The 2026 midterms could shape LGBTQ+ rights, access to gender-affirming care and federal policy. Trans Americans and advocates weigh the stakes.
By: Christine Nicco/TRT Reporter—
For Ellie Spoering, the political debate over transgender rights is not abstract. It reaches into her closest relationships and her sense of safety.
“Like all trans people in the U.S. right now, the relentless attacks, both through real action and through political messaging, have had a profound impact on my own health and wellbeing,” Spoering, a trans woman, told LGBTQ Nation this month. “I don’t have any trans friends who are not feeling the impact of these attacks, especially my friends in red states. We are feeling increasingly isolated, depressed, and unsafe.”
Her account comes as the Trump administration and courts have reshaped policy on transgender health care and participation in school sports. The outcomes of the November midterms could determine how much room Congress has to respond.
The administration finalized a rule barring federal Medicare, Medicaid and Children’s Health Insurance Program funding from covering gender-affirming care for minors, according to LGBTQ Nation’s report on the policy. Separately, Vice President JD Vance asked the Justice Department and the Health and Human Services inspector general to investigate hospitals and clinics over alleged improper billing for transgender care, LGBTQ Nation reported. Critics say the inquiry could deter providers from offering care that remains legally available.
In June, the Supreme Court upheld state laws barring transgender girls and women from school sports teams consistent with their gender identity in cases from West Virginia and Idaho. The decision followed the court’s 2025 ruling in United States v. Skrmetti, which upheld Tennessee’s restrictions on certain gender-affirming medical treatments for minors. The Trevor Project says 27 states have laws banning transgender students from school sports.
For LGBTQ+ advocates, the legal shifts make elections more consequential. But they do not guarantee a quick reversal.
Kelley Robinson, president of the Human Rights Campaign, has warned that a failure to flip Congress could set LGBTQ+ rights back “generations.” In an interview with Politico, Robinson called the election a “reality-check” and said it was critical to put a check on the Trump administration. HRC says it is investing $15 million in its 2026 electoral effort, including work in eight targeted House districts, and supporting Senate races in several states.
In July, Robinson said HRC was adding experienced staff to strengthen its work on policy, politics and coalition building. The hires, she said, would help the group “defend our community, expand equality, and build the power needed to create lasting change,” according to the organization’s announcement.
Democrats and redistricting
Polling offers Democrats some reason for optimism, though the measures vary by poll and date. In early September, the Silver Bulletin generic-ballot average put Democrats ahead by about seven points, with its likely-voter adjustment widening the margin. A Focaldata-Financial Times poll, conducted from Aug. 28 to Sept. 2, found Democrats leading by seven points among likely voters and reported that President Donald Trump’s approval rating had fallen to a low in the poll’s tracking.
The national numbers do not tell the whole story. A mid-decade redistricting fight has altered the map, and Republicans are likely to benefit from changes in several states, Newsweek reported. That could make it harder for Democrats to translate a national polling lead into control of the House.
Spoering, meanwhile, is not counting on the election to change her circumstances soon.
“I don’t see the midterm elections as having much impact on these threats, unfortunately,” she told LGBTQ Nation. “And in the short term, seeing the increase in attack ads and violent rhetoric from the GOP has been making things much worse, and will continue to do so at least up until election day.”
She said she is moving quickly to seek top surgery through the Affordable Care Act while her coverage remains in place. “I feel like, at the moment, that if I don’t do this now, I may never get the chance again.”
A Democratic House majority could bring new oversight and affect which legislation advances, though any response would depend on election results and action by Congress. If Democrats retake the House, Minority Leader Hakeem Jeffries could become the first elected Black speaker, a change that would carry historic significance as well as influence over the chamber’s agenda.
Robinson has urged supporters not to give up on organizing. “We are not without hope and we are certainly not without power,” she has said. “It’s time that we own that power.”
For Spoering and other trans Americans, the campaign is playing out against immediate questions about health care, safety and belonging. The election is weeks away. What happens next will depend not only on who votes, but on what the people they elect choose to do.
