These state supreme court races could decide abortion access and trans rights

In the heated news coverage of what’s at stake in the 2026 midterms, state supreme court races are drawing relatively little attention. Yet these are highly significant elections.

Thirty-one states are holding supreme court elections in 2026, with voters nationwide picking judges to fill more than 60 open seats.

As a law professor whose research and writing focuses on reproductive health, I’m watching these races closely. That’s because in the coming years these courts will have the final word on many consequential legal fights around abortion and trans healthcare.

When the U.S. Supreme Court overturned Roe v. Wade in 2022, ending a half-century of federal constitutional protection for abortion, it handed this major issue back to the states. As a result, in addition to prompting ballot initiatives, the court’s decision in Dobbs v. Jackson Women’s Health Organization has also spurred litigation in state courts.

These cases ask judges to discern, for example, whether state constitutions create a right to abortion – or, at least, prohibit restrictions on abortion access.

Moreover, in weighing the legality of abortion bans, state judges must determine specific issues of abortion access. Idaho’s high court recently approved Republican officials’ rewritten wording for a ballot initiative that would repeal the state’s abortion ban; advocates for the initiative argue that the language misrepresents Idaho’s abortion law.

In Indiana, the state Supreme Court recently heard arguments over whether a religious freedom law creates an exception to the state’s near-total abortion ban. The plaintiffs in that case argued that their faiths allowed or required the procedure in circumstances the ban currently forbids.

Increasingly, the U.S. Supreme Court has been handing questions concerning transgender rights back to states, too.

In June 2025, the Supreme Court ruled 6-3 in United States v. Skrmetti that Tennessee’s ban on puberty blockers and hormone therapy for transgender minors does not count as sex discrimination under the U.S. Constitution. Consequently, that and similar bans only need to pass the lowest level of judicial review; they no longer have to pass the higher bar of “strict scrutiny.”

This means lower courts can essentially rubber-stamp the bans that state legislatures have passed. In fact, the Skrmetti decision cleared the way for the roughly two dozen states with similar bans to keep enforcing them.

Skrmetti did not, however, require any state to pass such a law. And it does not address how far the ruling extends to adults or whether it applies to other related aspects of gender-affirming care, such as insurance coverage.

In other words, the people who now decide whether abortion restrictions stay on the books or whether a minor can get gender-affirming care are, in many cases, not justices sitting on the U.S. Supreme Court. In many cases, they will be state supreme court judges.

In Montana, judicial races could change the ideological bent of the state’s top court. Judicial elections in the state are technically nonpartisan, but Republicans see a chance to retake the state Supreme Court with judges they endorse.

In 2023, its Democrat-endorsed majority ruled that the state constitution protects abortion rights. It also determined that attempts to stop one class of health providers – advanced practice registered nurses – from performing abortions violated those rights.

Judges who upheld restrictions affecting residents’ reproductive rights will face voters this fall in Alabama, Arizona, Florida, North Dakota, Oklahoma and Texas. In some of these races, abortion is a live – and legally dynamic – issue.

North Carolina’s high court also leans heavily conservative. This year one of just two Democrats on the seven-judge panel – incumbent Democrat Anita Earls – is up for reelection. If she loses, the GOP would gain a near-total supermajority on North Carolina’s Supreme Court. That outcome would likely cement the party’s edge on key political matters for years to come.

Michigan looks like the mirror image of North Carolina. All justices there are officially nonpartisan, but Democrat-backed justices hold a 6-1 majority on the seven-member court. Chief Justice Megan Cavanagh and Justice Noah Hood – both Democrats – are up for reelection this fall.

Democrats are hoping to retain their edge, in part to keep abortion protected. Voters enshrined abortion rights directly into Michigan’s Constitution in 2022, and the state’s highest court has already interpreted that amendment to dismiss abortion-related restrictions.

Ohio is a powerful example of what is at stake in this year’s state supreme court races. Republicans hold a 6-1 majority on the state’s high court, a dominant position built over successive election cycles in 2022 and 2024.

In the 2026 midterms, Ohio’s only Democratic state Supreme Court justice, Jennifer Brunner, is defending her seat against a Republican challenger. If Brunner loses, Ohio’s highest court could become a unanimous conservative bench – one that will likely determine the outcome of high-profile cases related to both abortion access and gender-affirming care.

Ohio voters approved a constitutional amendment in 2023 protecting abortion access. The amendment establishes that individuals have the right to make their own reproductive decisions. The language covers contraception, fertility treatment, continuing a pregnancy, miscarriage care and abortion up to fetal viability. It also asserts that the state generally cannot interfere with these decisions.

Now, lower courts are litigating whether restrictions on abortion access – for instance, the state’s 24-hour waiting period and ban on telehealth for medication abortion – can survive scrutiny under that amendment.

The Ohio Supreme Court may eventually decide that case. In my assessment, an even more conservative Ohio court might be inclined to read the voter-approved abortion amendment as narrowly as possible.

Ohio’s Supreme Court is similarly poised to make big decisions on trans rights. For example, it could uphold the state’s ban on gender-affirming care for transgender minors. That would reverse a 2025 appellate ruling that had struck down the law, which was passed over the veto of Republican Gov. Mike DeWine.

Even if they don’t change the partisan makeup of these courts, elections for state supreme court seats in places such as Ohio may matter for the scope and breadth of rulings that claw back individual rights. Or they may foretell how a conservative near-supermajority might lock in abortion and trans restrictions for a generation.

Whoever wins these judicial races in November will not just be interpreting the law. In a real sense, they will be writing the next chapter of it.

This story was produced in collaboration with Rewire News Group, a nonprofit newsroom that covers reproductive health.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Rachel Rebouché, The University of Texas at Austin

Rachel Rebouché does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.