By JT Santana | jtwb768
Three days ago, on October 15, a 16-year-old opened fire at Silver Rail Elementary School in Bend, Oregon. A teacher and three children—ages 5, 8, and 11—were killed. A 7-year-old child and another teacher were wounded. The five-year-old became the youngest person killed in a school shooting since Education Week began its current tracking system in 2018. As of October 16, the publication had counted 26 shootings at K–12 schools resulting in injuries or deaths during 2026, leaving 17 people dead and 26 injured. Nine of those killed were children.
At almost the exact same moment, political campaigns across America are spending staggering sums warning voters about another supposed emergency threatening children.
“Sex changes.”
“Sex changes for kids.”
“Childhood sex change surgery.”
“Taxpayer-funded sex changes.”
Surgeons appear on television screens. Operating rooms appear in campaign commercials. Ominous narrators describe Democrats permitting medical procedures on children. The intended message is difficult to miss: Your children are in danger, and the people on the other side of the ballot are responsible.
There is one rather inconvenient problem.
Many of the claims are false, distorted, or based on votes that had little or nothing to do with surgery.
FactCheck.org reported on October 12 that Republican politicians and outside groups had spent more than $100 million on more than 200 television, streaming, and digital advertisements containing the words “sex change” since August 1. More than $77 million of that spending occurred in federal Senate races alone. The ads have appeared in contests from Iowa to Ohio, Texas, Alaska, and Florida.
One hundred million dollars.
Apparently America has located an unlimited campaign budget for an extraordinarily rare medical procedure, much of it already restricted or prohibited by state law.
Meanwhile, children are practicing where to hide from gunfire.
If our political class wants to campaign on “protecting the children,” I have a proposal.
Start with the children who are actually being shot.
Here in Iowa, a Pronoun Vote Somehow Became Surgery
We do not need to travel far to see how the political trick works.
Immediately after Iowa’s June 2 primary, Republican U.S. Senate candidate Ashley Hinson released an advertisement attacking Democratic nominee Josh Turek. The narration accused Turek of supporting children “changing gender without parental consent.” The screen went further: “sex changes for kids.”
And there were surgeons.
Actual footage of people performing surgery appeared behind Turek’s image.
That seems fairly straightforward. If you put “sex changes for kids” on a screen while showing surgeons operating, most viewers will infer that you are talking about surgery.
Except Hinson’s campaign later told PolitiFact that the ad was not referring to gender-affirming surgery.
Well, that is convenient.
Apparently the surgeons were there for ambiance.
Perhaps they wandered into the commercial from an episode of Grey’s Anatomy.
Perhaps someone at the production company searched “totally unrelated medical imagery” and accidentally selected footage of an operating room.
The factual problem went deeper. The primary evidence cited against Turek was his vote against Iowa Senate File 496, a 2023 education law. That provision required schools to notify parents when a student requested an accommodation affirming a gender identity different from school records, including use of another name or pronoun.
It did not authorize gender-affirming medical treatment.
It did not regulate surgery.
It did not create a mechanism for schools to arrange medical procedures.
It concerned school communication with parents.
PolitiFact examined the claim and rated it False. Turek was absent when Iowa lawmakers voted on the separate 2023 legislation prohibiting gender-affirming medical procedures for minors. His campaign has said he opposes gender-affirming surgery for minors.
There is a legitimate debate buried under all that theatrical smoke. Should a school notify parents when a student asks teachers to use another name or pronoun? What should happen when a child fears hostility or abuse at home? How much discretion should educators have? Where should parental authority end and student privacy begin?
Those are hard questions.
None requires an operating room.
Converting a vote about school notification into footage of surgeons is not public education. It is political image-making intended to make a voter mentally leap from pronoun to scalpel before anyone has time to ask what the cited legislation actually did.
Then the campaign says it was never talking about surgery.
Of course.
And the surgeons were presumably there to discuss the weather.
This Is No Longer an Isolated Campaign Gimmick
Iowa is one example of a national strategy.
FactCheck.org reviewed advertisements in competitive Senate contests and found similar distortions. In Ohio, ads attacking Democratic candidate Sherrod Brown claimed that he supports “sex changes for minors.” The evidence included a 2023 interview in which Brown said health-care decisions for children belong among children, parents, families, and doctors rather than politicians. That answer addressed a broad proposal covering medication and surgery; Brown did not say he supported surgery on children.
