Missouri’s Catholic bishops have stepped up their campaign for a constitutional amendment that would sharply restrict abortion and prohibit gender transition procedures for minors, as the state prepares to vote on the measure in November.

Voters will consider Amendment 3 on November 3. The proposal would remove the state constitution’s protection for “reproductive freedom” and prohibit abortion, with exceptions for medical emergencies, fetal anomalies, rape and incest. It would also ban gender transition surgeries for minors, as well as the prescription of cross-sex hormones and puberty blockers to them.