For Celeste Michael, the transgender community is being used as a pawn in Missouri’s push to ban abortion.

When the 23-year-old went to vote in Lee’s Summit last November, signs outside her polling place falsely claimed an abortion rights amendment would legalize transgender surgeries for minors. Nearly 52% of voters approved the measure, enshrining legal abortion in the state constitution.

Now, Missouri Republican lawmakers have put a new question on the 2026 ballot asking voters to strike down that vote and reimpose an abortion ban. But the ballot measure would also ban transgender health care for minors, which is already illegal under state law.

“It’s using trans people as a scapegoat so that they can get what they want,” said Michael, a transgender woman from Lee’s Summit. “People right now are very scared and polarized about trans issues and there’s a lot of misunderstanding when it comes to gender-affirming care for minors.”

As voters across the state gear up to vote Nov. 3, 2026, on whether to once again ban abortions, the ballot measure faces sharp criticism for tying abortion rights to transgender health care. Critics who spoke with The Star frame the question as another attempt to confuse voters into banning access to abortion.

The decision by Republican lawmakers to place the measure on the ballot comes as abortion rights remain popular nationwide — even in conservative states like Missouri. However, support for transgender health care and other LGBTQ rights is more limited, polling has shown.

“We’ve kind of been in a moment of backlash against transgender rights generally,” said Mary Ziegler, a law professor at the University of California-Davis who closely follows legal fights over abortion access. “Hitching your star to that particular argument makes some sense when you’re trying to diffuse, essentially, the fact that you’re embracing an unpopular position on abortion.”

The backlash to transgender rights has sparked a national wave of Republican legislation to restrict access to gender-affirming care, which includes hormone therapy. While much of the discussion, including in Missouri, has centered on surgeries, research shows that gender-affirming surgeries are rare — particularly among minors.

“Decades of research shows that health care for trans youth is safe, effective and essential to the well-being of trans youth,” said Katy Erker-Lynch, the executive director of PROMO, an LGBTQ rights organization. “This is about weaponization and politicization of people’s lives.”

The onslaught of attacks on transgender rights fueled Missouri lawmakers to enact a law in 2023 that banned gender-affirming care, including hormone therapy, puberty blockers and surgeries, for minors.

The law, which opponents say was built around misinformation about gender-affirming care, prompted some transgender residents to flee the state and medical professionals to stop providing care.

Trans health care ban

Although it’s already illegal, the upcoming ballot language allows abortion opponents to campaign on the idea that the abortion ban, called Amendment 3, would also permanently ban gender-affirming care for minors.

“I think it’s an important piece of that,” Sam Lee, a longtime anti-abortion lobbyist, said of the decision to include the transgender language. “I certainly think it could influence voters who, you know, maybe they’re not sure where they are on abortion, but there are a lot of voters and polling shows us a lot of voters who oppose gender transition surgeries for minors.”

Supporters of the ballot measure are likely to point out that Missouri’s current ban on gender-affirming care allows the restrictions on hormone therapy and puberty blockers to expire in 2027. However, Missouri’s ban on gender-affirming surgeries for minors, a frequent focus of Republicans, does not expire.

Erker-Lynch said the expiration date was included so the state could research the impact of the ban and potentially reassess the decision. For example, in Utah, a state that banned gender-affirming care, the state’s health department later found that transgender health care generated “positive mental health and psychosocial functioning outcomes,” according to NBC News.

Missouri Republicans had a chance to remove the ban’s expiration date for hormone therapy and puberty blockers through state law this past legislative session. But the bill did not come up for a final vote in the House despite passing the Senate.

The inclusion of the transgender language in the proposed abortion ban sparked intense debate during the most recent session. It has also fueled a lawsuit from the ACLU of Missouri that seeks to strike the measure from the ballot or, failing that, reword the ballot language.

Democratic senators spent hours filibustering the legislation in the final days of the session, saying they would allow Republicans to pass it only if they removed the ban on gender-affirming care.

“Their idea is bad and the only way they can get it to pass is they have to throw something out there, which we call ballot candy,” Senate Minority Leader Doug Beck, a St. Louis-area Democrat, told reporters in May, saying the language was intended to trick voters into approving the abortion ban.

But Republican senators decided to keep the language intact and employed a rare procedural maneuver to shut down the Democratic filibuster and place the measure on the 2026 ballot.

“A lot of people think that’s really important,” Sen. Mike Cierpiot, a Lee’s Summit Republican, told The Star after the vote, referring to the transgender language. “They want to make sure that we don’t do that anymore.”

When pressed about the fact that gender-affirming care was already banned in state law, Cierpiot said the measure would place the ban in the state constitution, making it “much harder to change.”

What would the measure do?

Ziegler, the law professor, emphasized that Republicans in Missouri did not add the transgender language because they were worried about gender-affirming care.

“I mean, if you read anything about the debates that went into the ballot measure, it’s all about, as they see it, restoring protection for the unborn,” Ziegler said.

The proposed amendment would strike down last November’s vote that legalized abortion in the state and overturned a previous ban on the procedure. The measure would only allow abortions in rare cases of medical emergencies, fetal anomalies and rape or incest within 12 weeks of gestational age.

While abortion opponents bristle at the idea that the amendment is an abortion ban, abortion rights advocates and providers argue that the language would effectively ban nearly all abortions in the state.

“Just last year, Missourians voted to end the abortion ban,” Mallory Schwarz, the executive director of Abortion Action Missouri, said in a statement. “Now, politicians are trying to trick voters into banning abortion again. They’ll use every trick they can think of, throw any group under the bus to force their agenda of power and control on Missouri families.”

The amendment is silent on when exactly abortion would be banned, but it completely removes and replaces the language of the November amendment, which was also called Amendment 3.

Therefore, it will likely be up to the courts to decide whether the proposed amendment, if passed, would reinstate Missouri’s previous abortion ban with the added exceptions or give lawmakers the ability to pass additional legislation to restrict access.

While the decision to tie the abortion ban to transgender health care has been roundly criticized as misleading, LGBTQ advocates say it also illustrates a continued attack on transgender Missourians.

That includes people like Michael, the transgender woman from Lee’s Summit. The politicization of trans people is scary and makes her feel dehumanized, she said.

But she hesitates to say that. When she’s spoken out against similar attacks in the past, she’s seen a barrage of hateful comments that led her to believe some people don’t view her and people in her community as humans, she said.

“They just know that they can rely on the fact that people hate trans people enough that they’re gonna vote for this also,” Michael said. “They’re uneducated enough on trans issues to not even realize that they’re voting for something that’s already in law.”

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