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Missouri Prohibit Abortion and Gender Transition Procedures for Minors Amendment (2026)

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Missouri Prohibit Abortion and Gender Transition Procedures for Minors Amendment

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Election date

November 3, 2026

Topic
Abortion policy and Constitutional rights
Status

On the ballot

Type
Legislatively referred constitutional amendment
Origin

State legislature



The Missouri Prohibit Abortion and Gender Transition Procedures for Minors Amendment is on the ballot in Missouri as a legislatively referred constitutional amendment on November 3, 2026.[1]

A "yes" vote supports repealing Amendment 3, which was approved by voters in 2024, which added a fundamental right to reproductive freedom, defined to include abortion and “all matters relating to reproductive health care,” to the Missouri Constitution, and would replace Amendment 3 with a new section to the Missouri Constitution, which would:

  • Prohibit abortion, except in cases of medical emergency, fetal anomaly, rape, or incest. For cases of rape and incest, the abortion can only be performed before 12 weeks;
  • Prohibit abortions based on the diagnosis or screening indicating the disability of the unborn child, except in cases of fetal anomaly;
  • Require parental consent for a minor seeking an abortion, except in cases of medical emergency where consent cannot be obtained;
  • Prohibit fetal organ harvesting after an abortion, which is defined as the collection of fetal tissue, organs, or fluids for the purpose of selling or collecting for scientific purposes, except for paternity testing, determination of anomaly or condition of the unborn child, or for law enforcement purposes;
  • Provide that women can access healthcare in cases of miscarriages and ectopic pregnancies;
  • Provide for the general assembly to enact laws and regulations regarding the provision of abortions, abortion facilities, and abortion providers; and
  • Prohibit gender transition surgeries for minors under eighteen, and prohibit the prescribing of cross-sex hormones or puberty blocking drugs to minors under eighteen. This does not include the use of surgeries, drugs, or hormones to treat children born with medically verifiable disorders of sex development, or to treat any infection, injury, disease, or disorder unrelated to the purpose of gender transition.

A "no" vote opposes repealing and replacing Amendment 3, keeping Amendment 3 in place, which provides for a fundamental right to reproductive freedom, including abortion and "all matters relating to reproductive health care."


Overview

What would this amendment do?

See also: Measure design

This amendment would overturn Amendment 3, which was passed by voters in 2024, which amended the state constitution providing for the fundamental right to reproductive freedom, including abortion.

The amendment would then add a new section that would prohibit abortion, except in cases of medical emergency, fetal anomaly, rape, or incest. For cases of rape and incest, the abortion can only be performed before 12 weeks. It would prohibit abortions based on a fetal disability diagnosis, except in cases of fetal anomaly. It would require parental or guardian consent for minors seeking an abortion and prohibit fetal organ harvesting. The amendment would also provide for the ability of a woman to access healthcare in cases of miscarriage and ectopic pregnancy.[1]

The amendment would also prohibit gender transition surgeries for minors under 18, and prohibit the prescribing of cross-sex hormones or puberty blocking drugs to minors under 18. This does not include the use of surgeries, drugs, or hormones to treat children born with medically verifiable disorders of sex development, or to treat any infection, injury, disease, or disorder unrelated to the purpose of gender transition.[1]

What are the arguments for and against this amendment?

See also: Support and opposition

State Sen. Brad Hudson (R-33), who supports HJR 73, said, "From constituents and individuals that I’ve been talking to about this issue, they want another opportunity to weigh in on this. They don’t feel like that they were given an option in Amendment 3 that accurately reflects who they are and where they are on the life issue."

Margot Riphagen, president and CEO of Planned Parenthood Great Rivers Action, who opposes the measure, said, "The majority of Missourians want to make their own decisions about health care without interference from prying politicians … We will not stand for more political games at the expense of the thousands of patients in Missouri who could finally access care they need without crossing state lines. Missouri voters will once again send a clear message that enough is enough."

How did this amendment get on the ballot?

See also: Path to the ballot

In order for the state legislature to refer a constitutional amendment to the ballot in Missouri, a simple majority vote is required in each chamber. The amendment was introduced by State Rep. Ed Lewis (R) as House Joint Resolution 73 (HJR 73). HJR 73 passed the House by 103-51 on April 17, 2025, and was agreed to in the Senate by 21-11 on May 14, 2025.[1]

Measure design

Click on the following sections for summaries of the different provisions of the ballot measure.[1]

Expand All
Abortion
Gender transition procedures for minors


Text of measure

Constitutional changes

See also: Article I, Missouri Constitution

The ballot measure would repeal Section 36 of Article I of the Missouri Constitution, and add a new section, Section 36a. The following underlined text would be added and struck-through text would be deleted:[1]

Note: Hover over the text and scroll to see the full text.

