Voters in five states will decide ballot measures on sex-rejecting procedures for minors and sex-separated school sports in the midterm elections. Missouri and Colorado will vote on whether to prohibit medical professionals from providing minors with surgeries, puberty blockers and cross-sex hormones for the purpose of gender transition. Colorado, Nebraska, Arizona and Washington will vote on whether to restrict school sports participation based on biological sex.
Missouri’s Amendment 3 would repeal the abortion amendment voters added to the state constitution in 2024. It would also prohibit gender transition surgeries for minors, along with cross-sex hormones and puberty blockers used for gender transition. Missouri passed a 2023 law restricting these procedures for minors, but that law is set to sunset in August 2027. Amendment 3 would put the restriction in the state constitution.
Colorado voters will decide two measures. Proposition 134 would require school and association-sponsored athletic teams to be classified as male, female or coeducational, and would bar males from female-designated sports. The measure defines male and female by sperm and ova production. Proposition 135 would prohibit healthcare professionals from performing invasive gender transition surgeries on minors, but it would not restrict puberty blockers or cross-sex hormones.
Arizona’s Proposition 318 is formally titled the “Require All Schools and Athletic Associations to Restrict Sports Participation and Access to Private Spaces Based on Sex Measure.” Nebraska and Washington voters will also decide sports measures tied to biological sex, confirmed by a healthcare professional or sex-screening protocol. These proposals are aimed at preventing biological males who identify as female from competing in women’s sports.
The votes come after years of state action across the country. Since 2021, more than 25 states have adopted laws requiring students to compete on school sports teams that match their biological sex. Another 27 states have passed laws prohibiting or restricting sex-rejecting medical treatments for minors. These ballot measures will show whether voters want those protections written directly by the people, not only by legislatures.
