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The vast majority of Americans — 7 in 10 — think that politicians are not informed enough about abortion and gender-affirming care to create fair policies, new polling by The 19th and SurveyMonkey found.

Partisan battles over both issues are expected in races up and down ballots in 2024. Republicans at all levels of government are pushing to restrict access to abortion and gender-affirming care, and the polling indicates that these efforts likely appeal only to the party’s most fervent base voters. GOP White House contenders are already talking abortion and gender identity as they tussle over the nomination, and as the battles to control Congress, statehouses and governors’ mansions take shape, Republican candidates’ early rhetoric about restricting access to abortion and gender-affirming care could become a liability in the general elections.

When asked whether “politicians are informed enough about abortion to create fair policies,” a sizable majority of voters from both parties said they strongly or somewhat disagreed. Seventy-six percent of Democrats disagreed, followed by 68 percent of Republicans and 69 percent of independents. This majority held across men, women and nonbinary Americans, as well as across races and ethnicities. 

When asked the same question about gender-affirming health care for minors, 77 percent of Democrats, 74 percent of Republicans and 69 percent of independents strongly or somewhat disagreed that politicians have enough information to create fair policy. This majority was also consistent across genders, ethnicities and races.

In the year after the Supreme Court overturned Roe v. Wade, ending the federal right to abortion access, Republican politicians at the state level have pressed to restrict abortion. In the race for the 2024 GOP presidential nomination, candidates are staking out their positions on the point in pregnancy at which abortion should be mostly or entirely banned. Republicans in Congress are already strategizing about how to curb the electoral losses they suffered in the 2022 midterms related to abortion restrictions even as other members of their party double down.

Republican elected officials at the state level have also been busy introducing and enacting laws to restrict gender-affirming care for transgender minors. Best-practice medical care for transgender youth is now restricted in 14 states, according to the independent nonprofit Movement Advancement Project. More states have passed restrictions, but some have been put on hold by the courts or not yet taken effect. On the campaign trail, GOP presidential candidates have lashed out at gender-affirming care for minors and the inclusion of transgender youth in sports teams that align with their gender identity.

The GOP’s emphasis on the issue does not appear to align with the views of most Americans, the survey found. Just 17 percent of Americans said politicians should focus on restricting gender-affirming care, while 33 percent said they should focus on protecting transgender people. Forty-four percent said politicians should not focus on transgender issues at all. A majority of Republicans — 58 percent — said “politicians should not focus on transgender issues.”

Democratic candidates, meanwhile, are increasingly tying the fights to protect abortion access and gender-affirming care — both in rhetoric about bodily autonomy and policies like the “shield laws” for medical providers who offer this care. 

Even Americans who oppose gender-affirming health care for minors disagree that politicians have enough information to craft fair policy: 80 percent disagree and just 19 percent agree, with almost no variation by party.

Meanwhile on abortion, a majority of those who say they think abortion should be completely or mostly illegal also don’t think politicians know enough to craft fair policy — 67 percent disagree with the statement “politicians are informed enough about abortion to create fair policies.”

Interviews by The 19th with poll respondents revealed a deep distrust in the electorate related to the creation of policies restricting gender-affirming care for minors even when individuals opposed it on a personal level. 

Gender-affirming care that many transgender and nonbinary people seek as part of their gender transition can include consultations with a primary care doctor, an endocrinologist or therapist; hormone replacement therapy and related monitoring; and surgery. Many respondents who said they oppose gender-affirming care for minors made the distinction in follow-up interviews that they support therapy and other mental health care for transgender youth but had reservations about hormones or surgery, which is very rare for minors. Even still, they didn’t believe politicians know enough to be writing fair policy.  

Marc Haughaboo, 51, a Republican who lives near Anchorage, Alaska, said he is a retired psychologist who worked with some children who identified as trangender. Haughaboo said he believes these children should receive “follow-up and psychiatric help,” but shouldn’t have access to treatment that could have life-long implications. He said he was distrustful that politicians would make informed policies. “They just don't educate themselves,” he said. 

On abortion, Haughaboo his views are more firm: Men politicians should not have input on the issue. “I'm a firm believer, everybody should mind their own business. I think the country would be a much happier place,” he added. 

SurveyMonkey conducted this poll online from August 24 to 31 among a national sample of 20,191 adults, with a modeled error estimate of plus or minus 1 percentage point. 

Kelley Allison, 54, is a Democrat who lives in Richmond, Virginia, a state that does not restrict best-practice medical care but where Republican Gov. Glenn Youngkin recently released guidance for schools that requires transgender students to use bathrooms and participate in sports that do not match with their gender identities. Youngkin also aims to pass a 15-week abortion ban if Republicans do well in this year’s state legislative elections.  

Allison said she somewhat opposes gender-affirming care for minors but also strongly disagrees that politicians have enough information to make fair policy on the issue. “I’m not a doctor, I’m not a psychologist, I’m not a mother, I’m a cis woman, so I don’t know how to answer that question,” Allison said. “I think politicians don’t know enough because they aren’t doctors, they aren’t psychologists and they don’t work with children directly.”

Allison said that after answering the poll she started researching gender-affirming care for minors and was “crestfallen” to discover high suicide rates among transgender youth. “I would much rather it be unrestricted and have them have this surgery and still be alive,” she said.

Kymeicko Williams, a 39-year-old Democrat in the Houston area, said she strongly opposes gender-affirming care for minors but also strongly disagrees that politicians can enact fair policy. She has worked as a juvenile probation officer and a fifth grade math teacher, and worries that minors “don’t have the capacity to make these types of decisions.” 

“I don’t think a 13-year-old is ready to make this type of life decision, but I do think if someone makes a declaration at 13, and then at 18 or 19 they want to change their gender, I have no problem with that. But I feel like the politicians have no understanding,” she said. 

Steve Apfel, a 63-year-old Republican who lives in the Los Angeles area, said he worries that the cost of gender-affirming medical care could be footed by taxpayers. But, he said, he was distrustful that politicians could make nuanced policies. 

“Politicians in general, in my mind, do not get it. They get information from these special interest groups … and that's that,” Apfel said. 

On abortion, he said he is disappointed with how some Republicans are approaching the issue, which he said is “between a woman and God.” Apfel criticized the ongoing blockade of military promotions by Republican Alabama Sen. Tommy Tuberville, founded in his opposition to a Pentagon policy of paying for travel for service members who need to leave their state to get abortion or other reproductive care. 

“This is the type of thing where it's like, OK, politics trumps everything else,” Apfel said.

Clarification: This story has been updated to better reflect the number of states where gender-affirming care is restricted.

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