Section 36(a).

1. The state's duty to protect public health and welfare includes protecting the integrity and ethics of the medical profession. The state's interest in regulating the practice of medicine is even greater in areas of medical and scientific uncertainty or in areas that raise grave moral and ethical concerns, including abortion and gender transition procedures.

2. An abortion may be performed or induced upon a woman in cases of medical emergency, fetal anomaly, rape, or incest. In the case of abortions performed or induced in cases of rape or incest, the abortion may be performed or induced no later than twelve weeks gestational age of the unborn child.

3. The general assembly may enact laws that regulate the provision of abortions, abortion facilities, and abortion providers to ensure the health and safety of the pregnant mother. These laws shall include, but not be limited to, laws requiring physicians providing abortion care to have admitting privileges at a nearby hospital; laws requiring facilities where abortions are performed or induced to be licensed and inspected for clean and safe conditions and adequate instruments to treat any emergencies arising from an abortion procedure; laws requiring physicians to perform a sufficient examination of the woman to determine the unborn child's gestational age and any preexisting medical conditions that may influence the procedure; and laws requiring ultrasounds to be performed only by physicians or licensed medical technicians.

4. No abortion shall be performed or induced upon a woman based on a prenatal diagnosis, test, or screening indicating a disability in an unborn child, except in cases of a fetal anomaly.

5. No public funds shall be expended for the purpose of performing, inducing, or otherwise assisting any abortion, except in cases of medical emergency, rape, or incest, as otherwise authorized by law.

6. Except in cases of a medical emergency in which consent cannot be obtained, no abortion shall be performed or induced upon a woman without her voluntary and informed consent, given freely and without coercion. In the case of a minor under the age of eighteen years who is not emancipated, no person shall knowingly perform or induce an abortion, except in cases of a medical emergency in which consent cannot be obtained, unless the attending physician has obtained:

(1) the written consent of the minor and a parent or legal guardian; and

(2) documentation of the consent is retained in the minor's medical record. Licensed medical physicians shall be required to provide women with medically accurate information. The general assembly may enact laws to provide for the right of a minor to consent to an abortion as granted by a court order.

7. Fetal organ harvesting after an abortion is not permitted under any circumstances.

8. A woman's ability to access health care in cases of miscarriages, ectopic pregnancies, and other medical emergencies shall not be infringed by the state.

9. No gender transition surgeries shall be knowingly performed on children under eighteen years of age, and no cross-sex hormones or puberty-blocking drugs shall be knowingly prescribed or administered for the purpose of gender transition to children under eighteen years of age. The provisions of this section shall not apply to the use of such surgeries, drugs, or hormones to treat children born with a medically verifiable disorder of sex development or to treat any infection, injury, disease, or disorder unrelated to the purpose of a gender transition.

10. Any action challenging the validity of any state law relating to reproductive health care shall be brought in the Circuit Court of Cole County, Missouri. If a pleading, written motion, or other paper drawing into question the constitutionality of a state statute does not include the state, one of its agencies, or one of its officers or employees in an official capacity, the party bringing the action shall file a notice of constitutional question and serve it on the attorney general and the attorney general shall have the right to intervene in the litigation.

11. The general assembly shall have the authority to enact laws to carry out the provisions of this section.

12. As used in this section, the following terms mean:

(1) "Cross-sex hormones", testosterone, estrogen, or other androgens given to an individual in amounts that are greater or more potent than would normally occur naturally in a healthy individual of the same age and sex; (2) "Fetal anomaly", a structural or functional abnormality in the unborn child's gestational development that would make life outside the womb impossible; (3) "Fetal organ harvesting", collection of fetal tissue, organs, or fluids, including any biological material, for the purpose of selling or collecting for scientific purposes, but shall not include the utilization of fetal tissue, organs, or fluids to determine the cause or causes of any anomaly, illness, death, or genetic condition of the unborn child, the paternity of the unborn child, or for law enforcement purposes; (4) "Gender transition surgery", a surgical procedure performed for the purpose of assisting an individual with identifying with and living as a gender different from his or her biological sex; (5) "Medical emergency", a condition that, based on reasonable medical judgment, so complicates the medical condition of a pregnant woman as to necessitate the immediate termination of her pregnancy to avert the death of the pregnant woman or for which a delay will create a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman. A medical emergency shall include, but not be limited to, an ectopic pregnancy at any point following the diagnosis of such and treatment for a miscarriage; (6) "Puberty-blocking drugs", gonadotropin-releasing hormone analogues or other synthetic drugs used to stop luteinizing hormone secretion and follicle stimulating hormone secretion, synthetic antiandrogen drugs to block the androgen receptor, or any other drug used to delay or suppress pubertal development in children for the purpose of assisting an individual with a gender transition;

