For Kelsey Gellner, a Seattle-based pediatric nurse, a statewide proposal to bar trans girls from sports participation feels like a violation of her duty as a medical professional. The ballot initiative includes a requirement she calls “invasive and extreme”: all students who wish to compete on girls’ teams would have to undergo genital exams.

“I tell my kids and patients that my No 1 job is to keep them safe,” said Gellner, who is also a board member of the Washington State Nurses Association. “I can say with confidence that girls do not want to have an unnecessary exam that creates an unsafe barrier.”