especially LGBTQ folks, and especially transgender folks who are more low-income. Learning about the access issues, the discrimination, the income issues, and ultimately some of the violence that comes out of not being able to get the healthcare you need just really showed me like it was a civil rights issue from my perspective.”

To build a data-driven case for policy reform, One Colorado launched statewide health surveys to document the experiences of LGBTQ+ Coloradans. The findings provided undeniable empirical evidence of systemic disparities: LGBTQ+ residents experienced higher rates of poverty, insurance denials, and clinical discrimination than the general population.

Equipped with this data, Wheeland and her allies formulated a two-pronged strategic roadmap: a focus on public benefits, pressuring Colorado Medicaid (HCPF) to explicitly cover gender-affirming medical services, as well as private insurance, demonstrating to the Division of Insurance (DOI) that denying coverage for gender-affirming care constituted unlawful discrimination under state law.

The 2013 Division of Insurance Bulletin: A Policy Turning Point

Changing statutory law through the state legislature in 2012–2013 presented political and legal risks. Because state statutes still categorized gender identity under sexual orientation, attempting to pass explicit statutory mandates through the General Assembly carried a high risk of failure or political compromise.

Instead, Wheeland and the One Colorado coalition pursued an administrative strategy: compelling state regulatory agencies to clarify and enforce existing nondiscrimination protections.

Working alongside medical experts like Dr. Rita Lee (CU Anschutz) and Dr. Dan Reardon (Children’s Hospital Colorado), the coalition formed an LGBTQ+ health coalition, mobilized community testimony, and engaged directly with the Governor’s Office and the Division of Insurance.

A key breakthrough occurred when the coalition persuaded major private carriers to voluntarily eliminate exclusionary language from their policies.

“Really what helped was getting a couple insurers to agree to it. The big one that agreed was Kaiser Permanente—They were the first,” Wheeland notes. “And then with them saying, ‘Yes, we should provide the care,’ the state was able to say, ‘OK, this is a discriminatory thing. We’ll put this out for everybody.'”

In 2013, the Colorado Division of Insurance issued a landmark administrative bulletin. The bulletin explicitly informed health insurers operating in the state that denying coverage for gender-affirming procedures, or denying routine care based on transgender status, violated state anti-discrimination standards.

“A bulletin is basically the state saying, ‘This is how we interpret the law,’ but it’s not statutory,” Wheeland explained. “The bulletin was very simple: it said you have to provide healthcare people need no matter their transgender status… We worked very hard to make sure that’s how it would be interpreted by the insurers and the state, and we got there. The bulletin was to insurers saying, ‘You have to provide transgender healthcare services. If you do not, you’re discriminating.'”

By securing this administrative mandate, Colorado established an early regulatory precedent. Rather than treating transgender care as an optional policy add-on, state policy formally defined gender-affirming treatments as medically necessary healthcare protected under civil rights law.

Inclusion of Youth and the Evolution of Anti-Discrimination Law

A notable feature of Colorado’s 2013 administrative action was its inclusive scope. Unlike current national debates that isolate pediatric care, the early administrative bulletin and subsequent Medicaid coverage frameworks applied to transgender individuals regardless of age, provided the care met established clinical guidelines for medical necessity.

“We included youth because it’s medically necessary. Doctors like Doctor Reardon know and have done the medical work and the medical research on the impacts and the importance of access to healthcare for transgender youth too,” Wheeland states. “We pushed for Medicaid to make sure it included youth, and they did… We basically didn’t make youth different; we made them part of the group.”

Wheeland attributes the efficacy of Colorado’s early policy work to the fact that clinical evidence, rather than political messaging, drove the decision-making process. Over time, Colorado lawmakers built upon the 2013 bulletin, eventually amending state statutes to remove gender identity from under “sexual orientation” and establishing explicit, standalone protections for gender identity across housing, employment, and healthcare.

For Wheeland, who grew up in Colorado during the era of Amendment 2—the 1992 voter-approved constitutional amendment that barred local governments from protecting gay citizens from discrimination—watching the state evolve into a sanctuary for civil rights carries deep personal significance.

“I’m a Colorado kid. I grew up here,” Wheeland reflects. “The first thing that I realized—that discrimination was real—was when state voters passed Amendment Two. I was a young teen, and I was like, ‘How can you say it’s okay to discriminate against people who are gay? That makes no sense to me.’ I think that was probably the first moment I realized there’s a lot of discrimination actually in the law, and why I wanted to get involved in anti-discrimination law generally.”

Intersectional Advocacy: Connecting Civil Rights Across Movements

Following her tenure at One Colorado, Wheeland continued working at the intersection of public policy, healthcare access, and civil rights. As Policy Director at Planned Parenthood of the Rocky Mountains, she helped expand gender-affirming hormone therapies within reproductive healthcare safety nets. Later, as author of Amendment FF at Hunger Free Colorado, she led the campaign that passed universal free school meals for public school students statewide.

Currently serving as Policy and Advocacy Director for Leverage Colorado, Wheeland’s work focuses on policy design that addresses the challenges faced by aging populations, including LGBTQ+ elders who experience high rates of historical trauma, economic instability, and healthcare discrimination.

