2026 Ballot Measures Target Transgender Youth in Sports and Medical Care

In the 2026 election cycle, voters in several states will decide ballot measures that would require school athletic teams to be designated by biological sex and bar “biologically male” students from competing on female teams, and prohibit gender-transition surgeries, cross-sex hormones, and puberty-blocking drugs for minors. The measures appear on ballots in Colorado, Arizona, Washington, Missouri and Nebraska, with each initiative framed as a response to prior legislative actions on the same issues.

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State-level restrictions on transgender youth began in 2020 when Idaho enacted the first law limiting participation on female sports teams to students identified as female at birth. Between 2020 and 2025, additional statutes and regulations were adopted in 27 other states, most under Republican trifectas; four states (Kansas, Kentucky, Louisiana, North Carolina) passed the measures after Republican legislatures overrode Democratic gubernatorial vetoes.

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A parallel wave of bans on gender-affirming medical procedures started in 2021 with Arkansas’s prohibition of such care for minors. By 2025, 27 states had enacted similar bans, again largely through Republican-controlled legislatures. Courts in Kansas and Montana have blocked enforcement of some of these bans.

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• As of 2026, 29 states have laws, regulations, or interscholastic rules limiting female sports participation to students of the female sex.

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• Twenty-seven states have enacted bans on surgical procedures for transgender minors.

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• Colorado’s supporting PAC, Protect Kids Colorado, reports $7.0 million in contributions, including $2.3 million from founder Brian Heywood. Opponents, led by No Hate in WA State, have raised $1.6 million, with $250,000 from the National Education Association.

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• Missouri’s Her Health, Her Future PAC has contributed $1.6 million to the amendment, while the opposing Stop the Ban PAC has raised $5.2 million, the ACLU Foundation providing $2.5 million.

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• Nebraska’s Fairness for Girls PAC disclosed $3.1 million, 99 % of which came from the nonprofit Restore the Good Life, Inc. As of July 22, no PACs had organized either for or against the Nebraska amendment.

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• On June 30, signatures were submitted for Nebraska’s amendment; the state required 125,821 signatures (10 % of the 1,258,210 registered voters recorded on July 1).

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Opponents in Arizona note that the state currently permits females to compete on male-designated teams, making Proposition 318 a reversal of existing policy.

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• “ He quoted Alana Jochum, state policy director at Advocates for Trans Equality, who said, "This harkens back to 2004 and the playbook around marriage equality.” — Trans Equality

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Voters will decide Arizona’s Proposition 318, Washington’s Sex Verification Requirements for Female School Sports Initiative, Missouri’s Amendment 3, and Nebraska’s constitutional amendment on sex-based sports eligibility in the November 2026 general election. Campaign financing continues to shape the contests, with both supportive and opposing PACs mobilizing resources ahead of the vote.

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