Health Care · Report · File No. 261105-429
Missouri voters reject combined abortion and trans care ban; other states split
Democrats won big on Tuesday, but ballot measures on abortion and transgender health care went different ways in different states. Missouri voters kept their abortion right and rejected new limits on care for minors, while Idaho rejected abortion protections.
Every quote in this story (2) was matched word for word against its source. How we work
Voters who backed Democratic candidates in Tuesday's midterm election did not vote the same way on state ballot questions about abortion and transgender health care, according to KFF Health News 1. In Missouri, voters rejected a measure that would have banned abortion and gender-affirming care for transgender minors 1.
The Missouri result came in a state President Donald Trump carried by 18 points in 2024 1. Opponents of the measure celebrated at an election night watch party in St. Louis, two years after Missouri voters added abortion protections to the state constitution 1.
The picture was mixed elsewhere. In Washington state, which Trump lost by 18 points, voters appeared to back a measure restricting trans kids' participation in youth sports, with 60% of votes counted on Wednesday 1. Voters also supported restrictions on trans athletes in youth sports in Arizona and Nebraska, and similar restrictions plus a ban on gender-affirming surgery for minors were leading in Colorado with about 80% of votes counted 1.
On abortion, voters in Virginia and Nevada backed protections, while Idaho voters rejected them 1. KFF reported that voters in three of the four states with abortion-related measures voted to protect access, and the Idaho measure failed 2.
From Channel GOPEl-Sayed: Medicaid cuts timed for after midtermsAbdul El-Sayed · 179 plays · captioned, with the source named
Missouri was the only state where abortion and transgender care were combined into a single ballot measure 1. The measure would have repealed the 2024 abortion protections and written into the constitution a ban on gender-transition surgery, hormone therapy and puberty blockers for minors 1. The legislature had already permanently blocked minors' access to gender-affirming surgeries and temporarily blocked new prescriptions for puberty blockers and cross-sex hormones until August 2027 1.
A survey of midterm voters by the NORC research organization, with questions from KFF, found abortion was the stronger motivator in Missouri 1. Of residents who voted against the measure, 59% said abortion policy was more important to their vote 1. Among voters who supported the bans, 60% weighted the two equally 1.
KFF's Alina Salganicoff said the two issues had not been linked this way before. "This is the first time we saw these two issues linked," she said 1.
The campaign manager for the group that supported the bans called the result a setback. "Tonight is a loss for women, a loss for children, and a loss for life," James Lawson of Her Health, Her Future said in an election night statement 1.
On the other side, Shira Berkowitz of the LGBTQ+ advocacy organization PROMO Missouri credited a canvassing campaign that included transgender Missourians going door to door. "We proved so powerfully that our visibility is not a liability," she said 1.
Outgoing Florida Gov. Ron DeSantis, a Republican, said his party's focus on transgender ads did not work. "I knew Republicans were in trouble when I was reading an overview about what were they running ads on, and they're spending hundreds of millions of dollars across the country on transgender ads," he told reporters Nov. 4 1.
That matters because the new Congress and state legislatures will set health policy next year, and the results show voters do not treat these questions as a single issue 12. For older readers, the Missouri outcome keeps the state's constitutional abortion protections in place, while the Idaho vote leaves that state's abortion laws among the most restrictive in the country 2.
The Record
- Missouri voters approved a constitutional right to abortion, passing the measure by fewer than 100,000 votes while Trump carried the state by over 550,000 1.
- Missouri voters rejected Amendment 3, which would have repealed the 2024 abortion protections and banned gender-affirming care for minors 12.
- With 60% of votes counted in Washington state, voters appeared to back a measure restricting trans kids' participation in youth sports 1.
Republish this story on your site or in your newsletter
Any site, blog or newsletter may run this story free of charge. Keep the credit line and its link to the original, do not sell it, and edit only for length or house style (the full terms). Photos carry their own licenses, noted under each photo on this page, so use the text alone unless a credit says otherwise.
Paste it into your editor's HTML view. The one-pixel image at the end tells our newsroom the story ran; it stores no reader data.
Sources
- KFF Health News, “Midterm Voters Split on Abortion and Trans Healthcare Ballot Questions” (2026-11-05). kffhealthnews.org/elections/abortion-transgender-healthcare-
- KFF, “Abortion on the Ballot in 2026: Polling Insights from Voters in Four States | KFF” (2026-11-05). kff.org/public-opinion/abortion-on-the-ballot-in-2026-pollin
Found an error? Tell the newsroom. Corrections are noted at the top of the story.
More from the files
Missouri voters reject Amendment 3, keeping abortion rights in the constitution
The measure, which would have reinstated a near-total abortion ban and added a constitutional ban on gender-affirming care for minors, won only 44% of the vote. It is the first time a state has turned back an attempt to undo an abortion-rights amendment.
Reported recording has Missouri abortion ban backer saying 'we're going to get there'
A newsletter says a recording from an Oct. 3 campaign event has Amendment 3 supporters describing its exceptions as short of their goal. Backers publicly call the measure a middle path, and Tuesday's vote looks close.
Missouri sponsor calls abortion ban 'middle of the road' as vote to undo 2024 rights nears
Ten days before the election, Missouri Republicans are asking voters to repeal the abortion-rights amendment that voters approved in 2024. The measure's backers say its exceptions protect women. Doctors, lawyers and a former state chief justice say those exceptions may not work in practice.
Delivered free to your door*
The Morning Edition
One short email at 7 a.m. Eastern: the day's top files, one clip worth your time, and the race to watch. Plain English, large type, no clutter.
*Your inbox. Free. Unsubscribe with one click, any time.