Five-second answer

Claim we investigated

I-638 won’t create opportunities for girls but it will force them into invasive sex verification exams in order to participate in sports.

Misleading. Every girl entering girls' sports would need a provider's sex verification, but the text requires no invasive exam. The filed text and the Attorney General's explanatory statement require a provider-signed sex verification for every student entering girls' competition, based on any one of anatomy, genetics or testosterone, so the step is new and mandatory but no invasive exam is; current sports-physical forms and WIAA rules confirm the step would be new.

Quote or cite this fact-check

FactHub rates the claim “I-638 won’t create opportunities for girls but it will force them into invasive sex verification exams in order to participate in sports” Misleading (high confidence): Every girl entering girls' sports would need a provider's sex verification, but the text requires no invasive exam. Reviewed October 23, 2026. https://facthub.org/n/article/wa-i638-officials-exam-claims/3

One-minute summary

What the evidence establishes

  • Established. Every student entering girls' individual or team competition would need a statement signed by her personal health care provider verifying her biological sex, as part of the sports physical. The officials are right that this is mandatory.
  • Established. The step would be new: today's standard sports-physical exam form has no sex item, and the WIAA says participation does not now require a doctor's sign-off on birth sex.
  • Established. Boys, and students on boys' or open teams, would not need verification, as the officials and the No campaign say.
  • Established. The provider may rely on any one of reproductive anatomy, genetic makeup or testosterone levels, so a girl can be verified without any genital examination. No invasive exam is required.
  • Established. WIAA physicals are valid for 24 months unless a district is stricter, so verification would recur at least every two years, as Sen. Murray and the No campaign say.
  • Not shown. Whether most girls would end up with an anatomy check, because genetic and hormone tests may not be covered by insurance, is unknown until implementing guidance is written.
  • Established. The No campaign's website says the measure bars transgender girls from 'any teams at any level'; the text covers only female-only competition.
  • Context. Nurses, family physicians, the PTA and the state's domestic and sexual violence coalition oppose the measure; the state and national pediatric academies have taken no public side.
Important context: Initiative IL26-638 is on Washington's November 3, 2026 ballot. It would bar students it defines as biologically male from female-only interscholastic competition, and require every student entering that competition to bring a statement from her personal health care provider verifying her biological sex. On September 29, 2026, the No campaign released statements from Gov. Bob Ferguson and Sen. Patty Murray; Rep. Pramila Jayapal spoke at the campaign's June 17 kickoff. This check rates the factual part of the governor's statement as the lead claim, rates the other officials' and the No campaign's exam claims as objections, and does not judge whether the policy is wise, fair or lawful. FactHub takes no position on I-638.

The evidence

The conclusion rests on the combined record. Expand each item to see its role and limitations.

Independence note: This check uses 6 methods across 11 institutions and 1 country or international grouping.
Evidence map
Method Institution / country Year(s) What it shows Key limitation Primary links
Primary legal text review Washington Secretary of State United States 2025 Section 3(1) requires district and WIAA rules to bar biologically male students from competing with and against female students in competition intended for female students only. Section 3(2) requires any student who elects to enter that competition to provide, as part of the required routine sports physical, a statement signed by her personal health care provider verifying her biological sex, relying only on one or more of reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels. Any one basis suffices. The text names no examination procedure and gives no role to school staff. The text does not define biological sex or personal health care provider, does not say whether prior medical records may be used, and sets no testosterone threshold. How it works depends on implementing rules that do not exist yet. Washington Secretary of State
Official explanatory statement review Washington Attorney General's Office United States 2026 The Attorney General's explanatory statement in the voters' pamphlet says the measure would generally prevent transgender girls from participating on girls' sports teams, that verification would have to rest on anatomy, genetics or testosterone, and that students would have to undergo some type of medical evaluation of their sex. It names no genital exam. The explanatory statement condenses the text and comes from the same state government; it is not an independent reading of how verification would be carried out. Washington Secretary of State
Athletic association rules and standard clinical forms review Washington Interscholastic Activities Association, American Academy of Pediatrics United States 2019, 2026 The WIAA requires a physical before a student's first practice and says it is good for 24 months unless the district is stricter. Its program covers grades 7 to 12. The current American Academy of Pediatrics exam form has no genital or sex item, though it asks clinicians to check femoral pulses; the family-completed history form asks sex assigned at birth. A WIAA official told KUOW that participation does not now require a doctor's sign-off on birth sex. Forms and rules show what a physical must contain, not what each clinic does. Districts may require physicals more often than the WIAA minimum. Washington Interscholastic Activities Association American Academy of Pediatrics American Academy of Pediatrics KUOW Public Radio
News reporting with interviews, and advocacy statements KUOW Public Radio, Washington State PTA, Washington State Coalition Against Domestic Violence & Sexual Assault United States 2026 KUOW reported that a visual genital exam, which can be done without touching the child, would likely be the most accessible option for most students. A pediatrician who supports the measure said providers could use findings from earlier well-child exams instead of a new inspection. The PTA argues insurers are unlikely to cover genetic or hormone tests, so many girls would face an anatomy check. The state's domestic and sexual violence coalition says the requirement could lead to unnecessary, expensive and invasive evaluations. These are predictions from a few clinicians and from organizations that oppose the measure, made before any guidance exists. None is data on what families would do. KUOW Public Radio Washington State PTA Washington State Coalition Against Domestic Violence & Sexual Assault
Review of the original releases and reports in which each statement was published No Hate in WA State, The Urbanist United States 2026 The No campaign's September 29 release quotes Gov. Ferguson and Sen. Murray. The Urbanist reported Rep. Jayapal's remarks at the campaign's June 17 kickoff, which the Northwest Progressive Institute recorded. The No campaign's website says the measure bans transgender girls from teams at any level, that verification would recur at least every two years, and, elsewhere, every year. A statement signed by more than 100 medical providers describes the verification as a reproductive organ exam or costly testing. Jayapal's words are from a news report of a recorded speech; we could not retrieve a transcript of the campaign's video, and the report elides part of the sentence. The release is the campaign's own document. No Hate in WA State The Urbanist No Hate in WA State No Hate in WA State
Review of organizations' own statements and news reporting Washington Academy of Family Physicians, Washington State Coalition Against Domestic Violence & Sexual Assault, The Seattle Times United States 2026 The Washington State Nurses Association's president co-wrote the No argument, and the No campaign lists the nurses' association and the state's domestic violence coalition among opponents. The Washington Academy of Family Physicians took a position against the measure on October 19, and the Washington State Coalition Against Domestic Violence & Sexual Assault urged a No vote on October 22. The Seattle Times reported that the Washington chapter of the American Academy of Pediatrics and the national academy declined to comment, and a pediatrician co-wrote the Yes argument. Organizational positions show who opposes, not why each member does; some statements were issued after the pamphlet was written. No Hate in WA State No Hate in WA State Washington State Coalition Against Domestic Violence & Sexual Assault The Seattle Times (via Yakima Herald-Republic) Washington Secretary of State
1. The filed text requires a provider's verification and lists three alternative bases Primary legal text review