One Ohio advertisement featured Soren Aldaco, who described receiving hormones as a teenager and later surgery. The wording created the impression that she underwent surgery as a minor without parental consent. She was 19 years old when the surgery occurred. That makes her experience relevant to debates over adolescent gender medicine, informed consent, and medical standards. It does not make an adult surgery a childhood surgery.
Texas supplies another example.
Ads attacking Democratic Senate candidate James Talarico claimed that he supported taxpayer-funded “sex change surgeries on young children.” The cited vote concerned a Texas bill that prohibited a much broader range of gender-affirming care, including medication. Talarico had voted for an amendment that would have narrowed the legislation to prohibit surgery for minors. The amendment failed. He has since publicly stated that he opposes gender-reassignment surgery for minors and would support a national prohibition on such surgery.
That should present a small messaging difficulty when constructing an advertisement saying the man supports surgery on children.
Apparently it does not.
Alaska has seen the same formula. Former U.S. Rep. Mary Peltola has been accused of repeatedly voting against prohibitions on taxpayer-funded “sex changes” for minors. The votes cited involved broader legislation and amendments covering medications, military health programs, abortion policy, and other provisions. Peltola has publicly stated that she does not support gender-reassignment surgery for children.
The recurring structure is remarkably consistent.
Find a complicated vote.
Remove the surrounding provisions.
Translate “gender-affirming care” into “sex change.”
Translate “sex change” into “surgery.”
Add frightening operating-room footage.
Say “kids.”
Run the advertisement until Election Day.
There is the 2026 campaign strategy.
Political consultants have discovered that policy nuance makes terrible television. A surgeon holding an instrument under bright operating lights works much better.
The Medical Reality Is Considerably Less Cinematic
None of this requires pretending that gender-affirming medical care for adolescents does not exist.
It does.
Nor does it require pretending that surgery has never been performed on someone younger than 18.
It has.
Facts remain facts regardless of which political side finds them useful.
The scale of the phenomenon, though, bears little resemblance to the campaign imagery currently flooding televisions and streaming services.
FactCheck.org’s review of the medical evidence found that prepubescent children are not offered gender-transition medications or surgery. Younger children may receive counseling or socially transition through names, pronouns, clothing, or hairstyles. Medical interventions occur later and remain subject to clinical standards and, in most circumstances involving minors, parental consent.
A study of insurance claims involving tens of millions of Americans found no gender-affirming surgical procedures among transgender or gender-diverse children younger than 12. Among adolescents ages 13 to 14, the rate was 0.1 per 100,000. Among those ages 15 to 17, it was 2.1 per 100,000, and procedures among older minors were overwhelmingly chest-related rather than genital surgery.
In February 2026, the American Society of Plastic Surgeons issued a position recommending that gender-related surgical procedures ordinarily occur at age 19 or later, subject to physicians’ clinical judgment. Existing Endocrine Society guidance has long placed surgeries involving removal of reproductive organs at age 18 or older.
People are free to look at those standards and say they remain too permissive.
They may believe no irreversible gender-related surgery should occur before adulthood. They may want tighter rules for hormones or puberty blockers. They may want stronger parental-consent requirements. They may question the evidence supporting particular treatments.
That is politics.
That is medicine.
That is public policy.
What does not qualify as serious debate is showing operating-room footage next to a candidate whose cited offense was opposing a law about whether teachers must tell parents that a student requested another pronoun.
Those are two different things.
Campaigns know it.
Fact-checkers know it.
Anyone who can distinguish a classroom from a hospital should know it too.
Now Compare the Political Theater With the Actual Bloodshed
On October 15, three children went to elementary school in Oregon and never went home.
A five-year-old.
An eight-year-old.
An eleven-year-old.
Their teacher died too.
Another seven-year-old was wounded.
Another teacher was wounded.
Two days later, campaign advertising across the country continued warning voters about “sex changes for kids.”
That juxtaposition is obscene.
It is not obscene to debate gender medicine. It is not obscene to believe minors should not undergo gender-related surgery. It is not obscene to support parental-notification laws. Americans can hold those positions in good faith.
