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HealthPublished by NPR Health • 10/29/2026, 9:00:00 AMOpen Original Report (NPR Health) ↗

Ahead of midterms, Missourians defend transgender healthcare

A campaign to defend transgender healthcare for young people in Missouri is taking an unhurried approach by talking with voters about the latest attempt to permanently ban gender-affirming care for minors in the state.

Ahead of midterms, Missourians defend transgender healthcare
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A campaign to defend transgender healthcare for young people in Missouri is taking an unhurried approach by talking with voters about the latest attempt to permanently ban gender-affirming care for minors in the state.

CREVE COEUR, Mo. — Reneé Luckfield tries not to knock like a cop.

In fact, the 29-year-old spends a lot of time thinking about how to make strangers comfortable when she shows up at their door to talk about transgender healthcare. A syncopated "tap — tap-tap-tap" sounds friendly even when she knocks loudly. In each encounter, she masks her own unease.

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"Honestly, it's not something that I'm entirely comfortable with," Luckfield, a transgender woman, said while walking door to door in this affluent St. Louis suburb. "And it's not fair that we have to do this work."

Transgender issues have become a major theme in this year's midterm elections, especially in Missouri, where voters are weighing a proposed constitutional amendment to bar minors from gender-transition surgery, cross-sex hormone therapy and puberty blockers. The potential ban is part of a proposed amendment to reinstate a near-total ban on abortion in the state.

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Voters in four other states will also decide on transgender issues this year: a proposed ban on transgender health care for minors in Colorado, and proposed restrictions on transgender athletes in youth sports in Arizona, Colorado, Nebraska and Washington.

Luckfield is part of an effort by the LGBTQ+ advocacy organization PROMO Missouri to defeat the Missouri measure by knocking on 100,000 doors across five of the state's largest metro areas before the election — an ambitious target the group is trying to reach with a mixture of full-time canvassers like Luckfield, the St. Louis lead, and volunteers who show up on weekends. About one out of every 10 knocks turns into a conversation, and they're aiming to have 10,000 conversations before Election Day. The group celebrated reaching 6,000 in early October, but the process is slow going, intentionally, as canvassers aim for open-ended, "transformative" conversations with potential voters.

The technique, "deep canvassing,"…

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