Maryland voters will decide whether to enshrine access to reproductive health care in the state constitution this November.

If approved by voters, Question 1 will amend Maryland’s constitution to guarantee “every person … the fundamental right to reproductive freedom,” including the ability to “prevent, continue or end one’s own pregnancy” without interference from the state.

Though the word “abortion” is not explicitly used in the question, it is an implied protection under the right to end a pregnancy.

The ballot initiative was originally put forth by Maryland House Speaker Adrienne A. Jones, a Baltimore County Democrat, in 2022 in advance of the U.S. Supreme Court decision that overturned the landmark decision in Roe v. Wade. It passed out of the House chamber that year, but was tabled when it reached the Senate.

The initiative was revived in 2023, when it passed both chambers largely along party lines. Gov. Wes Moore, a Democrat, signed the bill that May, signaling his support for the measure.

Abortion has been a major talking point this election cycle, with Democratic U.S. Senate nominee Angela Alsobrooks alleging that her opponent, Larry Hogan, a Republican, could be the vote that enforces a federal abortion ban if he is elected. Hogan, who had vetoed abortion access bills during his gubernatorial administration, publicly came out in favor of abortion access earlier this year.

In 1991, the General Assembly passed legislation allowing abortions to be performed in Maryland until a fetus reaches viability, considered to be at about 24 weeks. After that, patients may receive abortion care only to protect their health or in the case of a fetal anomaly. This law was codified through a 1992 ballot referendum.

Because federal law takes precedence over state policy, Maryland physicians would be limited or unable to provide abortion care if Congress passed a national restriction on its access.

Some voters are concerned that the ballot measure would restrict parental control over their children’s health care, and would allow them to seek gender-affirming care without parental knowledge or consent.

Retired Baltimore City District Court Judge Katie Curran O’Malley, the chief executive officer of the Women’s Law Center of Maryland, told The Baltimore Sun in an interview Thursday that the argument is “absurd” and is being used to “bastardize” what the amendment actually does.

“None of that’s true,” O’Malley said. “These arguments are being used to scare people.”

Under state law, minors have the ability to seek out and consent to medical treatment or advice related to HIV prevention, sexually transmitted infections, drug and alcohol abuse, contraception and pregnancy.

They can also consent to a physical examination following alleged rape or sexual assault without permission from their parent or guardian.

Children aged 12 and up can seek out and consent to mental health care services without their parents. However, children under 16 are unable to consent to the use of medication to treat a mental health disorder.

Minors can consent to any medical treatment if they are married, have a child of their own or live separately from their parents and are able to support themselves.

“Surgical gender transitioning is not included in either the amendment” or in existing parental consent law, O’Malley said.

The ballot question, which does not mention the right to gender-affirming care, does not seek to alter existing parental medical consent or abortion laws.

“That every person, as a central component of an individual’s rights to liberty and equality, has the fundamental right to reproductive freedom, including but not limited to the ability to make and effectuate decisions to prevent, continue, or end one’s pregnancy,” the ballot question states. “The state may not, directly or indirectly, deny, burden, or abridge the right unless justified by a compelling state interest achieved by the least restrictive means.”

“It has nothing to do with sexual transition,” O’Malley said of the ballot question. “That’s a completely different thing. Having an abortion and being a transgender person are two different things.”

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