The obscenity lies in the scale of attention given to a politically useful fear compared with the weary familiarity surrounding children getting shot.
Education Week had documented 26 K–12 school shootings resulting in injury or death during 2026 by October 16. Forty-three people had been shot. Seventeen were dead. Nine of those dead were students or other children.
Those numbers need context. Definitions of “school shooting” vary substantially among researchers and news organizations. Education Week uses a relatively narrow standard requiring a firearm to be discharged on K–12 school property or a school bus during school or a school-sponsored event, with someone other than the shooter suffering a gunshot injury. The figure should not be confused with broader databases that include guns displayed or fired without injuries.
Yet nobody disputes that the shootings occurred.
Nobody has to infer them from a vote on pronouns.
Nobody needs creative campaign editing.
There are bodies.
There are hospitals.
There are police investigations.
There are grieving families.
There are classrooms that will never feel quite the same again.
The U.S. Government Accountability Office examined 318 school shootings occurring from the 2009–10 through 2018–19 school years. Shootings arose from disputes, accidents, suicides, domestic incidents, targeted attacks, and other circumstances. About half involved a current or former student. Shootings occurring inside school buildings tended to be deadlier than those occurring outside.
School shootings are still uncommon relative to the tens of millions of children who attend school each day.
So is gender-related surgery among minors.
Here is the critical difference.
Nobody is spending $100 million pretending school shootings happen when they do not.
The Broader Gun Numbers Are Worse
School shootings receive enormous attention, yet they represent a fraction of firearm harm involving American children.
KFF’s March 2026 analysis of CDC mortality data found that 2,228 Americans age 17 or younger died from firearms in 2024. From 2014 through 2024, nearly 22,000 children and adolescents died by firearm. The firearm death rate among Americans 17 and younger increased from 1.8 per 100,000 in 2014 to 3.0 in 2024.
There is some good news in the latest figures. The rate declined from 3.5 per 100,000 in 2023 to 3.0 in 2024. Pretending improvement has not occurred would be dishonest.
The longer trend remains grim.
The number of youth firearm deaths rose 68 percent across the decade examined by KFF. Gun assaults accounted for at least three of every five youth firearm deaths since 2020. In 2024, firearm suicides accounted for another 31 percent.
These deaths do not all present the same policy problem. A teenager murdered in community violence, a child killed accidentally after finding an unsecured handgun, and an adolescent dying by suicide involve different circumstances. Treating every firearm death as one phenomenon produces sloppy policy.
They share something rather fundamental, though.
They happened.
The children existed.
The firearms existed.
The injuries existed.
The death certificates exist.
This is where the campaign contrast becomes so jarring.
More than $100 million has been poured into political advertising invoking “sex changes” since August 1. In many cases, the claims stretch votes on broad legislation into allegations that candidates support surgery on young children. One of the most prominent examples happened right here in Iowa, where a vote about schools, names, pronouns, and parental notification somehow acquired an operating-room soundtrack.
Imagine $100 million worth of political advertising about secure firearm storage.
Imagine candidates trying to outdo one another on reducing youth suicide.
Imagine $100 million in political messaging explaining how children gain access to loaded firearms.
Imagine the same emotional intensity directed at preventing the next elementary-school shooting.
Apparently the market research found that transgender children generate better campaign footage.
“Protect the Children” Has Become a Marketing Department
Political rhetoric involving children has a special quality. Once a politician announces that children are in danger, ordinary standards of skepticism seem to evaporate.
Ask questions and someone accuses you of not caring about children.
Request evidence and somebody tells you the threat is too serious to wait.
Point out an exaggeration and suddenly you are defending the exaggerated behavior itself.
That is how a vote about parental notification becomes “sex changes for kids.”
The phrase itself is brilliantly engineered political language. “Gender-affirming care” sounds clinical and vague. “Sex changes for kids” sounds immediate, physical, irreversible, frightening, and graphic.
Then show a surgeon.
Message delivered.
The technique works by collapsing distinctions.
A pronoun becomes a transition.
A transition becomes medical treatment.
Medical treatment becomes surgery.
Surgery becomes genital surgery.
An adolescent becomes a child.
A vote against a broad bill becomes support for every practice prohibited somewhere inside that bill.