(7) "Reasonable medical judgment", a medical judgment that would be made by a reasonably prudent physician, knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved.

13. All provisions of this section are severable. If any provision of this section is found by a court of competent jurisdiction to be unconstitutional or unconstitutionally enacted, the remaining provisions of this section shall be and remain valid.


 Text of Section 36:

Section 36. 1. This Section shall be known as "The Right to Reproductive Freedom Initiative."

2. The Government shall not deny or infringe upon a person's fundamental right to reproductive freedom, which is the right to make and carry out decisions about all matters relating to reproductive health care, including but not limited to prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care, and respectful birthing conditions.

3. The right to reproductive freedom shall not be denied, interfered with, delayed, or otherwise restricted unless the Government demonstrates that such action is justified by a compelling governmental interest achieved by the least restrictive means. Any denial, interference, delay, or restriction of the right to reproductive freedom shall be presumed invalid. For purposes of this Section, a governmental interest is compelling only if it is for the limited purpose and has the limited effect of improving or maintaining the health of a person seeking care, is consistent with widely accepted clinical standards of practice and evidence-based medicine, and does not infringe on that person's autonomous decision-making.

4. Notwithstanding subsection 3 of this Section, the general assembly may enact laws that regulate the provision of abortion after Fetal Viability provided that under no circumstance shall the Government deny, interfere with, delay, or otherwise restrict an abortion that in the good faith judgment of a treating health care professional is needed to protect the life or physical or mental health of the pregnant person.

5. No person shall be penalized, prosecuted, or otherwise subjected to adverse action based on their actual, potential, perceived, or alleged pregnancy outcomes, including but not limited to miscarriage, stillbirth, or abortion. Nor shall any person assisting a person in exercising their right to reproductive freedom with that person’s consent be penalized, prosecuted, or otherwise subjected to adverse action for doing so.

6. The Government shall not discriminate against persons providing or obtaining reproductive health care or assisting another person in doing so.

7. If any provision of this Section or the application thereof to anyone or to any circumstance is held invalid, the remainder of those provisions and the application of such provisions to others or other circumstances shall not be affected thereby.

8. For purposes of this Section, the following terms mean:(1) "Fetal Viability". the point in pregnancy when, in the good faith judgment of a treating health care professional and based on the particular facts of the case, there is a significant likelihood of the fetus’s sustained survival outside the uterus without the application of extraordinary medical measures.(2) "Government", a. the state of Missouri; or b. any municipality, city, town, village, township, district, authority. public subdivision or public corporation having the power to tax or regulate, or any portion of two or more such entities within the state of Missouri
[2]

Support

Supporters

Officials

Organizations

  • Missouri Catholic Conference
  • Missouri Right to Life

Arguments

  • Jamie Morris, executive director of the Missouri Catholic Conference: "With how close that vote was, I don’t believe the average Missouri resident is comfortable with abortion with no regulations. This is a way to craft policy more protective of mom and baby and represents the view of most Missourians better than Amendment 3."

Opposition

Opponents

Officials

Organizations

  • ACLU of Missouri
  • Abortion Access Missouri

Arguments

  • Tori Schafer, director of Policy and Campaigns at the ACLU of Missouri: "Last November, Missourians made clear that they want to make personal decisions around abortion care with their families and doctors, not with politicians. This deceptive amendment is a trojan horse to reinstate Missouri’s total abortion ban and all the medically unnecessary restrictions that made access to abortion unattainable prior to the passage of the Right to Reproductive Freedom Initiative last November. Missourians want honesty, respect, and access to abortion but HJR 73 is the antithesis to all of these values. Missourians will vote no on this amendment to stop the abortion ban and protect reproductive freedom."
  • Margot Riphagen, president and CEO of Planned Parenthood Great Rivers Action: "The majority of Missourians want to make their own decisions about health care without interference from prying politicians, and they made this abundantly clear at the ballot box in November. We will not stand for more political games at the expense of the thousands of patients in Missouri who could finally access care they need without crossing state lines. Missouri voters will once again send a clear message that enough is enough."


