Missouri voters have rejected an amendment that would have reversed reproductive rights protections they adopted in 2024 and placed restrictions on transgender minors’ medical care in the state constitution.

The Associated Press called Amendment 3’s defeat Tuesday, with opposition exceeding 55 percent of the vote. The result preserves constitutional protections for abortion and defeats Republican lawmakers’ effort to undo them by pairing an abortion ban with restrictions on transgender healthcare.

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The defeat does not repeal Missouri’s existing restrictions on gender-affirming care for minors. It prevents those restrictions from being added to the constitution, where they would have been harder to reverse.

The two measures shared a number but had opposite purposes. In 2024, Amendment 3 established constitutional reproductive rights protections with 51.6 percent support. This year’s Amendment 3 would have dismantled those protections and restored a ban on most abortions.

As ProPublica reporting published by The Advocate explained in August, Republican lawmakers bundled the abortion rollback with restrictions on transgender healthcare after failing to defeat the 2024 amendment. During that earlier campaign, abortion opponents falsely claimed the reproductive rights measure would allow gender transition surgeries for minors.

This time, the proposal explicitly targeted both abortion and transition-related care. Supporters ran ads emphasizing the transgender care restrictions, while opponents argued that the provision was intended to attract votes for the broader rollback of reproductive rights.

The rejected amendment would have allowed abortions in medical emergencies and cases involving fetal anomalies, as well as pregnancies resulting from rape or incest within the first 12 weeks. Supporters presented those exceptions as a compromise; opponents said they were inadequate and that lawmakers were disregarding voters’ 2024 decision.

Missouri enacted restrictions on gender-affirming care for minors in 2023. Its statutory prohibition on transition-related surgeries has no expiration date, while restrictions on puberty blockers and hormone therapy are scheduled to expire in August 2027. Amendment 3 would have placed those restrictions in the Constitution without that expiration date. Voters declined to do so.