Missouri voters will face a November 2026 ballot measure — officially designated Amendment 3 — that would simultaneously overturn the 2024 Amendment 3 that embedded the right to reproductive freedom in the state constitution, and impose new constitutional prohibitions on gender transition surgeries and hormone treatments for minors under 18. A new poll conducted in mid-March 2026 found the measure leading 47 percent to 40 percent, with 12 percent unsure. KCUR, the NPR affiliate in Kansas City, reported the results on March 19 under the headline "Missouri voters may back abortion ban because of trans health care ban." Fox 2 St. Louis confirmed polling showing support for overturning the 2024 voter-approved abortion amendment.

The 2024 Amendment 3 was one of a series of post-Dobbs state constitutional measures in which voters enshrined abortion access directly into state law; it passed with approximately 52 percent of the vote in Missouri. The new 2026 Amendment 3 would replace it with a provision prohibiting abortion except in cases of medical emergency, fetal anomaly, rape, or incest — with the rape and incest exception limited to abortions before 12 weeks of pregnancy. The polling found that almost 60 percent of Missourians support allowing abortion before the eighth week and 47 percent support access up to the 12th week — suggesting the abortion-specific provisions of the amendment would likely fail if voted on alone.

The bundling of the abortion ban with the transgender care prohibition appears to be the key political calculation. The poll found that 73 percent of respondents oppose gender transition surgeries for minors and 67 percent oppose gender transition medications including puberty blockers and cross-sex hormones for minors. Republicans support the bundled amendment 70 to 18 percent; Democrats oppose it 21 to 67 percent. The Missouri Independent reported that the ban on transgender care "boosts support for outlawing abortion," framing the bundled initiative as a strategy to use the more broadly popular trans care restrictions to carry the more divisive abortion ban over the 50 percent threshold.

Abortion rights advocates and the ACLU of Missouri have criticized the bundling strategy, arguing it conflates two legally and medically distinct issues to make it harder for voters to express nuanced preferences. Slate characterized the approach as "Republicans' new plan to trick people into voting against abortion rights." Anti-abortion advocates and conservative legislators respond that the two provisions reflect a consistent pro-life, pro-family framework — protecting unborn children from abortion and protecting minors from what they characterize as irreversible medical interventions. The November vote will be the first direct test of whether the post-2024 backlash against Missouri's abortion rights amendment, combined with the transgender care issue, can reverse a voter-approved constitutional right for the first time in the post-Dobbs era.