Section 3(1) requires district and WIAA rules to bar biologically male students from competing with and against female students in competition intended for female students only. Section 3(2) requires any student who elects to enter that competition to provide, as part of the required routine sports physical, a statement signed by her personal health care provider verifying her biological sex, relying only on one or more of reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels. Any one basis suffices. The text names no examination procedure and gives no role to school staff.

Limit: The text does not define biological sex or personal health care provider, does not say whether prior medical records may be used, and sets no testosterone threshold. How it works depends on implementing rules that do not exist yet.

Verify: Initiative Measure No. IL26-638, final filed text (filed June 2, 2025)

2. The Attorney General's explanation describes the same requirement Official explanatory statement review

The Attorney General's explanatory statement in the voters' pamphlet says the measure would generally prevent transgender girls from participating on girls' sports teams, that verification would have to rest on anatomy, genetics or testosterone, and that students would have to undergo some type of medical evaluation of their sex. It names no genital exam.

Limit: The explanatory statement condenses the text and comes from the same state government; it is not an independent reading of how verification would be carried out.

Verify: 2026 General Election voters' pamphlet (statewide edition), Initiative Measure IL26-638, pp. 21-22

3. Today's sports physicals have no sex verification and recur every 24 months Athletic association rules and standard clinical forms review

The WIAA requires a physical before a student's first practice and says it is good for 24 months unless the district is stricter. Its program covers grades 7 to 12. The current American Academy of Pediatrics exam form has no genital or sex item, though it asks clinicians to check femoral pulses; the family-completed history form asks sex assigned at birth. A WIAA official told KUOW that participation does not now require a doctor's sign-off on birth sex.

Limit: Forms and rules show what a physical must contain, not what each clinic does. Districts may require physicals more often than the WIAA minimum.

Verify: WIAA Handbook 2026-27 Preparticipation Evaluation: Physical Examination Form (PPE 5th edition, revised) Preparticipation Evaluation: History Form (PPE 5th edition, revised) Transgender ballot initiative could require genital exams for WA secondary school students (Sarah Mizes-Tan, June 4, 2026)

4. Reporting and advocates on how verification would work in practice News reporting with interviews, and advocacy statements

KUOW reported that a visual genital exam, which can be done without touching the child, would likely be the most accessible option for most students. A pediatrician who supports the measure said providers could use findings from earlier well-child exams instead of a new inspection. The PTA argues insurers are unlikely to cover genetic or hormone tests, so many girls would face an anatomy check. The state's domestic and sexual violence coalition says the requirement could lead to unnecessary, expensive and invasive evaluations.

Limit: These are predictions from a few clinicians and from organizations that oppose the measure, made before any guidance exists. None is data on what families would do.