“It’s all connected to me,” Wheeland says. “It’s a justice movement and anti-discrimination, and the transgender community is part of that… Trauma creates a lot of other issues—like poverty, like negative healthcare outcomes, like not seeking help when you need it. Making sure all kids have access to the healthcare and the food and the things that they need, no matter who they are, is important.”

Preserving Proactive Policy in an Era of Rollbacks

Looking at the national landscape, where executive orders, court decisions, and state-level restrictions are shifting access to gender-affirming care, Wheeland stresses the distinction between state-level protections and federal vulnerabilities.

While federal non-discrimination standards under Title IX and Section 1557 of the ACA remain subject to shifting judicial interpretations of “sex,” states like Colorado that built explicit statutory and administrative protections offer a stronger shield against regulatory rollbacks.

However, Wheeland cautions against shifting entirely into a reactive defense posture. The long-term security of healthcare equity depends on continuing to advance proactive policy, expanding clinical education, and funding civil rights infrastructures.

“I hate that right now we’re on defense and we can’t be doing things that are proactively improving people’s lives as much as we should be able to,” Wheeland emphasizes. “Colorado became a caring state because we had a bunch of coalitions come together of non-profits and others to push back on public policy that’s hurtful, and in that, build a whole system so that they could have the strength to do proactive policy—not just be reactionary. How do we still do the proactive in Colorado and not lose that trajectory?”

Colorado’s journey from passing Amendment 2 in 1992 to enacting protected healthcare access in 2013 highlights the power of structured administrative policy. As Ashley Wheeland’s work demonstrates, lasting civil rights progress requires moving beyond broad commitments to equality. It depends on doing the technical, administrative work necessary to ensure every patient receives medically necessary, non-discriminatory care.

Beyond Niche Medicine: How Dr. Rita Lee Is Normalizing Transgender Healthcare as Essential Primary Care

When discussing the landscape of transgender-affirming healthcare, public rhetoric often frames gender-affirming treatments as specialized, highly isolated medical interventions. However, for clinicians on the frontlines of internal medicine, these practices represent something far more fundamental: routine, holistic patient care grounded in basic human dignity and medical ethics.

Dr. Rita Lee, MD, a Professor of Internal Medicine at the University of Colorado Anschutz School of Medicine, has spent over two decades working to shift gender-affirming care out of narrow clinical silos and integrate it directly into primary healthcare. Her journey into medicine began with a childhood desire to care for others, but her professional calling took shape during a pivotal period in her medical training.

“When I was in medical school, I essentially kind of came out to myself and had a healthcare experience that was not very positive as somebody who newly identified with the LGBTQ+ community,” Dr. Lee recalls. “I thought to myself at the time, we have very little curriculum on this content in medical school, and if I was this embarrassed or ashamed as somebody who is within the healthcare community to advocate for my own health, how would the rest of the community feel? So that’s actually how I became involved in working in this area.”

As Dr. Lee worked to build medical education curricula inclusive of LGBTQ+ health, she recognized a glaring disparity within the broader movement for health equity. While public and clinical attention was increasingly turning toward marriage equality and sexual orientation, gender identity remained largely overlooked.

“At the time, there was more movement publicly around marriage equality for lesbian and same-sex marriage, and the transgender community was being not left behind, but there wasn’t as much effort and work in that area,” Dr. Lee says. “That’s where we needed to focus more of our time and energy.”

Building Knowledge in the Early Days

In the early 2010s, formal clinical guidelines and research literature regarding transgender health were remarkably scarce. Physicians attempting to provide evidence-based care were often forced to forge their own paths, leaning on cross-disciplinary collaboration and peer-to-peer knowledge sharing.

“Way back when,  most of the work around the LGBTQ community was around HIV, and it was primarily centered around men who have sex with men,” Dr. Lee explains. “In the early days, there was almost very little literature out there on transgender folks in general, let alone gender-affirming care. As I increased my own awareness of this as a need, a lot of us who did this early work, much of it was kind of self-taught. We worked with each other, we taught each other, we would talk to our endocrinology colleagues, our psychiatry colleagues—asking, ‘Are you doing this work? What does it look like? How do we support each other?'”

This grassroots clinical exchange coincided with landmark local research. In 2014, One Colorado published Invisible, a baseline report shedding light on the severe healthcare barriers and discrimination faced by transgender Coloradans. Dr. Lee was among the early contributors and collaborators who helped lay the groundwork for these data collection efforts.

“A lot of that kind of work led up to that Invisible report that really highlighted, particularly in Colorado, the particular needs of the trans community,” Dr. Lee notes. “That was the impetus for creating our integrated transgender program as well as highlighting that as a focus area.”

What the data revealed was simple yet transformative: simply providing a welcoming, non-judgmental healthcare environment fundamentally altered patient outcomes.

“One of the things that stood out for me was just having an inclusive and supportive provider, even if they didn’t necessarily have specific training, how that alone improved health,” Dr. Lee reflects. “A lot of primary care practices, I imagine, were like, ‘Hey, all we have to do is create a supportive and inclusive environment.’ And when we do that, more people get their flu shots, more people get their wellness exams. It’s important that people recognize transgender and non-binary folks are more than just their hormones. They are whole human beings that need well care, vaccines, and preventive care, just like anybody else.”

