President Donald Trump’s approval rating has plummeted. The Republican-controlled Congress, which reached “new lows for productivity,” is also historically unpopular. An April Gallup poll found that Americans’ disapproval of Congress hit 86%, “tying the record high for the institution.” As the midterm elections approach, the GOP finds itself defending seats in deep red states.
But Republicans do have one thing in their corner: the world’s richest person, Elon Musk.
After a falling out with Trump and the Republican Party last year, Musk has begun financially supporting Republicans again through his super PAC, America PAC. The New York Times reported in July that Musk “authorized his super PAC to spend $100 million to $120 million” to boost Republicans in the midterms.
How is Musk spending his ad dollars? He is playing the hits.
Across the country, Musk’s America PAC is spending money on advertising attacking Democrats for purportedly supporting “taxpayer-funded sex change surgeries on kids.” But gender-affirming surgeries are extremely rare for minors in the United States. A 2024 study by Harvard researchers “found little to no utilization of gender-affirming surgeries by transgender and gender-diverse (TGD) minors in the U.S.” And transgender youths themselves make up a very small part of the population.
Research has shown that gender-affirming care can be beneficial for the mental health of transgender youths and can save lives. But this care centers around supporting the children, not surgery.
Musk has spent years attacking trans people. Musk has an estranged transgender daughter, whom he has described as “dead, killed by the woke mind virus.” (In 2022, in a California court filing to change her name, Musk’s daughter wrote, “I no longer live with or wish to be related to my biological father in any way, shape or form.”)
Across Texas, Ohio, Michigan, Iowa, and Alaska, Musk’s America PAC spent about $1 million on these ads between September 5 and 21. America PAC has spent the majority of this money attacking Texas Democratic Senate candidate James Talarico, spending over $500,000 in Texas.
But the claims in the ads are not true. None of the candidates being attacked by Musk’s super PAC actually support these surgeries for minors.
America PAC’s ads attacking Talarico reference a Fox News article from March 2026 which states, “[Talarico] also voted against a bill to ban sex change surgeries for children.” (The Fox News article never mentions taxpayer funding.)
The underlying bill, Texas SB 14, which Talarico voted against in 2023 as a state representative, not only banned surgery for minors, but other gender-affirming care. Talarico called the bill “overly broad” and instead supported an amendment to the bill that would have only banned surgery. (State Medicaid funding for “sex change operations” was already prohibited in Texas, including for adults, before SB 14 was passed.)
Earlier this month, Talarico said in an interview with Fox News that he does not support gender-affirming surgeries for minors. When asked if he would support a nationwide ban on such surgeries, Talarico said, “Absolutely.”
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America PAC’s ads about Sherrod Brown, the Democratic nominee for U.S. Senate in Ohio, cite a 2023 interview in which Brown was asked about a bill sponsored by then-Senator JD Vance (R-OH) that would have made it a felony to provide surgery or other gender-affirming care to trans minors.
Brown said, “A child’s health care decisions are between them, their parents, their families and their doctors.” He did not offer support for “taxpayer-funded sex changes on children” as the ads claim.
Vance’s bill was referred to committee and never received a vote.
In its ads attacking Josh Turek, an Iowa state representative running for Senate, America PAC cites his 2025 vote against Iowa House File 1049, a bill funding the state’s health and veterans departments. There was a provision in the bill that stated state Medicaid money “shall not be used for reimbursement for sex reassignment surgery or associated procedures.” It was a blanket ban, with no mention of minors.
At the time of this vote, such surgeries for children were already banned outright in Iowa. (Turek was absent from the Iowa House when the ban was passed in 2023.) So his vote against the 2025 budget bill had absolutely no impact on “taxpayer-funded sex changes for children,” which were not occurring anyway.
In June, a spokesperson for Turek told PolitiFact that he does not support surgeries for trans minors.
America PAC’s ad about Abdul El-Sayed, the Democratic nominee for U.S. Senate in Michigan, is deceptive. It features clips of a viral exchange between El-Sayed and Fox News host Jesse Watters in which Watters asks El-Sayed if he supports surgeries for trans minors. It splices in this response from: “Do you really want to have this conversation? Are you circumcised?… You probably should want to move on.”
The ad takes El-Sayed’s “move on” line out of context. It says, “Abdul El Sayed supports sex changes for minors and tells parents they should move on.” He was addressing Watters, not parents.
In the interview, El-Sayed said, “I just think the government shouldn’t tell you what kind of healthcare you should have,” adding, “I’m not advocating anything.”
El-Sayed made similar statements at a recent campaign event. “The decision about what healthcare is necessary ought to be held between a patient — and or their parents if they’re under the age of 18 — and their doctor,” El-Sayed said. “That’s it.”
America PAC claims that Mary Peltola, a former Alaska representative running for Senate, supports taxpayer-funded gender-affirming surgeries (without specifying such surgeries for minors).
To support its claim, America PAC points to a vote Peltola took in 2024 against an amendment to a defense policy bill. The amendment barred dependent minors of service members from getting most gender-affirming care through the Exceptional Family Member Program (EFMP).
EFMP is a program meant to provide support to military families coordinating care for family members with special needs. The EFMP program, however, never provided surgeries for trans people because the program does not provide any medical procedures. That is provided through TRICARE, which does not fund such surgeries. Peltola never voted for anything that would have provided taxpayer funding for “gender transition surgeries.”
The amendment was not included in the final version of the law. Peltola ultimately voted to pass the bill, which included other restrictions on gender-affirming care for minors.