Campaign finance

See also: Campaign finance requirements for Missouri ballot measures

Ballotpedia did not identify ballot measure committees registered to support or oppose the ballot measure.[3]

Cash Contributions In-Kind Contributions Total Contributions Cash Expenditures Total Expenditures
Support $0.00 $0.00 $0.00 $0.00 $0.00
Oppose $0.00 $0.00 $0.00 $0.00 $0.00
Total $0.00 $0.00 $0.00 $0.00 $0.00

Background

Status of abortion in Missouri

As of May 27, 2025, abortions were halted in the state after the Missouri Supreme Court overturned prior lower court decisions that had temporarily allowed abortions to resume.[4] Prior to voters approving Amendment 3 in 2024, abortion was banned in the state with limited exceptions. Amendment 3, which voters approved on November 5, 2025, provided for the fundamental right to reproductive freedom, which was defined to include abortion and "all matters relating to reproductive health care." On December 20, 2024, Jackson County Judge Jerri Zhang ruled Missouri's total abortion ban, 18-week ban, 14-week ban, eight-week ban, and "reasons ban," were unconstitutional and unenforceable by the courts. Judge Zhang also struck down other laws, including the 72-hour waiting period, mandatory informed consent requirements, the requirement that physicians be physically present while the patient takes the medication to induce an abortion, and criminal penalties associated with abortion bans. On February 14, 2025, a Jackson County Circuit Court judge blocked further restrictions that prevented abortion clinics from operating, which included a facility licensing requirement, which restored abortion access in the state. The lawsuit was brought forward by two Planned Parenthood affiliates in Missouri.[5][6]

The reinstated abortion ban, which came back into place on May 27, 2025, prohibited abortion in Missouri with exceptions for medical emergencies. However, the Missouri Constitution provided for the right to an abortion up to fetal viability.

U.S. Supreme Court rulings on abortion

Dobbs v. Jackson Women’s Health Organization (2022)

See also: Dobbs v. Jackson Women’s Health Organization

In 2018, Jackson Women’s Health Organization, a clinic and abortion facility in Mississippi, challenged the constitutionality of the "Gestational Age Act" in federal court. The newly-enacted law prohibited abortions after the fifteenth week of pregnancy except in cases of medical emergencies or fetal abnormalities. The U.S. district court granted summary judgment in favor of the plaintiffs, holding that the law was unconstitutional, and put a permanent stop to the law's enforcement. On appeal, the 5th Circuit affirmed the district court's ruling. Click here to learn more about the case's background. On May 17, 2021, the Supreme Court of the United States agreed to hear the case.[7]

On June 24, 2022, in a 5-4 vote, the Supreme Court of the United States found there was no constitutional right to abortion and overruled Roe v. Wade (1973) and Planned Parenthood v. Casey (1992). In a 6-3 ruling, the court upheld Mississippi's abortion law at issue in the case. Roe v. Wade found that state laws criminalizing abortion prior to fetal viability violated the Due Process Clause of the Fourteenth Amendment of the United States Constitution. In Planned Parenthood v. Casey, the Supreme Court reaffirmed the essential holding of Roe v. Wade but rejected the trimester framework established in the case. The high court affirmed that states could not ban abortions before fetal viability.

Roe v. Wade (1973)

In 1973, the Supreme Court of the United States issued its ruling in Roe v. Wade, finding that state laws criminalizing abortion prior to fetal viability violated the Due Process Clause of the Fourteenth Amendment of the United States Constitution. The high court held that states can regulate and/or prohibit abortions (except those to preserve the life or health of the mother) once a fetus reaches the point of viability. Roe v. Wade defined fetal viability as "the interim point at which the fetus becomes 'viable,' that is, potentially able to live outside the mother's womb, albeit with artificial aid." The high court further noted that "viability is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks."[8]

The ruling established a strict trimester framework to guide state abortion policies. States, according to this framework, were prohibited from banning or regulating abortion during the first trimester of pregnancy. During the second trimester, states were permitted to regulate abortion to protect the mother's health. During the third trimester, states were allowed to ban abortion, except in cases where an abortion is needed to preserve the life or health of the mother.[8]

Abortion regulations by state

As of September 4, 2025, 41 states restricted abortions after a certain point in pregnancy.[9] The remaining nine states and Washington, D.C., did not. Of the 41 states with established thresholds for restrictions on abortion:

