Referred by the General Assembly
Amendment 3
Reproductive healthcare and gender transition procedures for minors
How it reads on the ballot
Shall the Missouri Constitution be amended to: Repeal the 2024 voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability; Allow abortions for rape and incest (under twelve-weeks’ gestation), emergencies, and fetal anomalies; Allow legislation regulating abortion; Ensure parental consent for minors’ abortions; Prohibit gender transition procedures for minors?
What your vote does (official language)
Yes
A “yes” vote will repeal Article I, Section 36, of the Missouri Constitution approved by the voters in 2024 which provided reproductive healthcare rights, including abortion through fetal viability; continue to ensure women’s ability to access medical care for medical emergencies, ectopic pregnancies, and miscarriages; allow legislation to regulate abortion providers and facilities to ensure health and safety; require informed and voluntary consent for an abortion, including parental or judicial consent for minors; allow restriction of abortions to cases of medical emergency, rape and incest under twelve weeks gestation, and fetal anomalies; prohibit public funding of abortions except in limited circumstances; and prohibit gender transition procedures for minors including gender transition surgeries, cross-sex hormones or puberty-blocking drugs, with exceptions for specific medical conditions.
No
A “no” vote will leave Article I, Section 36, of the Missouri Constitution approved by voters in 2024 in place; will not limit abortion to cases of medical emergency, rape and incest under twelve weeks gestation, and fetal anomalies, but leave access to abortion available through fetal viability; will not prohibit gender transition procedures for minors.
Cost estimate: State governmental entities estimate no costs or savings. Greene County estimates it may experience an unknown increase in tax revenue. Other local governmental entities estimate no costs or savings.
Taxes: If passed, this measure will not increase or decrease taxes.
The analysis
Amendment 3 would repeal the reproductive rights provision Missouri voters approved in 2024. It would generally limit abortion to medical emergencies, fetal anomalies, and cases of rape or incest occurring before 12 weeks of pregnancy, while allowing the legislature to regulate abortion and requiring parental or judicial consent for minors. It would also place a constitutional prohibition on gender transition procedures for minors, including surgeries, cross sex hormones, and puberty blocking drugs, subject to specified medical exceptions. A no vote would leave the 2024 provision in place, including abortion access through fetal viability and no constitutional prohibition on those procedures.
What supporters say (the case for a yes vote)
- The Archdiocese of St. Louis's Respect Life Apostolate describes the measure as a way to restore Missouri's pro-life protections after the 2024 amendment, while preserving exceptions for medical emergencies, fetal anomalies, and rape or incest before 12 weeks. Archdiocese of St. Louis
- The Missouri Catholic Conference argues that the amendment would restore or preserve parental consent requirements for minors seeking abortions, permit health and safety regulation of abortion providers and facilities, and prohibit gender transition procedures for minors. Missouri Catholic Conference
What opponents say (the case for a no vote)
- Tori Schafer of the ACLU of Missouri, part of the Stop the Ban Missouri coalition, said the measure "is an abortion ban that takes away a woman's right to make her own medical decisions and instead puts it in the hands of politicians and lawyers," and that "politicians are trying to trick Missouri voters into banning abortion by combining these two separate topics." KCUR, May 27
- The Stop the Ban Missouri campaign says that in 2024 "the people of Missouri decided to stop Missouri's abortion ban," and that "now, politicians are trying to overturn the will of the people and ban abortion again." KCUR, May 27
Neutral ground
What’s not in dispute
- The measure was placed on the November 2026 ballot as Amendment 3 and would repeal the reproductive rights amendment approved by Missouri voters in 2024. Missouri Secretary of State
- The proposed exceptions include medical emergencies, fetal anomalies, and rape or incest occurring before 12 weeks of pregnancy. KCUR, May 27
- The measure would prohibit gender transition surgeries, cross sex hormones, and puberty blocking drugs for minors, with exceptions described in the proposal. ProPublica
- Missouri law enacted in 2023 already restricts gender transition treatment for minors. Its ban on puberty blockers and cross sex hormones expires in 2027; its ban on surgeries is permanent. News Tribune, Sept 13
- The most recent public poll, the SLU/YouGov poll of 900 likely Missouri voters taken August 13 to 24, 2026 (margin of error about 4 points), found 43% for Amendment 3, 44% against and 13% unsure. News Tribune, Sept 13
Questions still open
- How courts would interpret the amendment's medical emergency, fetal anomaly, rape and incest, parental consent, and medical condition exceptions is unresolved.
- How the constitutional language would interact with existing Missouri statutes and future legislation is unresolved.
- Whether the existing statutory restrictions on gender transition procedures for minors would be changed, expanded, or made harder to amend by the constitutional prohibition is unresolved.
Publicly supporting
- Archdiocese of St. Louis Respect Life Apostolate Archdiocese of St. Louis
- Missouri Catholic Conference Missouri Catholic Conference
- Her Health, Her Future (campaign backed by Gov. Mike Kehoe) KCUR, May 27
Publicly opposing
- Stop the Ban Missouri (coalition including the ACLU of Missouri) KCUR, May 27
For cities and counties
Available reporting says the official fiscal analysis found no estimated costs or savings for state governmental entities and generally no costs or savings for local governmental entities, although Greene County reported an unknown possible increase in tax revenue. The measure's direct effects on local services would likely depend on future enforcement and legislation.
Note on sources: Public campaign and news coverage is substantially more developed than the publicly accessible legislative hearing and floor debate material identified here. The available sources document the principal arguments on both sides, but do not provide a complete, independently verified record of all testimony, endorsements, or implementation analyses.
Reviewed September 24, 2026.