Soon a viewer believes kindergartners are being wheeled into operating rooms under circumstances their parents know nothing about.
Campaign strategists do not need voters to research legislation after dinner.
They need voters angry for thirty seconds.
Gun violence creates a far less convenient political story. Firearms involve constitutional rights, suicide, homicide, domestic violence, accidental death, criminal access, lawful ownership, storage practices, background checks, law enforcement, mental health, community conditions, school security, and an entrenched national gun culture.
There is no single villain.
There is no single solution.
There is no thirty-second advertisement capable of resolving it.
So we increasingly get security theater around one issue and fear theater around another.
One sends politicians to microphones.
The other sends children under desks.
Iowa Voters Should Demand Better Than This
Iowa deserves a serious U.S. Senate campaign.
Ashley Hinson has a record to defend. Josh Turek has a record to defend. There are legitimate disputes over taxes, health care, agriculture, water quality, federal spending, reproductive rights, immigration, education, foreign policy, gun rights, LGBTQ policy, and the future direction of the country.
Ask them about those things.
Ask Turek what limits he supports on medical interventions involving transgender minors.
Ask Hinson what federal role she believes exists in regulating those treatments.
Ask both candidates what they would do about youth firearm deaths.
Ask them about school security.
Ask them about suicide.
Ask them about firearm access by minors.
Ask them what federal legislation they would support after the next school shooting.
Ask them what evidence would persuade them to change course.
Those questions require candidates to govern rather than advertise.
I am far less interested in seeing a surgeon inserted into a campaign commercial about pronouns.
Hinson’s ad is particularly revealing precisely since the underlying disagreement was real. Turek opposed the 2023 Iowa education bill containing the parental-notification requirement. Hinson supports that requirement. Great. Campaign on it.
Tell voters exactly what the law required.
Tell voters why you believe Turek was wrong.
Let him explain his vote.
Let voters decide.
There was no need to transform it into “sex changes for kids.”
There was certainly no need to place surgeons on the screen and then explain afterward that the campaign was not talking about surgery.
That is not clarity.
That is misdirection with good lighting.
If We Are Going to “Protect the Children,” Let Us Mean It
I am tired of watching “the children” appear in American politics mainly when somebody needs a weapon for a culture war.
Children deserve protection from inappropriate medical treatment.
They deserve protection from medical neglect.
They deserve protection from abuse.
They deserve protection from exploitation.
They deserve protection from bullying.
Transgender children belong in every one of those sentences.
They deserve protection from bullets too.
That last statement should not require ideological qualification.
No one has to surrender the Second Amendment to admit that 2,228 firearm deaths among Americans age 17 and younger in a single year is a serious national problem. No one has to support every gun-control proposal ever introduced. No one has to pretend a single statute would prevent every murder, suicide, accidental discharge, or school attack.
We could at least display the same level of political urgency.
Yet here we are, weeks from the 2026 midterms, with more than $100 million in advertising containing the words “sex change.” Candidates are being accused of supporting surgeries they say they oppose. Votes on broad legislation are being converted into surgical endorsements. In Iowa, a disagreement about school notification was presented beside footage from an operating room.
Then, on October 15, a five-year-old, an eight-year-old, an eleven-year-old, and their teacher were killed at an elementary school.
No campaign consultant had to manufacture that threat.
No narrator had to exaggerate it.
No misleading footage was necessary.
The operating room in the political ad was imagery.
The emergency room treating a gunshot victim is real.
Perhaps that should tell us something about where our priorities have gone badly wrong.
If politicians genuinely want to spend the closing weeks of this election telling me how desperately they want to protect children, fine.
I am listening.
Just spare me the fictional operating room long enough to explain what you plan to do about the gunfire.
References
FactCheck.org. (2026, October 12). Republican ads distort the facts in claiming Democratic support for “sex changes” for kids.
McCullough, C. (2026, June 5). In Iowa Senate race, Hinson ad distorts Turek’s stance on gender-affirming care for minors. PolitiFact.
Panchal, N. (2026, March 12). Child and adolescent firearm deaths: National trends and variation by demographics and states. KFF.
U.S. Government Accountability Office. (2020). K–12 education: Characteristics of school shootings (GAO-20-455).
Education Week. (2026, October 16). School shootings this year: How many and where.