  • Twelve states restrict abortion after conception
  • Four states restrict abortion at six weeks post-fertilization
  • Two states restrict abortion at 12 weeks post-fertilization
  • Zero states restrict abortion at 15 weeks post-fertilization
  • One state restricts abortion at 18 weeks since the last menstrual period
  • Three states restrict abortion at 20 weeks post-fertilization or 22 weeks after the last menstrual period
  • Four states restrict abortion at 24 weeks since the last menstrual period
  • Fourteen states restrict abortion at fetal viability
  • One state restricts abortion in the third trimester

The maps and table below give more details on state laws restricting abortion based on the stage of pregnancy. Hover over the footnotes in the table for information on legislation pending legal challenges or otherwise not yet in effect.

Some of the terms that are used to describe states' thresholds for abortion restriction include the following:

  1. Conception: This threshold prohibits all abortions after conception, although some states provide exceptions if the woman's life or health is threatened.[10]
  2. Fetal heartbeat: This threshold restricts abortions after a fetal heartbeat can be detected, which may begin six weeks after the last menstrual period.[11][12]
  3. Fetal viability: In Roe v. Wade, SCOTUS defined fetal viability. The Supreme Court further noted that "viability is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks."[13]
  4. Last menstrual period: This threshold marks the beginning of a pregnancy from the first day of a woman's last menstrual period.[11]
  5. Post-fertilization: Thresholds using post-fertilization mark the beginning of pregnancy at the time of conception, which can occur up to 24 hours following intercourse. A threshold of 20 weeks post-fertilization is equivalent to 22 weeks since last menstrual period.[14]
  6. Post-implantation: Thresholds using post-implantation mark the beginning of pregnancy at the date on which a fertilized egg adheres to the lining of the uterus, roughly five days after fertilization. A threshold of 24 weeks post-implantation is equivalent to 27 weeks since last menstrual period.[14]

Abortion restriction threshold maps

Expand All
Fetal viability
Conception
Fixed-week and trimester cutoffs


Abortion restrictions by state

State abortion restrictions based on stage of pregnancy
State Does the state restrict abortion after a specific point in pregnancy? Threshold for restriction
Alabama Yes Conception
Alaska No None
Arizona Yes Fetal viability[15][16]
Arkansas Yes Conception
California Yes Fetal viability
Colorado No None
Connecticut Yes Fetal viability
Delaware Yes Fetal viability
Florida Yes Six weeks post-fertilization
Georgia Yes Six weeks post-fertilization
Hawaii Yes Fetal viability
Idaho[17] Yes Conception
Illinois Yes Fetal viability
Indiana Yes Conception
Iowa Yes Six weeks post-fertilization
Kansas Yes 20 weeks since last menstrual period
Kentucky Yes Conception
Louisiana Yes Conception
Maine Yes Fetal viability
Maryland No None
Massachusetts Yes 24 weeks post-fertilization
Michigan No None
Minnesota No None
Mississippi Yes Conception
Missouri Yes Fetal viability[18][19]
Montana Yes Fetal viability
Nebraska Yes 12 weeks post-fertilization
Nevada Yes 24 weeks post-fertilization
New Hampshire Yes 24 weeks since last menstrual period
New Jersey No None
New Mexico No None
New York Yes Fetal viability
North Carolina Yes 12 weeks post-fertilization
North Dakota Yes Fetal viability[20]
Ohio Yes 20 weeks post-fertilization[21]
Oklahoma Yes Conception
Oregon No None
Pennsylvania Yes 24 weeks since last menstrual period
Rhode Island Yes Fetal viability
South Carolina Yes Six weeks post-fertilization
South Dakota Yes Conception
Tennessee Yes Conception
Texas Yes Conception
Utah Yes 18 weeks since last menstrual period
Vermont No None
Virginia Yes Third trimester since last menstrual period
Washington Yes Fetal viability
Washington, D.C. No None
West Virginia Yes Conception
Wisconsin Yes 20 weeks post-fertilization
Wyoming Yes Fetal viability
Sources:Guttmacher Institute, "State Policies on Later Abortions," accessed August 16, 2024; CNA, "TRACKER: Check the status of abortion trigger laws across the U.S.," accessed August 16, 2024; The Fuller Project, "How major abortion laws compare, state by state," accessed August 16, 2024

History of abortion ballot measures

See also: History of abortion ballot measures

In 2024, 11 statewide ballot measures related to abortion were certified in Arizona, Colorado, Florida, Maryland, Missouri, Montana, Nebraska, New York, Nevada, and South Dakota for the general election ballot on November 5 — the most on record for a single year.

