Reproductive rights have emerged as one of the most important issues this election, and millions of voters in 10 states will decide on ballot measures that would enshrine abortion rights in their constitutions.

In Hail-Mary attempts to defeat these amendments in Missouri, Maryland and New York, where they seem likely to pass, conservative groups are falsely claiming that pro-choice ballot measures are really efforts to perform gender-affirming surgeries on minors without parental consent.

At the Moms for Liberty annual summit in August, former President Donald Trump claimed children were getting gender reassignment surgeries at schools. There is no truth to the comment, but it plays into Republican fearmongering about trans people — and especially trans youth — that has ramped up over the last few years. The Trump campaign has spent $20 million on anti-trans ads despite polling showing that it’s not a major concern for the American public.

Some conservative organizations seem to hope that sparking fears about children getting surgeries without parental consent will sink ballot measures that are actually about abortion rights, an issue that generally enjoys broad support on both sides of the political aisle.

In Missouri, voters will decide on Amendment 3, which would protect the right to an abortion in the state, effectively reversing the current ban that’s in place.

The Thomas More Society, a Catholic legal organization that recently sued to keep Amendment 3 off the ballot and lost, claims in its voter guide that the amendment pertains to “gender transition treatments and surgeries,” including for minors.

“I would love to hear a credible argument that replacing one’s reproductive organs is not a matter relating to reproductive health care,” Mary Catherine Martin, a lawyer for the group, told the Missouri Independent. “Because that’s the only way it’s not covered by this.”

Advocates and legal experts have said the amendment has nothing to do with gender-affirming care for minors. (Missouri banned gender-affirming care for minors last year.)

“It’s so absurd and has nothing to do with reproductive health care,” Marilyn McLeod, the president of the League of Women Voters of Missouri, told HuffPost. “It’s all misinformation.” The group supports the measure and has released infographics to combat the misinformation surrounding the amendment.

But even in states where abortion remains legal and reproductive advocates are looking to expand those rights further, anti-choice activists have been muddying the waters with outlandish claims about trans youth and parental rights.

In Maryland, the reproductive choice amendment is Question 1. It would amend the state constitution to include the right to reproductive freedom, which further cements the right to an abortion in the reliably blue state. The measure is likely to pass.

But still, Health Not Harm, a committee made up of parents, medical professionals and faith leaders, is sending text messages that claim voting “yes” would allow minors to get gender-affirming surgeries without parental consent.

“VOTE NO on deceptive MD Question 1. ‘Reproductive Freedom’ = gender transitions on kids without parent consent!” read one text message signed by the group.

The group’s website has similar language about voting no on the measure to protect children from gender transitions.

Under Maryland law, minors do not need parental permission to get an abortion. Health Not Harm claims the same would be true for minors seeking gender-affirming care, although legal counsel for the Maryland state legislature has stated clearly that it would not.

“This has nothing to do with that,” Katie O’Malley, the executive director of the Women’s Law Center of Maryland, told a Baltimore ABC affiliate. “This language is all about reproductive health care. Trans women and men need reproductive health care and this will protect their rights, but it doesn’t enshrine gender-affirming care in the state constitution.”

Voters are hearing similar claims in another blue state. New York is preparing to consider Proposition 1 — a state-level version of the Equal Rights Amendment, anti-discriminatory legislation that has been stalled in Congress for decades. New York’s Prop 1 expands already-existing statutes that ban discrimination based on race and religion to include sex, gender identity and pregnancy status.

Coalition to Protect Kids, a right-wing group in the state, is spreading rumors that voting “yes” would harm children and women, and would allow doctors to perform gender-affirming surgeries on children without parental consent.

“We love our kids and we should protect our kids,” the group said on its Facebook page. “Transitioning is an adult decision. Minors should not be transitioning and definitely without a parents [sic] knowledge or consent.”

It doesn’t appear that New Yorkers are buying into the false claims in large numbers. Support for Prop 1 is at 69%, according to an October Siena Research Institute poll.

Despite the effort from anti-choice groups to conflate lies about transgender youth and abortion rights, support for abortion nationwide is at record highs. But even if the anti-choice groups aren’t successful in defeating abortion measures with misinformation, the effort itself is damaging to the electoral process.

“If someone is told things that misconstrue what’s on the ballot, that’s a disservice,” McLeod said. “Our democracy depends on good information.”