Verify: Transgender ballot initiative could require genital exams for WA secondary school students (Sarah Mizes-Tan, June 4, 2026) Washington State PTA Opposes Initiative IL26-638 (August 6, 2026) Protecting Young People's Safety: Why the Coalition Opposes I-001 and I-638 (October 22, 2026)

5. What the officials, the No campaign and the medical statement said Review of the original releases and reports in which each statement was published

The No campaign's September 29 release quotes Gov. Ferguson and Sen. Murray. The Urbanist reported Rep. Jayapal's remarks at the campaign's June 17 kickoff, which the Northwest Progressive Institute recorded. The No campaign's website says the measure bans transgender girls from teams at any level, that verification would recur at least every two years, and, elsewhere, every year. A statement signed by more than 100 medical providers describes the verification as a reproductive organ exam or costly testing.

Limit: Jayapal's words are from a news report of a recorded speech; we could not retrieve a transcript of the campaign's video, and the report elides part of the sentence. The release is the campaign's own document.

Verify: Sen. Patty Murray, Governor Ferguson, Affiliated Tribes of Northwest Indians, Seattle School Board, and Local Governments Strongly Oppose I-638 and I-001 (press release, September 29, 2026) Democratic Leaders Launch 'No Hate in WA State' Campaign Opposing Anti-Trans Ballot Measures (Amy Sundberg, June 25, 2026) About I-638 100+ Doctors and Other Medical Providers Issue Statement Opposing IL26-001 and IL26-638 (August 24, 2026)

6. Which medical and parent groups oppose the measure Review of organizations' own statements and news reporting

The Washington State Nurses Association's president co-wrote the No argument, and the No campaign lists the nurses' association and the state's domestic violence coalition among opponents. The Washington Academy of Family Physicians took a position against the measure on October 19, and the Washington State Coalition Against Domestic Violence & Sexual Assault urged a No vote on October 22. The Seattle Times reported that the Washington chapter of the American Academy of Pediatrics and the national academy declined to comment, and a pediatrician co-wrote the Yes argument.

Limit: Organizational positions show who opposes, not why each member does; some statements were issued after the pamphlet was written.

Verify: Sen. Patty Murray, Governor Ferguson, Affiliated Tribes of Northwest Indians, Seattle School Board, and Local Governments Strongly Oppose I-638 and I-001 (press release, September 29, 2026) WA Association of Family Physicians Takes Position to Oppose Let's Go WA Ballot Measures IL26-638 and IL26-001 (October 19, 2026) Protecting Young People's Safety: Why the Coalition Opposes I-001 and I-638 (October 22, 2026) Despite objections, doctors group cited in WA voter guide on trans sports ban (Elise Takahama, August 27, 2026) 2026 General Election voters' pamphlet (statewide edition), Initiative Measure IL26-638, pp. 21-22

Common questions

“Sen. Patty Murray, September 29, 2026: "I-638 would force every girl who wants to play a school sport to have a doctor verify her sex, often through an invasive physical exam, every time she needs a sports physical"”

Our rating: Mostly true

Most of this is accurate. Every girl entering girls' competition would need her provider to verify her sex as part of the sports physical, and WIAA physicals recur every 24 months, so the step would repeat. KUOW reported that a visual exam would likely be the most accessible route for many students, which supports 'often'. Two parts overstate: a girl joining a boys' or open team would not need it, and a visual check is not invasive in the medical sense. Her separate line that the measure is 'bankrolled by a single far-right megadonor' is answered by FactHub's campaign-funding check.

Related claim: Individuals fund most of I-638's Yes side; a foundation and unions fund No. — Individuals other than Brian Heywood gave 52% of Yes committee money; a foundation and unions gave 63% of No's.

“Rep. Pramila Jayapal, June 17, 2026: the measure "literally forces these invasive, disgusting exams on every girl who wants to play a sport, just so that they can target a handful of trans kids."”

Our rating: False

The text forces a provider's verification, not an exam: the provider may rely on genetic makeup or testosterone instead of anatomy, and a pediatrician who supports the measure says earlier well-child findings could be used. No girl is literally forced into an invasive exam. Her point that few athletes are affected is close to the record: FactHub's placements check traces the Yes campaign's 269 placements to ten athletes.

Related claim: The Yes campaign's 269 girls'-event placements check out, from ten athletes. — The Yes campaign's 269 placements in Washington girls' events, including 74 firsts, check out; they come from ten athletes. Rated Mostly true.

“Vote No Because Doctors and Nurses Warn It Requires Invasive Genital Exams On Girls”

Our rating: False

Doctors and nurses did warn about exams, but the measure does not require them. A provider may verify sex from genetic makeup or testosterone levels, any one basis suffices, and the Attorney General's statement names no genital exam. FactHub's companion check rates the claim that I-638 will require genital exams False.

Deeper analysis: Initiative 638 requires a doctor's sex verification, not a genital exam. — FactHub rates the claim that Initiative 638 will require genital examinations False: the text lets providers verify sex by genetic testing or testosterone levels instead. This links to the version that was current when this fact check was written. Read the latest version.

“The WA State Nurses Association, Planned Parenthood Alliance Advocates, and doctors warn this measure would subject girls to medically unnecessary, embarrassing, and potentially harmful genital exams.”