Ten of the ballot measures addressed state constitutional rights to abortion. Voters approved seven of them in Arizona, Colorado, Maryland, Missouri, Montana, New York, and Nevada, while three measures were defeated in Florida, Nebraska, and South Dakota. One, in Nebraska, to limit the timeframe for when an abortion can be performed was approved.

Since the 1970s, abortion-related policies have been a topic for statewide ballot measures across the U.S.

From 1970 to 2024, there were 65 abortion-related ballot measures, and 44 (68%) of these had the support of organizations that described themselves as pro-life. Voters approved 12 (27%) and rejected 32 (73%) of these 44 ballot measures. The other 21 abortion-related ballot measures had the support of organizations that described themselves as pro-choice or pro-reproductive rights. Voters approved 15 (71%) and rejected six (29%).

Before Roe v. Wade in 1973, three abortion-related measures were on the ballot in Michigan, North Dakota, and Washington, and each was designed to allow abortion in its respective state.

The following graph shows the number of abortion-related ballot measures per year since 1970:

State constitutional rights and abortion-related ballot measures

Constitutional rights

The topic constitutional rights addresses ballot measures that establish a state constitutional right to abortion. Campaigns that support these measures often describe themselves as pro-choice or pro-reproductive rights.

State Year Measure Yes No Outcome
Arizona 2024 Proposition 139, Right to Abortion Initiative 61.61% 38.39%
Approveda
Colorado 2024 Right to Abortion and Health Insurance Coverage Initiative 61.97% 38.03%
Approveda
Florida 2024 Amendment 4, Right to Abortion Initiative[22] 57.17% 42.83%
Defeatedd
Maryland 2024 Maryland Question 1, Right to Reproductive Freedom Amendment 76.06% 23.94%
Approveda
Missouri 2024 Missouri Amendment 3, Right to Reproductive Freedom Initiative 51.60% 48.40%
Approveda
Montana 2024 CI-128, Right to Abortion Initiative 57.76% 42.24%
Approveda
Nebraska 2024 Nebraska Initiative 439, Right to Abortion Amendment 49.01% 50.99%
Defeatedd
Nevada 2024 Nevada Question 6, Right to Abortion Initiative 64.36% 35.64%
Approveda
New York 2024 New York Proposal 1, Equal Protection of Law Amendment 62.47% 37.53%
Approveda
South Dakota 2024 Constitutional Amendment G, Right to Abortion Initiative 41.41% 58.59%
Defeatedd
Ohio 2023 Issue 1: Right to Make Reproductive Decisions Including Abortion Initiative 56.78% 43.22%
Approveda
California 2022 Proposition 1: Right to Reproductive Freedom Amendment 66.88% 33.12%
Approveda
Michigan 2022 Proposal 3: Right to Reproductive Freedom Initiative 56.66% 43.34%
Approveda
Vermont 2022 Proposal 5: Right to Personal Reproductive Autonomy Amendment 76.77% 23.23%
Approveda


Constitutional interpretation

The topic constitutional interpretation addresses ballot measures designed to provide that state constitutions cannot be interpreted to establish a state constitutional right to abortion. These types of amendments are designed to address previous and future state court rulings on abortion that have prevented or could prevent legislatures from passing certain abortion laws. Campaigns that support these measures often describe themselves as pro-life.

State Year Measure Yes No Outcome
Kansas 2022 No State Constitutional Right to Abortion and Legislative Power to Regulate Abortion Amendment 41.03% 58.97%
Defeatedd
Kentucky 2022 No State Constitutional Right to Abortion Amendment 47.65% 52.35%
Defeatedd
Louisiana 2020 Amendment 1: No Right to Abortion in Constitution Amendment 62.06% 37.94%
Approveda
Alabama 2018 Amendment 2: State Abortion Policy Amendment 59.01% 40.99%
Approveda
West Virginia 2018 Amendment 1: No Right to Abortion in Constitution Measure 51.73% 48.27%
Approveda
Tennessee 2014 Amendment 1: No State Constitutional Right to Abortion and Legislative Power to Regulate Abortion Amendment 52.60% 47.40%
Approveda
Florida 2012 Amendment 6: State Constitution Interpretation and Prohibit Public Funds for Abortions Amendment 44.90% 55.10%
Defeatedd
Massachusetts 1986 Question 1: No State Constitutional Right to Abortion and Legislative Power to Regulate Abortion Amendment 41.83% 58.17%
Defeatedd


