Colorado on Wednesday filed yet another lawsuit against the Trump administration — this time to stop a new rule that prohibits Medicaid dollars from paying for transgender transition services for minors.

The question of transgender services has increasingly become a core election matter in Colorado. This November, residents will vote on two measures that implicate the question.

Phil Weiser, the attorney general and Democratic gubernatorial candidate, announced that Colorado joined a coalition of states challenging the Trump administration’s “attempt to prohibit states from using federal Medicaid funds for gender-affirming healthcare for low-income minors or some young adults.”

Last month, the Centers for Medicare and Medicaid Services issued a rule saying states’ Medicaid plans must say they will not pay for “sex-rejecting procedures for children under 18.” The same rule applies to the Children’s Health Insurance Program, which is run by states but whose funds largely come from the federal government.

The new rule kicks in this October.

The rule allows for a grace period — Medicaid and CHIP beneficiaries who currently get cross-sex hormone therapy to claim federal assistance for up to six more months.

The federal government said it is aware of about 17 state Medicaid programs that cover “one or more forms of sex-rejecting procedures for children.”

When asked about Colorado’s lawsuit, Victor Marx, the Republican nominee for governor, said “life-altering” transgender transitions should not be paid for with taxpayer money.

“Attorney General Weiser is free to make his legal arguments regarding federal authority and Medicaid,” the Republican candidate’s camp said. “Victor’s position is straightforward: children deserve compassion, support and appropriate mental and physical healthcare, but life-altering medical decisions involving gender transition should not be normalized or financed by taxpayers before a child is old enough to fully understand their long-term consequences.”

In November, Colorado voters will face several questions regarding transgender issues. Initiative No. 110 seeks to ban gender surgeries for minors. A second measure, Initiative No. 109, asks voters to ban biological men from playing in women’s sports.

During an Aug. 27 debate in Colorado Springs, Weiser said he does not support either measure, noting that he has sat down with families they would affect.

While Marx did not attend the debate, Greg Lopez, the independent candidate for governor, said he supports both measures, noting that he, too, has sat down with people who went through gender surgeries as minors and now regret it as adults.

The Attorney General’s Office — now part of more than 70 lawsuits challenging the Trump administration — argued in its latest filing that the proposed rule stripping Medicaid coverage for transgender‑related care “would set a troubling and unlawful precedent” by allowing the executive branch, without congressional approval, to override licensed medical practitioners’ individualized judgments with a blanket, agency‑imposed ban on services and reimbursement it disfavors.

The coalition of states argued that Congress has long left them to decide which Medicaid and Children’s Health Insurance Program services they cover, within statutory limits. The states also contended that federal health agencies are now acting without authority to override state Medicaid decisions and providers’ individualized treatment judgments. The rule, they said, instead imposes a categorical ban on what they called medically necessary care for low‑income transgender adolescents, blocking federal reimbursement for those services.

The White House has described surgical procedures and hormonal treatment as the irreversible “chemical and surgical mutilation” of children.

Shortly after returning to the White House, Trump sought to use its funding leverage to immediately change the conduct of institutions that receive federal dollars. The White House’s position has put hospitals offering some form of transgender services in Colorado in a conundrum, as continuing such services could mean losing federal funding, which is a major source of revenue.

Supporters of gender transition for children have argued that puberty blockers, for example, have been in use since the 1980s and are “overwhelmingly safe if used appropriately.” Others said “affirming” students’ gender identity can “improve their mental health and academic outcomes.”

Critics of transitioning minors have countered that America is an outlier, with several European countries, after embracing “gender affirming care,” now emphasizing psychological care over the transition of young people. In particular, the National Health Service in England said it will no longer prescribe “puberty blockers” to children and other young people seeking gender transitions, saying there is “not enough evidence of safety and clinical effectiveness.”  

In adopting the new Medicaid rule, the Trump administration cited the decision of European countries to focus on psychotherapy as the first line of treatment, rather than chemical or surgical interventions.

The administration also said the federal health agency’s review indicated “serious concerns about outcomes associated with certain medical interventions, such as puberty blockers, cross-sex hormones, and surgeries, that attempt to transition children and adolescents away from their sex.”