Which 2026 Transgender Ballot Measures Passed? Results From Colorado, Missouri, Arizona, and Washington

TransHealthHub

2 days ago

4 min read

Voters in four states decided on six ballot measures involving transgender young people on November 3, 2026. Four passed: Colorado Propositions 134 and 135, Arizona Proposition 318, and Washington Initiative 638. Missouri's Amendment 3 failed, and Washington's Initiative 001 is on track to fail. None of the passed measures take effect before December 3, 2026.

At TransHealthHub, we set out what each measure does and when it starts. We do not endorse or oppose any candidate, party, or ballot measure.

Key Takeaways

Missouri rejected Amendment 3, which won about 44% of the vote. It would have written a ban on medical care for transgender minors into the state constitution.
Colorado's measures start January 1, 2027. Both change state law rather than the constitution, so lawmakers can amend them.
Washington's Initiative 638 takes effect December 3, 2026, and applies to every student who signs up for a girls-only team.
28 states now limit youth access to this care, as of November 6, 2026, according to the KFF policy tracker.

Counts stay unofficial until each state certifies, and some are still being counted.

All six measures and how each finished

State	Measure	What it does	Result	Yes / No
Colorado	Prop 134	School and college teams by sex	Passed	52.7% / 47.3%
Colorado	Prop 135	Bans certain surgery for minors	Passed	52.3% / 47.7%
Missouri	Amendment 3	Would have added a care ban to the constitution	Failed	44.5% / 55.5%
Arizona	Prop 318	Teams and athletics facilities by birth certificate	Passed	58.9% / 41.1%
Washington	Initiative 638	Bars trans girls from girls' K-12 sports	Passed	56.0% / 44.0%
Washington	Initiative 001	Would have restored the 2024 parental-rights law	Failing	47.5% / 52.5%

What Colorado voters approved

Both measures passed. The Associated Press called Proposition 134 on November 5 and Proposition 135 on November 6, according to the Colorado Sun. Both take effect January 1, 2027.

Proposition 134 requires public and private K-12 schools and colleges to designate every team as male, female, or co-ed, without specifying how a school should confirm a student's sex, Chalkbeat Colorado reports.

Proposition 135 prohibits surgery for anyone under 18 performed in response to a minor's perception of sex or gender, with exceptions for male circumcision and for a medically verifiable disorder of sex development. It does not restrict counseling, social transition, or medication. No Colorado hospital says it currently provides those surgeries to patients under 18, and opponents say the wording could reach some surgeries for youth who are not transgender, the Sun reported.

The American Medical Association, American Academy of Pediatrics, American Psychological Association and the Endocrine Society regard this care as evidence-based and medically necessary and oppose government interference in these decisions.

Why Missouri's Amendment 3 failed

Amendment 3 failed, winning about 44% of the vote. It would have reversed the abortion rights voters approved in 2024 and added a ban on medical care for transgender minors to the constitution. Missouri is the first state where voters declined to put such a ban in a constitution, the Missouri Independent reported.

The practical effect is narrow. Missouri already restricts this care by statute, and under the Missouri SAFE Act the surgery ban carries no end date, while the provision covering hormones and puberty-pausing medication "shall expire on August 28, 2027."

What changes in Arizona

Proposition 318 passed. The Associated Press called it at 1:32 a.m. on November 4, when it led with 58% of the vote, KJZZ reported. It takes effect January 1, 2027.

Teams at public schools, private schools, and athletic associations are designated by the sex on a student's original birth certificate. Bathrooms, showers and locker rooms integral to athletic engagement are limited the same way, and athletes may sue schools that knowingly violate the law, according to KTAR News. A 2022 law already barred transgender girls from girls' teams, so the facilities rules are the larger change.

What Washington voters decided

Washington split. Initiative 638 passed, and Initiative 001 is failing, with 52.5% voting no in the state count last updated November 8.

Initiative 638 bars transgender girls from girls-only K-12 sports at public schools and at private schools in the state athletic association. A student seeking a female-designated team must provide a form signed by her own healthcare provider verifying her sex, based on "reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels," the Attorney General's explanatory statement says. A birth certificate is not a permitted method, and the requirement applies to every student who signs up, not only to students someone believes are transgender.

It takes effect December 3, 2026, the date the Secretary of State certifies the election.

What this means for families elsewhere

Access depends on where a family lives. As of November 6, 2026, 28 states had enacted laws or policies limiting youth access to this care, and 54% of transgender youth ages 13 to 17 live in one of them, according to KFF. Families can check their own state against the current list. Most support for transgender young people is social and psychological, and none of these measures reaches it.

Frequently asked questions

Did voters ban supportive care for minors anywhere in 2026? No state added a new ban on hormones or puberty-pausing medication. Colorado's Proposition 135 covers surgery only, and Missouri's Amendment 3 failed.

Do Colorado's measures restrict counseling or social transition? No. Its text reaches surgery only.

Can lawmakers change any of this? In Colorado, yes, because both measures are statutory. In Arizona, a voter-approved measure is far harder to amend.