Our rating: False

We rate what the sentence asserts, that the measure would subject girls to genital exams, and the text contradicts it: a provider may verify sex from genetic makeup or testosterone levels, any one basis suffices, and the Attorney General's statement names no genital exam. The attribution is accurate: the nurses' association president and Planned Parenthood Alliance Advocates' state director co-signed the No argument, and more than 100 providers signed a statement. Sex verification serves no medical purpose, so 'medically unnecessary' is fair. But who warned does not change what the text requires, so we rate the sentence False, like the pamphlet heading that the measure requires invasive genital exams. Whether many girls end up with an anatomy check depends on cost, insurance and guidance not yet written.

“Doctors say this poorly written measure will subject girls to new invasive genital examinations.”

Our rating: False

We rate what the sentence asserts, not whether some doctors said it. Some doctors do say this, and verification would be new, since today's exam form has no genital item. But the measure would not subject girls to genital examinations: a provider may rely on genetic or hormone results instead, and the text does not rule out earlier records. The text contradicts the claim, as it contradicts the pamphlet heading that the measure requires invasive genital exams (False).

“Today girls in elementary, middle, and high school remain fully clothed during sports physicals.”

Our rating: Misleading

True today, but the measure doesn't require undressing. The standard sports-physical exam has no genital item, and a retired school nurse who co-signed the No argument says students stay fully clothed in group physicals (the form does ask clinicians to check femoral pulses and the abdomen, and practice varies). But the sentence's point, in a rebuttal arguing the measure would subject girls to genital exams, is that I-638 would make girls undress, and that is not so: a provider may verify sex from genetic makeup or testosterone levels, and the text does not rule out a girl's own provider relying on what they already know from past care. Elementary students are not in WIAA interschool sports, which start at grade 7, or 6 where a district opts in.

“This measure - the most extreme in the nation - exempts boys, and bans parents from using birth certificates.”

Our rating: Misleading

One part is accurate: verification applies only to students entering female-only competition, so boys are exempt. The other two mislead. Most of the 27-plus state laws reach further in scope and enforcement, and I-638 is strictest only in verifying every girl (FactHub rates 'most extreme' Misleading). The text never mentions birth certificates; it lists three bases a provider relies on, so a certificate alone cannot verify sex, but nothing bans parents from showing one (FactHub rates that claim Misleading). The comparison with other states' birth-certificate rules is also not like for like. The 11 state laws that rely on a birth certificate use the original certificate issued at birth. In Washington, the sex on a birth certificate can be changed: since January 27, 2018, WAC 246-490-075 has allowed a change to M, F or X, and for a minor the application needs a provider's statement that the change is consistent with the minor's identity. So a Washington certificate need not show the sex recorded at birth.

Related claim: Most state girls'-sports laws reach further than I-638, except in verifying every girl. — Most state laws go further on scope and enforcement; I-638 is strictest only in medically verifying every girl. Rated Misleading; 'boys are exempt' rated True.

“IL26-638 is opposed by pediatricians, nurses, parents, and sexual assault prevention groups because it discriminates against girls and puts them at risk of harm.”

Our rating: Misleading

Some named groups do oppose it: the Washington State Nurses Association, the Washington State PTA, the Washington Academy of Family Physicians and the state's domestic and sexual violence coalition, and pediatricians are among the 100-plus signers of the providers' statement. But 'pediatricians' overstates: the state and national pediatric academies took no position, and a board-certified pediatrician co-wrote the Yes argument. 'Parents' are on both sides: the PTA opposes the measure, and a parent advocate co-wrote the Yes argument. And we found no evidence that verification by a girl's own provider 'puts them at risk of harm'; the coalition warns of possible invasive evaluations, which the text does not require. Accurate names joined to an overstated list and an unsupported claim of harm leave a wrong impression.

“No Hate in WA State website: I-638 is "a statewide ban excluding trans girls from participating on any teams at any level."”

Our rating: False

The text bars biologically male students only from competition intended for female students only. Boys' teams, open teams and coed teams are untouched, so transgender girls could still play on them. The Attorney General's statement says the measure would 'generally prevent transgender girls from participating on girls' sports teams', not on any team.

“No Hate in WA State website: "If I-638 passes, at least every two years all girls who want to participate in sports will have to be sex certified by a doctor as a new part of their sports physicals"”

Our rating: Mostly true

Accurate on the main point: verification is tied to the required physical, which the WIAA makes valid for 24 months unless a district is stricter, and it would be new. It applies to girls entering girls' competition, not to a girl on a boys' or open team. The same page elsewhere says 'every year', which overstates the WIAA minimum.

“Statement by more than 100 medical providers, August 2026: "Under IL26-638, all girls who want to play on a team at the K-12 level will need a medical certification of her sex defined as a physical “reproductive organ exam,” or costly genetic or hormone testing."”