Status of gender transition procedures for minors in Missouri

As of 2025, gender transition procedures for minors were prohibited in Missouri. On June 7, 2023, Senate Bill 49 (SB 49), also called the "Missouri Save Adolescents from Experimentation (SAFE) Act," was signed into law by Gov. Mike Parson (R), and went into effect on August 28, 2023. SB 49 prohibited healthcare providers from performing gender transition surgeries or prescribing cross-sex hormones and puberty-blocking drugs to individuals under 18 years old. The law included exceptions for minors with medically verifiable disorders of sex development or conditions that pose an imminent danger to life or major bodily function without surgery. The SAFE Act was set to expire on August 28, 2027, due to a sunset clause.[23]

Path to the ballot

Amending the Missouri Constitution

See also: Amending the Missouri Constitution

A simple majority vote is required during one legislative session for the Missouri General Assembly to place a constitutional amendment on the ballot. That amounts to a minimum of 82 votes in the Missouri House of Representatives and 18 votes in the Missouri State Senate, assuming no vacancies. Amendments do not require the governor's signature to be referred to the ballot.

House Joint Resolution 73 (2025)

State Rep. Ed Lewis (R) introduced the constitutional amendment into the Missouri General Assembly as House Joint Resolution 73 (HJR 73) on January 28, 2025. The constitutional amendment moved through the legislature between January 28, 2025 and May 14, 2025.[1]

  • January 25, 2025: HJR 73 was introduced to the Missouri House of Representatives.
  • April 17, 2025: The Missouri House voted 103-51 to pass the amendment, and referred the amendment to the Senate.
  • May 14, 2025: The Senate voted 21-11 to pass the amendment.


Partisan Direction Index = +98.4% (Republican)
Democratic Support
0.0%
Republican Support
98.4%
Missouri House of Representatives
Voted on April 17, 2025
Votes Required to Pass: 82
YesNoNV
Total103518
Total %64314.9
Democratic (D)0502
Republican (R)10316
Missouri State Senate
Voted on May 14, 2025
Votes Required to Pass: 18
YesNoNV
Total21112
Total %62325.8
Democratic (D)0100
Republican (R)2112

Anna Fitz-James v. Secretary of State Denny Hoskins


BP-Initials-UPDATED.png This article contains a developing news story. Ballotpedia staff are checking for updates regularly. To inform us of new developments, email us at editor@ballotpedia.org.



Lawsuit overview
Issue: Does the ballot measure constitute a single subject, and have fair ballot language and summary?
Court: Circuit Court of Cole County
Plaintiff(s): Anna Fitz-JamesDefendant(s): Secretary of State Denny Hoskins

  Source: Lawsuit Filing

Anna Fitz-James (along with the ACLU of Missouri and Stinson LLP), filed a lawsuit against Secretary of State Denny Hoskins regarding the single-subject clause of the ballot measure and whether the measure has fair ballot language and summary. In regard to the fair ballot language, the ACLU said, "Amendment 3 fails to inform voters that, if passed, it will eliminate the fundamental right to reproductive freedom; abolish explicit constitutional protections for prenatal care, childbirth, postpartum care, birth control, and respectful birthing conditions; and would overturn protections against prosecution for physicians related to pregnancy outcomes."[24]

Regarding the single-subject rule, the ACLU said in a statement, "In addition to the misleading and inaccurate summary statement, Amendment 3 violates the state’s single subject clause for ballot measures that will amend the Constitution. Specifically, Amendment 3 erroneously categorizes several topics to fall under the definition of 'reproductive health care,' including banning health care for transgender adolescents, arbitrarily forcing all legal actions 'relating to reproductive health care' to be heard in Cole County Circuit Court, and creating a notification system for the Attorney General on all private and non-state involved lawsuits questioning the constitutionality of state statutes."[24] Sam Lee of Campaign Life Missouri, a proponent of the amendment, said in regards to the single subject rule, "It’s a weak argument, because even supporters of what passed in November last year link reproductive health care with transgender care."[25]

How to cast a vote

See also: Voting in Missouri

See below to learn more about current voter registration rules, identification requirements, and poll times in Missouri.

