Former President Donald Trump has given the issue oxygen in the election’s closing weeks. At a women-focused town hall on Wednesday, he promised to ban biological males from competing in girls sports through executive action.

Meanwhile, his campaign and allied groups have flooded the airwaves with an ad highlighting Vice President Kamala Harris’s past support for sex reassignment surgeries for prison inmates.

“Kamala’s for they/them. President Trump is for you,” a narrator says in one version of the ad.

The commercials, running in swing states from Pennsylvania to Michigan, have catapulted the issue to the political forefront as Trump rests his hopes of a second term in the White House on his ability to paint Harris as extreme.

The emphasis is not limited to the presidential race, however. Republicans, guided by focus groups and internal polling, are spending on the issue down-ballot, too, viewing transgender politics as a way to motivate their base while appealing to soft Democrats.

Since Labor Day, the Senate Leadership Fund, an outside group linked to Minority Leader Mitch McConnell (R-KY), has mentioned the subject in all of its ads targeting Sen. Sherrod Brown (D-OH), one of the most endangered Senate Democrats.

The attacks have become so persistent that national Democrats released an ad clarifying that Brown views transgender participation in sports as a decision for individual leagues, not the government.

In Arizona, the campaign of Republican Kari Lake has seized on her Democratic opponent being named a “trans equality champion.” The LGBT advocacy group that announced the award earlier this month counted most House Democrats on its list.

“Ruben Gallego is too far left to be our senator,” reads one campaign text Lake sent voters on Thursday.

This cycle is hardly the first time transgender politics has been a factor in high-profile races. The flashpoint dates back to the “bathroom bills” of a decade ago when Republican Gov. Pat McCrory lost his reelection bid in North Carolina after signing the first state law limiting transgender bathroom use.

Before that, Republicans used voter sentiment against gay marriage as a political wedge. In President George W. Bush’s successful reelection campaign, they engineered a number of ballot measures that were credited with boosting turnout.

Yet Jon Schweppe, the policy director for the socially conservative American Principles Project, has never seen this scale of investment in the culture wars. All told, Republicans have poured more than $65 million into television ads on transgender politics since August, according to one analysis.

“That, to me, is the biggest change this cycle: That the consultant class seems to get it now in a way they didn’t previously,” Schweppe said. “And I think that’s going to be a big win for the party.”

The investment is reminiscent of Democrats’ focus on abortion in the months after the Supreme Court overturned Roe v. Wade, a ruling that weighed down Republicans’ performance in the midterm elections. Democratic spending on the issue eclipsed $100 million in 2022 and could once again this year.

But unlike abortion access, transgender politics does not rank in the top 10 of voter concerns.

“This is trying to inflame people who have very strong negative feelings about people who are transgender,” said Daniel Fee, a Democratic strategist in Pennsylvania who questioned its crossover appeal.

Harris echoed that sentiment in a Wednesday interview with Fox News. Asked for the first time about her support for sex reassignment surgery in prisons, she called the topic “really quite remote” compared to the big ticket issues that will drive the election. 

But her answer to Fox’s Bret Baier, in which she tempered her support before pivoting to attack Trump, suggests her campaign sees the issue as a liability.

“I will follow the law. And it’s a law that Donald Trump actually followed,” she said, citing the hormone therapy the Trump administration provided to a small number of inmates through its Bureau of Prisons.

The first surgery for a transgender inmate did not occur until 2022, under President Joe Biden.

There is anecdotal evidence the issue has appeal beyond cultural conservatives. Schweppe’s organization conducted focus groups after the midterm elections that found even liberal women uncomfortable with the idea of biological males in women’s sports.

His group’s findings generally track with polling that shows majority opposition to, among other things, puberty blockers for minors.

Still, it’s not clear Republicans can peel away Democratic votes when the economy and immigration are ranked as more pressing issues in the minds of voters.

One voter, a retiree from Roxborough, told the Washington Examiner at Harris’s August rally in Philadelphia that he would be voting Democratic despite his opposition to biological males competing in women’s sports.

If nothing else, Republicans are counting on the issue to help motivate their base. In Arizona, “boys in girls locker rooms” yard signs can be seen around North Scottsdale for a local school race, while attendees at GOP events this month named the issue repeatedly.  

“We don’t want boys playing in girls sports,” said Phillip Davis, a 42-year-old subcontractor in Prescott Valley. “It’s one of my top issues – there’s a lot – immigration and taxes,” he added, explaining he has supported Trump twice and plans to do so again.

“I’m against encouraging all these surgeries,” said Crystal Tyler, an emergency room nurse who lives outside of Tucson. “Children should not be included in that.”

Transgender surgeries are rare in federal prisons. So far, there have been only two instances of operations being compelled by court order. As for sports, transgender participation is uncommon despite high-profile episodes.

Lia Thomas, who broke school records on the University of Pennsylvania swim team, is one of several transgender athletes who have fueled a national debate over fairness versus inclusion.

The debate could nonetheless have impacts that extend beyond political discourse. While in office, Trump raised the standard for transgender inmates to receive medical intervention. Biden then reversed the rules upon taking office.

The issue has forced a pivot to the right among Democrats in red states. Rep. Colin Allred (D-TX), who is challenging Sen. Ted Cruz (R-TX) in Texas, voted against a 2023 bill that would have barred transgender participation in women’s sports.

These are the ads airing across Texas. @tedcruz‘s campaign has been pouring resources into attack ads that focus on transgender participation in youth sports. @ColinAllredTX responded to the ads with one of his own: pic.twitter.com/gg3JtopWd6

— Samantha-Jo Roth (@SamanthaJoRoth) October 17, 2024

But in his Senate race, he joined Brown in striking a more conservative tone. Last week, he released an ad opposing their participation, calling it a matter of his Christian faith.