Our rating: Misleading

Girls entering girls' competition would need a provider's certification, so the core is right. But the text does not define it as a 'reproductive organ exam': that phrase is not in the measure, which says 'reproductive anatomy' as one of three bases a provider may rely on, and names no exam. 'K-12' overstates the reach of WIAA sports, which start at grade 7, or 6. Whether genetic or hormone tests are costly to families depends on insurance, which FactHub checks separately.

“Verification would just reuse what sports physicals already record, so nothing changes for girls.”

Short answer: No, it is a new step

The officials are right on this. The family-completed history form asks sex assigned at birth, but the provider does not verify it, the exam form has no sex item, and the WIAA says participation does not now require a doctor's sign-off. A provider's signed verification would be new for every girl in girls' competition.

Related claim: Pediatric checkups already document sex, though many Washington girls lack a regular provider. — Regular checkups document anatomy and sex, but a quarter of Washington children lack a personal provider to sign. The Yes claim is rated Mostly true.

“Boys would have to be verified too.”

Short answer: No

The officials and the No campaign are right: Section 3(2) applies only to students who elect to compete in activities intended for female students only. FactHub rates the No argument's 'boys are exempt' True.

Conclusion

The officials are right about the core fact. Under Section 3(2), every student who elects to compete in girls' individual or team competition would have to provide, as part of the required sports physical, a statement signed by her personal health care provider verifying her biological sex. That is a new step: today's standard exam form has no sex item, and the WIAA says participation does not now require a doctor's sign-off on birth sex. Boys and students on open or boys' teams would not need it. Sen. Murray is also right that, because WIAA physicals are valid for 24 months, the verification would recur with each physical. Where the statements go wrong is the word invasive, and in some cases the claim that an exam is compelled. The text names what the provider may rely on, not a procedure: reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels, any one of which suffices. A genetic test or a testosterone blood test satisfies it without any genital examination, and a pediatrician who co-wrote the Yes argument told KUOW that providers could rely on findings from earlier well-child visits; the text neither allows nor forbids that explicitly. The governor's sentence takes the accurate fact (mandatory verification) and attaches to it an inaccurate one (invasive exams for all girls), which is why we rate it Misleading rather than False. Rep. Jayapal's statement that the measure 'literally forces these invasive, disgusting exams on every girl' is contradicted by the text's alternatives, so we rate it False, consistent with FactHub's rating of the claim that I-638 will require genital exams. Sen. Murray hedged ('often through an invasive physical exam'); KUOW reported that a visual exam would likely be the most accessible route for most students, so we rate her sentence Mostly true, with 'invasive' the overstatement, since a visual check involves no touching. The strongest case for the officials' concern is practical. Genetic and hormone tests may not be covered by insurance, the PTA argues that for many girls the practical result would be an anatomy check, and a quarter of Washington children have no personal provider to sign. Those points could make an anatomy-based check common; they do not make it required, and no implementing guidance yet exists to settle it. The governor's first clause, that I-638 'won't create opportunities for girls', is a prediction we do not rate. FactHub's companion check found 269 placements in Washington girls' events by athletes the measure would exclude, coming from ten athletes, including 74 firsts; under the measure those places would go to girls, though the number of athletes is small. The No campaign's related wording varies in accuracy. Its pamphlet heading says the measure 'Requires Invasive Genital Exams', which the text contradicts (False). Its sentences that nurses, Planned Parenthood Alliance Advocates and doctors 'warn' the measure would subject girls to genital exams, and that 'doctors say' it will, are False for the same reason: we rate what a sentence asserts, not whether someone said it, and the text lets a provider rely on genetics or testosterone instead. Its rebuttal's 'fully clothed' sentence is true of today's physicals but Misleading, because its point is that I-638 would make girls undress, and the measure does not require that. Its list of opponents is Misleading: nurses, the family physicians' academy, the PTA and the state's domestic and sexual violence coalition do oppose the measure, but the state and national pediatric academies have taken no public side and a pediatrician co-wrote the Yes argument, parents are on both sides, and we found no evidence that verification by a girl's own provider puts girls at risk of harm. Its 'most extreme' sentence is Misleading too, and its birth-certificate comparison is not like for like: other states' birth-certificate rules use the original certificate issued at birth, while in Washington the sex on a birth certificate can be changed. Its website's statement that the measure bans transgender girls from 'any teams at any level' is false: only female-only competition is covered. Confidence is High because the lead claim concerns what the measure requires, which the filed text answers directly and the Attorney General's statement confirms. How verification would work in practice remains unknown until guidance is written.

How we checked

  1. Defined the lead claim as the factual part of Gov. Ferguson's statement: that I-638 will force girls into invasive sex verification exams to play sports. Treated 'won't create opportunities for girls' as a prediction and did not rate it.
  2. Found each official's words in the release or report where they were first published: the No campaign's September 29, 2026 release (Ferguson, Murray) and The Urbanist's report of the June 17 kickoff (Jayapal), whose video the Northwest Progressive Institute posted.
  3. Read the measure's filed text and the Attorney General's explanatory statement in the voters' pamphlet.
  4. Checked current practice against the WIAA handbook and the standard American Academy of Pediatrics sports-physical forms.
  5. Weighed reporting and advocacy on how verification would work in practice (KUOW, Washington State PTA, the state's domestic and sexual violence coalition).
  6. Checked which groups oppose the measure against their own statements and the Seattle Times' report on the pediatric academy.
  7. Rated six sentences of the No campaign's pamphlet argument, quoted from FactHub's dataset of the campaigns' pamphlet statements, and recorded limits for each line of evidence.