How to vote in Missouri


See also

  • Ballot measure lawsuits
  • Ballot measure readability
  • Ballot measure polls

External links

Footnotes

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Missouri Legislature, "HJR 73," accessed April 18, 2025
  2. Note: This text is quoted verbatim from the original source.
  3. Missouri Ethics Commission, "Candidates and Committees," accessed May 24, 2025
  4. Missouri Independent, "Missouri Supreme Court order reinstates ‘de facto abortion ban’ across the state," May 27, 2025
  5. KSDK, "Missouri judge knocks down state's near-total abortion ban, but some hurdles linger," December 20, 2024
  6. Politico, "Abortion access to restart in Missouri, clinics say, following state court ruling," February 15, 2025
  7. SCOTUSblog, "Court to weigh in on Mississippi abortion ban intended to challenge Roe v. Wade," May 17, 2021
  8. 8.0 8.1 Cornell University Law School, "Roe v. Wade," accessed April 27, 2017
  9. Note: Exceptions to these thresholds are generally provided when pregnancy threatens the mother's life or health.
  10. The Fuller Project, "How major abortion laws compare, state by state," accessed December 4, 2022
  11. 11.0 11.1 Kaiser Family Foundation, "States with Gestational Limits for Abortion," August 1, 2020
  12. Guttmacher Institute, "State Bans on Abortion Throughout Pregnancy," September 1, 2021
  13. Supreme Court of the United States, Roe v. Wade, January 22, 1973
  14. 14.0 14.1 Guttmacher Institute, "The Implications of Defining When a Woman Is Pregnant," May 9, 2005
  15. Voters approved Proposition 139 on November 5, 2024, amending the state constitution to provide for the fundamental right to abortion, among other provisions. The amendment was set to go into effect once Gov. Katie Hobbs (D) certified the election results following the November 25, 2024, canvass deadline.
  16. Axios, "When Arizona's new abortion measure will take effect," November 7, 2024
  17. In a 6-3 decision in Moyle v. United States (consolidated with Idaho v. United States), the U.S. Supreme Court on June 27, 2024, reinstated a U.S. District Court for the District of Idaho ruling that temporarily blocked the state of Idaho from enforcing the part of a 2022 law that barred abortion in case of certain medical emergencies.
  18. Voters approved Amendment 3, which provided for a right to abortion in the state constitution. The amendment was set to take effect 30 days after the election.
  19. Missouri Independent, "Missouri voters approve Amendment 3, overturn state’s abortion ban," November 5, 2024
  20. On September 12, 2024, a state judge ruled against North Dakota's abortion ban. The state appealed the ruling, and litigation is ongoing.
  21. Ohio voters approved Issue 1 in 2023, allowing the state to restrict abortion only after fetal viability. However, the state's previous restrictions on abortion—such as SB 127, which banned abortion at 20 weeks post-fertilization—remained on the books. As of August 2024, courts had not weighed in on the interaction between Issue 1 and the older laws.
  22. Note: Florida Amendment 4 needed to receive a 60% vote to be approved.
  23. Bill Track 50, "MO SB 49," accessed May 28, 2025
  24. 24.0 24.1 Missouri ACLU, "MISSOURI ACLU SUES STATE FOR DECEPTIVE BALLOT LANGUAGE ON MEASURE TO REINSTATE ABORTION BAN," July 2, 2025
  25. Missouri Independent, "Lawsuit challenges ballot language for proposed Missouri abortion ban ," July 3, 2025
  26. Missouri Secretary of State - Elections and Voting, "Frequently Asked Questions," accessed April 4, 2023
  27. 27.0 27.1 27.2 Missouri Secretary of State, "Register to Vote," accessed April 4, 2023
  28. 28.0 28.1 28.2 NCSL, "State Profiles: Elections," accessed August 27, 2024
  29. BillTrack50, "MO HB1878," accessed April 4, 2023
  30. Missouri Secretary of State, "FAQs Voter Registration," accessed August 27, 2024
  31. Under federal law, the national mail voter registration application (a version of which is in use in all states with voter registration systems) requires applicants to indicate that they are U.S. citizens in order to complete an application to vote in state or federal elections, but does not require voters to provide documentary proof of citizenship. According to the U.S. Department of Justice, the application "may require only the minimum amount of information necessary to prevent duplicate voter registrations and permit State officials both to determine the eligibility of the applicant to vote and to administer the voting process."
  32. Missouri Secretary of State, "How To Vote," accessed August 27, 2024
  33. Missouri Secretary of State, "Do I need an ID to vote?" accessed April 3, 2023