We’re 10 days out from the midterm elections in the U.S., and attacks on trans rights have taken center stage. Repeating a strategy championed by Trump’s presidential campaign in 2024, supporters of the Republican Party have been flooding the internet and airwaves with ads targeting trans people. Some Democrats have also joined in, campaigning on promises to “keep transgender ideology out of our schools” and stop “biological men playing women’s sports.”

While congressional and statewide elections are important, trans rights are also at stake in some of the most influential but oft-forgotten elections: ballot measures. These measures, which give voters the opportunity to weigh in on whether a state or local law should pass, can have serious impact. In 2008, California’s Proposition 8 temporarily banned gay marriage in the state, and in 15 states women first won the right to vote via ballot measures.

This year, wealthy and powerful individuals and organizations have lobbied to get major anti-trans initiatives on the ballot in Arizona, Colorado, Missouri, Nebraska and Washington. If passed, they could ban trans people from sports and bathrooms, restrict access to gender-affirming healthcare, pressure schools to out kids to their parents and introduce invasive sex tests for young girls. Here’s everything you need to know about the five measures:

1. Arizona: Proposition 318-> An Expanded Sports Ban with Bathroom Restrictions

Proposition 318 is a major expansion of Arizona’s current restrictions on trans athletes. In 2022, the state passed a lawbanning trans girls from participating on girls’ sports teams in public schools.

This proposition extends the ban to apply to essentially all competitive sporting events in the state, including private schools, colleges and universities and private athletic leagues like Little League or club sports. Additionally, it adds a new provision requiring “restrooms, locker rooms, shower rooms or other private spaces that are integral to athletic engagement” to be restricted to people of the corresponding sex assigned at birth. Critics have noted that the exact definition of “integral to athletic engagement” is unclear and that it could be used against audience members at sporting events in addition to athletes themselves. If it passes, it will take effect on Jan. 1.

Originally proposed by Republican state Rep. Selina Bliss, the language was crafted with the help of Tim Mooney, a GOP political consultant who has made pushing conservative ballot measures a major priority of his career. An investigation by LOOKOUT and Westword reported that Mooney has won 55 out of the 62 ballot campaigns he’s worked on and raked in $22 million from political committees since 2010.

Ballot propositions in Arizona are especially powerful because the state’s constitution prevents lawmakers from repealing them if they succeed. Hazel Heinzer, a licensed marriage and family therapist, former NCAA athlete and mother of two nonbinary children from Arizona, told Uncloseted Media that the panic against trans athletes is causing huge emotional distress for her 9- and 12-year-old kids. Heinzer, who is cisgender, says that bathroom restrictions put a target on all women—she has been confronted in the restroom on multiple occasions just for having short hair. In one instance, she remembers a man watching her child walk into the bathroom before asking another person, “Is that a transgender?”

“It’s really clear that people have been hearing that rhetoric, whether it’s on the national scale or locally, because it feels like people are paying attention more when we go into the bathroom,” Heinzer says. “That level of surveillance from regular people is really scary.”

2. Colorado: Propositions 134 and 135-> A Sports Ban and a Gender-Affirming Surgery Ban

Colorado has two anti-trans measures on the ballot. Proposition 134 would ban trans girls from girls’ sports, stating that athletes must join the team that matches their “biological reproductive system.” Critics argue that this language may open up young athletes to invasive inspections designed to confirm their sex. There would be no appeals process for a challenge to an athlete’s sex.

Proposition 135, meanwhile, would prohibit gender-affirming surgeries for people under 18 and block the usage of any state or federal funds, including Medicaid, on said surgeries. Gender-affirming surgeries are extremely rare for teenagers and virtually nonexistent for youth aged 12 and under. The few surgeries that do occur are almost exclusively chest-related. Medical associations in the state have criticized the initiative for removing agency over medical decisions from the patient, their families and their provider and instead handing it to the government.

Mooney is also involved with these propositions, which are being spearheaded by Protect Kids Colorado, a local advocacy group that opposes “indoctrination concerning sexualization & gender transition.” Mooney told LOOKOUT and Westword that other contributors to the campaign include former Colorado Secretary of State Scott Gessler, Colorado Parent Advocacy Network Executive Director Lori Gimelshteyn and Jennifer Sey, the founder of anti-trans clothing brand XX-XY Athletics.

Jessica DeMoulin, a Colorado native who has a 17-year-old trans daughter, says these proposals set dangerous precedents for government overreach. She told Uncloseted Media that accessing healthcare is difficult enough without adding new restrictions for doctors, and that allowing the government to shape the definition of womanhood gives them the power to enforce harmful gender roles.