Editorial note: Scope: this article rates the factual part of Gov. Ferguson's September 29, 2026 statement, and, as rated objections, statements by Sen. Murray and Rep. Jayapal, the No campaign's website, a statement signed by more than 100 medical providers, and six sentences from the No campaign's voters' pamphlet argument and rebuttal. Each official's words are quoted from the release or report in which they were first published. FactHub's companion checks rate the No argument's genital-exam, birth-certificate and 'most extreme' claims in depth. Practical effects depend on implementing guidance that does not exist yet. No external specialist review has been recorded.

Expert-review status

No external specialist review has been recorded.

Funding and conflicts

Funding: No external funding for this piece.

Ownership: Published by the FactHub Research Team.

Conflicts: None known.

Sources

Sources are labeled by kind, with what this fact check takes from each, so readers can check the evidence independently.

  1. Government Washington Secretary of State. Initiative Measure No. IL26-638, final filed text (filed June 2, 2025)

    The measure's full text; Section 3 contains the competition rule and the verification requirement.

    Reliability: The official filed text posted by the Secretary of State. It is the measure itself; the sponsor wrote it.

    • District and WIAA rules must bar biologically male students only from competition intended for female students only.

      What the source says
      must prohibit biologically male students from competing with and against female students in athletic activities with separate classifications for male and female students if the athletic activity is:
      Sec. 3(1)

    • A student entering female-only competition must provide a statement signed by her own health care provider verifying her sex, as part of the sports physical.

      What the source says
      A student who elects to participate in individual or team competition activities intended for female students only governed under subsection (1) of this section shall provide, as part of the required routine sports physical examination, a health examination and consent form or other statement signed by the student's personal health care provider that verifies the student's biological sex,
      Sec. 3(2)

    • The provider may rely on any one of anatomy, genetic makeup or testosterone, so no single procedure is required.

      What the source says
      relying only on one or more of the following: The student's reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels.
      Sec. 3(2)
  2. Government Washington Secretary of State. 2026 General Election voters' pamphlet (statewide edition), Initiative Measure IL26-638, pp. 21-22

    The Attorney General's explanatory statement (p. 21) and the campaigns' arguments with their authors (p. 22).

    Reliability: The explanatory statement is the Attorney General's neutral summary. The arguments on p. 22 are printed as each campaign submitted them; the Secretary of State does not check them.

    • The Attorney General says the measure would generally keep transgender girls off girls' teams, not off all teams.

      What the source says
      This would generally prevent transgender girls from participating on girls' sports teams.
      p. 21, The Effect of the Proposed Measure if Approved

    • The Attorney General says the provider's verification would have to be based on anatomy, genetics or testosterone.

      What the source says
      That form must be signed by the student's personal health care provider. The verification would have to be based on the student's reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels.
      p. 21, The Effect of the Proposed Measure if Approved

    • The Attorney General says students would need some type of medical evaluation, without naming a genital exam.

      What the source says
      Students would thus have to undergo some type of medical evaluation of their sex to participate in interschool sports designated for female students only.
      p. 21, The Effect of the Proposed Measure if Approved

    • The president of the Washington State Nurses Association co-wrote the No argument.

      What the source says
      Justin Gill, APRN, President, WA State Nurses Association;
      p. 22, Argument against, Written by

    • Qualifies: The Yes argument's authors include a parent and education advocate and a board-certified pediatrician, so parents and pediatricians are on both sides.

      What the source says
      Alesha Perkins, Parent and Education Advocate … Board-Certified Pediatrician
      p. 22, Argument for, Written by
  3. Party to the dispute No Hate in WA State. Sen. Patty Murray, Governor Ferguson, Affiliated Tribes of Northwest Indians, Seattle School Board, and Local Governments Strongly Oppose I-638 and I-001 (press release, September 29, 2026)

    The No campaign's release in which the governor's and senator's statements were first published.

    Reliability: Has a stake in this finding. The committee opposing I-638, which wrote the No argument in the voters' pamphlet. The Seattle Times reported the same Ferguson wording the same day as a written statement.

    • Qualifies: Gov. Ferguson's statement, the lead claim, as the No campaign released it.

      What the source says
      I-638 won’t create opportunities for girls but it will force them into invasive sex verification exams in order to participate in sports.
      Statement attributed to Governor Bob Ferguson · Bob Ferguson, Governor of Washington

    • Qualifies: Sen. Murray says every girl would need a doctor to verify her sex, often through an invasive physical exam, at each sports physical.

