Missourians will vote on more than just abortion when they decide whether to ratify Amendment 3 this November. In fact, a “yes” vote could empower doctors to provide life-altering gender transition drugs and surgeries to children without their parents’ consent. That might sound crazy and extreme, but the measure’s sweeping language opens the door for gender-ideology activists to pursue such arguments. And not enough people are talking about it—regardless of what they believe about abortion.
The ballot measure seeks to create a “fundamental right . . . to make and carry out decisions about all matters relating to reproductive health care.” Because the measure does not define “reproductive health care,” we must look elsewhere.
Abortion Action Missouri is one of the two activist organizations that “put abortion on the ballot in Missouri.” On its webpage for “other sexual & reproductive health care resources,” Abortion Action Missouri provides an entire section on “gender-affirming care.” A few clicks later, you will find out where to get “gender-affirming surgery” and “gender-affirming hormone therapy.” Let’s be clear about what this means: the sponsor of Amendment 3 equates “reproductive health care” with non-reversible, life-altering “gender-affirming” surgeries for “children.”
Missourians for Constitutional Freedom, the other group behind Amendment 3, has partnered with an organization called PROMO—“Missouri’s statewide LGBTQ+ public policy and advocacy organization.” Why would this organization have a vested interest in Amendment 3? Because PROMO is focused on “[r]emoving barriers to accessing healthcare,” including “gender-affirming healthcare.”
But it’s not just the two sponsors of Amendment 3. The National Women’s Law Center—a prominent pro-abortion and gender-ideology activist group that supports Amendment 3—also provides us with the clarity of the ballot measure’s broad scope. As the NWLC argues, “[p]rotecting the right to self-determination of gender identity and bodily autonomy is part of reproductive justice.” That means laws “should ensure people of all genders can make their own decisions about their bodies and their futures.” Most troubling, the NWLC claims that “[t]rans youth also often need access to gender affirming care to make their own medical decisions about their bodies and futures—including their reproductive futures.”
Amendment 3 threatens Missouri’s laws that currently protect children from experimental and non-reversible gender transition treatments like puberty blockers, cross-sex hormones, and top and bottom surgeries. That’s because the measure says “[a]ny denial, interference, delay, or restriction of the right to reproductive freedom shall be presumed invalid.” It doesn’t take a lawyer to know what gender-ideology activists could try to argue if the measure becomes part of Missouri’s constitution.
A prohibition on these life-altering procedures for children experiencing gender dysphoria would be “presumed invalid.” Requiring that parents consent to, or even know about, them would be considered “interference” and therefore “presumed invalid.” And any requirement to see if a child desists from his or her gender dysphoria—which happens in the vast majority of cases when a wait-and-see approach is followed—would be a “delay” and thus “presumed invalid.”
What would happen if a doctor botched a surgery altering a child’s genitalia or a child were to seek legal recourse for the lifelong harms that the surgery has inflicted on him or her? That surgeon could argue he’s protected from any liability. What’s more, parents may have no recourse against that surgeon or other collaborators who secretly facilitated their child’s “transition.” How so? Amendment 3 declares that no “person assisting a person in exercising their right to reproductive freedom … [can] be penalized, prosecuted, or otherwise subjected to adverse action for doing so.” This reads like an open invitation to experiment on children with impunity.
As a lawyer for Alliance Defending Freedom—a nonprofit law firm that contends for the truth in law, policy, and the public square—my colleagues and I know the other side’s playbook. We have seen activists push expansive interpretations of laws across the country. Most recently, we have witnessed the Biden-Harris administration’s unlawful rewriting of Title IX—a federal law designed to create equal opportunities for female students in education and athletics—by redefining “sex” to include “gender identity.” These rules require schools to ignore the biological distinction between male and female, thus allowing males who identify as female to enter girls’ private spaces like restrooms, locker rooms, and showers. And these rules prohibit schools from keeping biological boys off of girls’ sports teams.
This November, Missouri voters will not just be deciding whether to enshrine a fundamental right to abortion in their state constitution. The transgender Trojan horse is openly galloping towards the state. Time will tell if Missourians will unsuspectingly welcome a fundamental right to that horse into their state.
Erik C. Baptist is senior counsel and director of the Center for Life at Alliance Defending Freedom.