“I worry about my kid being excluded. … Any time that you’re setting rules on who can be included and who can’t, that just limits our opportunities,” DeMoulin says. “And I worry about the girls that are stronger, or taller, or they have shorter hair, or they don’t like wearing dresses. The government overreach to try to define what a girl should look like or behave like, that concerns me.”

3. Missouri: Amendment 3-> Adding a Gender-Affirming Care Ban to the Constitution While Removing Abortion Rights

Amendment 3 would repeal Missouri’s constitutional protections for abortion and it would enshrine the state’s ban on gender-affirming care for minors into the constitution. In 2024, voters in the state passed a ballot measure to add the right to abortion into Missouri’s constitution in response to a ban on the procedure passed two years earlier in the wake of Roe v. Wade being overturned. Amendment 3 would undo that amendment, putting the statewide law banning abortion in most cases back into place.

The decision to attach the largely unrelated abortion and gender-affirming care provisions into the same amendment has faced sharp criticism, with opponents portraying it as an attempt to confuse voters and use anti-trans hysteria to trick them into supporting an abortion ban. Gender-affirming care has been banned for minors in Missouri since 2023, and that ban will stay on the books whether or not Amendment 3 passes. However, adding the ban to the state constitution will make it harder to challenge or overturn.

The amendment is being spearheaded by a nonprofit incorporated in September called Her Health, Her Future, with a PAC by the same name funding the campaign. Their leadership includes campaign manager James Lawson, who took a leave of absence from his role as deputy chief of staff at the state Attorney General’s office to contribute, and treasurer Claudia Kehoe, who is the First Lady of Missouri. Former Missouri Attorney General Andrew Bailey, who was also serving as co-deputy director of the FBI until September, also started a new PAC to promote the amendment with support from Republican Sen. Josh Hawley.

4. Nebraska: Initiative Measure 442-> Adding a Sports Ban to the Constitution

Initiative Measure 442 would take Nebraska’s already existing ban on trans athletes and enshrine it in the state’s constitution. Nebraska passed a lawbanning trans athletes from competing on the correct gendered sports teams last year. If Initiative Measure 442 passes, that ban will become a part of the state constitution, making it significantly harder to challenge or undo.

The group behind the initiative, Fairness for Girls, is led by a committee that includes former Republican state Sen. Julie Slama, University of Nebraska regent Rob Schafer and Elizabeth Nunnally, a leader at the Nebraska Family Alliance, which is a state-level affiliate of the Southern Poverty Law Center-designated anti-LGBTQ hate group Focus on the Family. Their top donors include the Nebraska Family Alliance and Restore the Good Life Inc., a dark money groupaffiliated with staffers of the state’s former Republican Gov. Pete Ricketts.

5. Washington: Initiatives 638 & 001-> A Sports Ban with Sex Testing Requirements and a School Privacy Restriction

Like Colorado, Washington has two anti-trans initiatives on the ballot. Initiative 638 bans trans girls from girls’ sports, but it goes further than similar laws by forcing all female athletes to submit evidence to verify their sex. The evidence could include “the student’s reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels,” and the requirement does not apply to athletes competing in boys’ sports. The initiative has been decried by advocates and educators for forcing young girls to have their genitalia examined unless they are able to conduct expensive genetic or hormonal testing. No Hate in WA State, one of the groups organizing against the initiative, has called it “the most extreme MAGA measure of its kind in the country.”

Initiative 001 would require schools to allow parents to access their children’s “medical or health records” and “records of any mental health counseling.” These provisions were previously passed in 2024 as part of a broader parental rights bill before being removed by the state legislature’s Democratic majority the following year. Advocates have raised concerns about the provisions, arguing that they could be used to force schools to out LGBTQ kids to potentially bigoted parents or to release sensitive information to abusive caretakers.

Both initiatives were spearheaded by Brian Heywood, a right-wing hedge fund owner from Seattle who has been pouring millions of dollars into conservative ballot initiatives via his PAC Let’s Go Washington. Other major donors include trucking mogul Steve Gordon, former tech businessman Lawrence Hughes and investor Peter Plath. The support of big business is perhaps unsurprising given that the PAC’s other major effort this year is an initiative to overturn the state’s increased income tax on millionaires.

Linden Jordan, who volunteers for No Hate in WA State, told Uncloseted Media that measures like this would have been horrible for him back when he was growing up as a trans kid. He fears they will only worsen an already extreme mental health crisis for trans youth, 40% of whom seriously considered suicide last year.

“Our trans kids have enough to deal with day-to-day in the kind of bullying they experience in schools anyway, and this is bullying on a grand scale,” he says. “And the ads that they’ve had on social media and on public media make trans kids feel like they’re monsters, cheating, all of that without any evidence.”