      What the source says
      I-638 would force every girl who wants to play a school sport to have a doctor verify her sex, often through an invasive physical exam, every time she needs a sports physical--that is disturbing and totally unacceptable.
      Statement attributed to U.S. Senator Patty Murray · Patty Murray, U.S. Senator from Washington

    • The No campaign lists the nurses' association and the state's domestic violence coalition among opponents, and notes the PTA opposes separately.

      What the source says
      Initiatives 638 and 001 are opposed by the WA State Nurses Association, the Washington State Coalition Against Domestic Violence, the League of Women voters, and hundreds of organizations, doctors, nurses, counselors, educators, and businesses.
      Closing paragraphs
  4. News report The Urbanist. Democratic Leaders Launch 'No Hate in WA State' Campaign Opposing Anti-Trans Ballot Measures (Amy Sundberg, June 25, 2026)

    A report on the No campaign's June 17, 2026 kickoff in Seattle, quoting Rep. Jayapal's remarks.

    Reliability: A Seattle urbanist news site; this is a news report, though the outlet's opinion page has opposed the measure. The quote elides part of Jayapal's sentence, marked [...] in the original.

    • Contradicts: Rep. Jayapal said the measure literally forces invasive exams on every girl who wants to play a sport.

      What the source says
      One of these initiatives forces our schools to out LGBTQIA+ kids to the very families that might throw them out, and the other [...] literally forces these invasive, disgusting exams on every girl who wants to play a sport, just so that they can target a handful of trans kids.
      Paragraphs on Jayapal's remarks · Pramila Jayapal, U.S. Representative (D-Seattle)
  5. Party to the dispute No Hate in WA State. About I-638

    The No campaign's explanation of the measure and answers to common questions.

    Reliability: Has a stake in this finding. The committee opposing I-638. Read October 23, 2026; the page is updated without dates.

    • Contradicts: The No campaign says the measure bars transgender girls from any team at any level.

      What the source says
      It takes decision-making power away from parents, schools and athletic associations with a statewide ban excluding trans girls from participating on any teams at any level.
      Opening summary

    • The No campaign says girls would be sex certified at least every two years as a new part of the physical.

      What the source says
      If I-638 passes, at least every two years all girls who want to participate in sports will have to be sex certified by a doctor as a new part of their sports physicals
      Answers to common questions

    • Qualifies: The same page's summary says the inspections would happen every year, which overstates the WIAA's 24-month physical.

      What the source says
      I-638 would require tens of thousands of elementary, middle and high school girls to undergo intrusive, potentially harmful medical sex inspections every year as a new part of sports physicals.
      Opening summary
  6. Party to the dispute No Hate in WA State. 100+ Doctors and Other Medical Providers Issue Statement Opposing IL26-001 and IL26-638 (August 24, 2026)

    The No campaign's release of a statement signed by more than 100 physicians, nurses and other providers, quoted in part.

    Reliability: Has a stake in this finding. Published by the No campaign; the signers are individual providers, not their professional societies.

    • Qualifies: The providers' statement describes the certification as a 'reproductive organ exam' or costly testing, terms the measure does not use.

      What the source says
      Under IL26-638, all girls who want to play on a team at the K-12 level will need a medical certification of her sex defined as a physical “reproductive organ exam,” or costly genetic or hormone testing.
      Statement excerpt
  7. Party to the dispute No Hate in WA State. WA Association of Family Physicians Takes Position to Oppose Let's Go WA Ballot Measures IL26-638 and IL26-001 (October 19, 2026)

    The No campaign's release announcing the family physicians' academy's position.

    Reliability: Has a stake in this finding. Published by the No campaign, reporting another organization's position; the academy's own announcement was not separately located.

    • The Washington Academy of Family Physicians, about 3,900 members, opposes the measure.

      What the source says
      representing approximately 3,900 family physicians, residents, and students has taken a position to oppose two Let’s Go Washington-sponsored ballot initiatives (IL26-001 and IL26-638).
      First paragraph
  8. Advocacy group Washington State Coalition Against Domestic Violence & Sexual Assault. Protecting Young People's Safety: Why the Coalition Opposes I-001 and I-638 (October 22, 2026)

    The statewide domestic and sexual violence coalition's statement urging a No vote.

    Reliability: Has a stake in this finding. A statewide coalition of domestic and sexual violence programs; it opposes the measure and links to the No campaign.

    • The state's domestic and sexual violence coalition urges voters to reject the measure.

      What the source says
      urges Washington voters to vote NO on Initiatives 001 and 638 this November.
      First paragraph

    • Qualifies: The coalition says the requirement could lead to invasive evaluations, a possibility rather than a requirement.

      What the source says
      These requirements could lead to unnecessary, expensive, and invasive medical evaluations and make it harder for some students to play sports.
      Vote NO on I-638 section
  9. News report The Seattle Times (via Yakima Herald-Republic). Despite objections, doctors group cited in WA voter guide on trans sports ban (Elise Takahama, August 27, 2026)

    Report on the pediatric academy's request to be removed from the Yes argument.

