Transgender healthcare has emerged as a significant issue in this year’s midterm elections across multiple states. In Missouri, voters face a proposed constitutional amendment that would prohibit minors from accessing gender-transition surgery, cross-sex hormone therapy, and puberty blockers. The measure is attached to a broader amendment aimed at reinstating the state’s near-total abortion ban.
PROMO Missouri, an LGBTQ+ advocacy organization, has launched an extensive campaign to defeat the transgender healthcare restrictions through a technique known as “deep canvassing.” The strategy involves one-on-one conversations designed to shift perspectives on contentious political topics. The group aims to knock on 100,000 doors across five major metropolitan areas and conduct 10,000 substantive conversations before Election Day. By early October, organizers had achieved 6,000 conversations, utilizing both full-time staff and weekend volunteers.
Missouri previously enacted restrictions on gender-affirming care for minors in 2023, when the Republican-dominated legislature permanently blocked access to gender-affirming surgeries and temporarily suspended new prescriptions for puberty blockers and cross-sex hormones for four years. The state is among 27 that have implemented such restrictions in the past five years. The proposed amendment currently polls competitively, with 43% supportive of the bans, 44% opposed, and 13% undecided.
Canvassers employ a structured approach to identify persuadable voters, asking individuals to rate their positions on banning abortion and restricting gender-transition procedures on a scale of 0 to 10. The campaign focuses on voters who oppose abortion restrictions but hold more ambivalent views on transgender healthcare access. Similar ballot measures are being decided in other states this year, including proposed bans on transgender healthcare for minors in Colorado and restrictions on transgender athletes in youth sports across multiple states.
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