From Niche Practice to Standard Medicine

Over the past decade, the landscape of adult gender-affirming care in Colorado has evolved significantly. Hormone therapy, once viewed as an obscure subspecialty, is increasingly integrated into general internal and family medicine practices.

“I have definitely seen gender-affirming care for adults, predominantly hormone therapy, become more widely accepted,” Dr. Lee says. “It is kind of the norm now for the vast majority of people in primary care practices. It’s not as much of a niche thing as it used to be. There are a lot more generalists in family medicine and internal medicine who have transgender patients as just part of our practice, and we provide care for everybody.”

Dr. Lee emphasizes that many medical therapies used in transgender-affirming care are not fundamentally novel or isolated to transgender populations. Hormone replacement therapies (HRT) have long been used in cisgender healthcare—such as prescribing estrogen for menopausal symptoms or testosterone for cisgender men with hypogonadism.

“A lot of the initial literature that we used in terms of thinking about safety and efficacy around hormone therapy for gender-affirming care came originally from the literature on hormone therapy for cisgender folks,” Dr. Lee explains. “A lot of the stuff that we knew about estrogen came from Women’s Health Initiative and other studies looking at menopausal women, or testosterone replacement for hypogonadal cisgender men. In those cases, for a lot of cisgender folks, that really is gender-affirming hormone therapy.”

To Dr. Lee, providing this care is not about separating patients into distinct clinical categories, but treating the whole person under standard medical frameworks. “To me, gender-affirming care is affirming somebody as being a human being. Potentially, gender-affirming hormone therapy might be a small part of that. Again, it’s like somebody who’s living with diabetes—They’re more than just whatever medication they’re taking, more than just diabetes. They are whole people who need other care as well, and I don’t necessarily see this as anything different or separate from that.”

Ethics, Evidence, and the Sacred Patient-Provider Relationship

As legislative debates and political scrutiny surrounding healthcare access intensify across the nation, physicians face an increasingly complex landscape. When asked about navigating these socio-political tensions while treating patients, Dr. Lee returns to the fundamental ethics governing the medical profession.

“Among the community, there is a certain amount of commitment to serving the patients that we swore an oath to serve,” Dr. Lee emphasizes. “These are all of our patients, and we would probably advocate the same way if they suddenly stopped allowing us to treat patients who were living with diabetes. Our patients are our patients; we treat them as whole human beings, and our goal is to provide the care that they need and is deemed medically necessary and supported by the evidence that we have. That is how I would like to think we all strive to practice.”

Central to this ethical obligation is the protection of the clinical dynamic from external interference. Medical decisions, Dr. Lee notes, should rely on established scientific evidence, clinical guidelines, and individual patient autonomy.

“For us, the patient-provider relationship is pretty sacred,” Dr. Lee says. “Those are all shared decision-making, informed consent conversations that we have. Outsiders should not necessarily be involved in that space.”

Looking toward the future, Dr. Lee advocates for continued scientific rigor, expanded education across all health disciplines, and consistent data collection to ensure healthcare systems remain responsive to all communities.

“I would love to see continued inclusion of gender identity as well as sexual orientation in national surveys as well as research studies, so that we can continue to gather more information and more data,” Dr. Lee says. “There’s not going to be more data if people aren’t included in the data that we’re actually collecting. I would love to see increased education for all health professionals across all the different health professions, so that we can continue to adequately take care of the patients that walk into our door. We need to be treating every group, every person, as a human that needs care.”

The Path Forward for Transgender Health Equity in Colorado

We know that Coloradans are concerned and tired of the ongoing polarization and division we are experiencing across our state and country. However, we have more in common that what we are led to believe separates us. Colorado has always become a state of inclusion and advancing equity, not exclusion and furthering disparities, we are decades away from the “Hate State” era. Let’s break through the noise and politicization of transgender Coloradans – anti-transgender rhetoric are distractions from what really matters – it doesn’t put food on the table or gas in your car,it doesn’t pay your rent or mortgage but it does take away the dignity and worth of an entire community, youth and adults, and that is not something any of us should stand idle by on.  

As noted in this article, attacks on the LGBTQ+ community and in particular, transgender Coloradans is not new or novel. From HIV advocacy, to marriage equality, safer schools, and health care access – these wins big and small, demonstrate that when we come together, across our differences and in the face of adversity, we can overcome and persist. As the Movement Advancement Project illustrates, while an unprecedented level of anti-LGBTQ+ bills have been introduced in state legislatures across the country each year, a historic level of those measures have been defeated because when people show up in their civic life, they make a difference. 

Like the innovators on transgender health who came before us, what is the legacy you want to leave behind for future generations of Coloradans? We are the parents, the families, the educators, the healthcare providers, and the neighbors that can do the work today so that twenty years from now, the OFM archives can tell the story of how we got to a brighter future.

The opinions expressed by interview subjects are purely those of the subjects, not the organizations they now represent. This piece was produced as part of a Sponsored Content initiative in collaboration with Colorado Health Foundation.