Rep. Brittany Pettersen held her four-week-old son on the House floor in February, telling Congress that children “need you the most” when “they’re the most vulnerable.” On December 17, when the House voted to protect children from medical interventions that international systematic reviews found cause irreversible harm, she voted no.
The Protect Children’s Innocence Act passed 216-211. Every Colorado Democrat opposed it—Pettersen, Diana DeGette, Joe Neguse, Jason Crow—along with Republican Gabe Evans, one of four Republicans nationwide to break ranks.
H.R. 3492 makes it a federal Class C felony to perform what the bill defines as “genital or bodily mutilation” or “chemical castration” on minors. Prohibited surgeries include castration, hysterectomy, mastectomy, phalloplasty, and vaginoplasty. Prohibited medications include puberty-blocking drugs and cross-sex hormones administered at doses intended to alter sexual characteristics.
Violators face up to 10 years in federal prison.
The bill extends liability to anyone who facilitates or transports a minor for these procedures, closing the loophole that allows families in the 27 states with bans to travel to sanctuaries like Colorado.
Exceptions exist for procedures addressing physical health conditions, for children with disorders of sexual development, and for treating complications from previous gender procedures. Mental health conditions do not qualify.
The UK’s Cass Review spent four years evaluating pediatric transgender healthcare. Its April 2024 conclusion: clinical practice had “outstripped the evidence base.” Clinicians were providing treatments despite lack of evidence that they reduce gender dysphoria or improve long-term mental health.
The UK’s National Institute for Health and Care Excellence reached similar conclusions in 2021. Puberty blockers produce “little or no change in gender dysphoria, mental health, body image, or psychosocial functioning.” The landmark Dutch study that provided original evidence for these treatments was rated “high risk of bias” and “poor quality overall.”
Documented risks include compromised fertility and impaired bone density. Effects on cognitive development remain unknown. Most youth who start puberty blockers proceed to cross-sex hormones.
Finland restricted these treatments after its own systematic review. Sweden followed. Then Denmark. Then Norway. The UK’s National Health Service restricted puberty blocker prescriptions after the Cass Review.
The Endocrine Society’s own commissioned reviews acknowledged benefits come from “low-quality evidence.” The society instructed clinicians to proceed anyway. WPATH suppressed systematic reviews it had commissioned when results didn’t support its guidelines.
Colorado moved the opposite direction. HB25-1309, passed this year, codifies gender-affirming care in state law and prohibits insurers from denying coverage.
Pettersen built her congressional identity on child advocacy. Her biography touts work on “affordable child care.” She flew to Washington four weeks postpartum because, she said, “nobody fights harder than a mom.”
Evans offered no public statement explaining his vote. He represents CD-8, a swing district he won by defeating Democrat Yadira Caraveo. His campaign emphasized law enforcement and protecting communities. He has issued press releases condemning Colorado Democrats for various votes.
The bill now goes to the Senate, where Democrats are expected to block it. Colorado’s representatives decided the medical industry’s position matters more than the medical evidence.
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