    Reliability: Seattle Times reporting syndicated by the Yakima Herald-Republic; it quotes both campaigns.

    • Qualifies: The state and national pediatric academies declined to comment, and a No consultant said the national academy has not taken a side.

      What the source says
      The Washington chapter of AAP, as well as the national organization, declined to comment, but Heather Weiner, a consultant on the No Hate For Washington State campaign, which counters the initiative in the voter guide, said the national expert association has not been involved on either side.
      Middle of story
  10. Other Washington Interscholastic Activities Association. WIAA Handbook 2026-27

    The rules for Washington's sanctioned interschool sports, including the physical-exam rule and the grades covered.

    Reliability: The WIAA is the nonprofit to which Washington school districts delegate interschool athletics; it would carry out I-638 for member schools.

    • A sports physical is good for 24 months unless the district is stricter, so verification tied to it would recur at least every two years.

      What the source says
      Physical exams are good for 24 months unless the school district has a more restrictive policy.
      Rule 18.4.0 interpretations, A-2

    • The WIAA program covers grades 7 to 12.

      What the source says
      Only students regularly enrolled in schools which are members of the WIAA in grades seven to 12 inclusive may participate in the program of the WIAA
      Appendix, Participation - Limitation Based on Gender
  11. Academic American Academy of Pediatrics. Preparticipation Evaluation: Physical Examination Form (PPE 5th edition, revised)

    The current standard sports-physical exam form; it lists no genitourinary item.

    Reliability: Published by the American Academy of Pediatrics for the 2019 multi-society PPE monograph, which predates I-638.

    • Qualifies: The exam form has no genital item but asks clinicians to check femoral pulses and the abdomen.

      What the source says
      Pulses (radial and femoral)
      Medical section, Cardiovascular
  12. Academic American Academy of Pediatrics. Preparticipation Evaluation: History Form (PPE 5th edition, revised)

    The family-completed history form for the standard sports physical.

    Reliability: Published by the American Academy of Pediatrics for the 2019 multi-society PPE monograph.

    • Qualifies: The history form, filled in by the family and kept with the doctor, asks sex assigned at birth; no provider verifies it.

      What the source says
      Sex assigned at birth (F, M, or intersex):
      History form, page 1
  13. News report KUOW Public Radio. Transgender ballot initiative could require genital exams for WA secondary school students (Sarah Mizes-Tan, June 4, 2026)

    Interviews with physicians who support and oppose the measure and with the WIAA about how verification would work.

    Reliability: Public radio reporting. Its interviews are useful evidence; its own description of the options uses wording ('visual genital exam') the text does not contain.

    • Qualifies: KUOW reported that a visual exam, done without touching, would likely be the most accessible option for most students.

      What the source says
      According to the initiative, students would have several options to confirm their sex: a visual genital exam, a lab test to determine their genetic makeup, or an analysis of testosterone levels in the blood. The genital exam, which a medical professional can conduct without touching the child, would likely be the most accessible option for most kids.
      Opening section

    • A pediatrician who co-wrote the Yes argument said doctors could use earlier well-child exam findings instead of a new inspection.

      What the source says
      Doctors could use this information to confirm birth sex without conducting a separate visual inspection for the sports physical, she said.
      Paragraphs quoting Erica Li · Erica Li, pediatrician and co-author of the Yes argument

    • The WIAA says participation does not now require a doctor's sign-off on birth sex.

      What the source says
      Sports participation does not require students to have a doctor sign off on their birth sex to play a sport, said Justin Kesterson, assistant executive director of the Washington Interscholastic Activities Association, which oversees middle and high school sports.
      Paragraphs quoting Justin Kesterson · Justin Kesterson, assistant executive director, WIAA

    • A retired school nurse who co-signed the No argument said students stay fully clothed in group sports physicals.

      What the source says
      Students don't take their clothes off. They're fully clothed
      Paragraph quoting Katie Johnson · Katie Johnson, retired school nurse and No campaign supporter
  14. Advocacy group Washington State PTA. Washington State PTA Opposes Initiative IL26-638 (August 6, 2026)

    The PTA's statement opposing the measure, with its argument about insurance coverage.

    Reliability: Has a stake in this finding. The PTA opposes the measure; its statements about insurance coverage are not sourced to insurers.

    • Qualifies: The PTA, which opposes the measure, argues insurers are unlikely to cover genetic or hormone tests, so many girls would face an anatomy exam in practice.

      What the source says
      Since insurance is unlikely to cover the other two options the initiative offers for gender verification, for many girls the practical result would be an intimate examination that serves no medical purpose and exists only to act as a gate keeper for sports eligibility, potentially beginning in middle school and possibly repeatedly.
      Statement body
  15. Government Washington State Legislature (Washington Administrative Code). WAC 246-490-075, Changing sex designation on a birth certificate (WSR 18-02-048, effective January 27, 2018)

    The Department of Health rule that lets the sex designation on a Washington birth certificate be changed.

    Reliability: The official text of a Department of Health rule, as published in the Washington Administrative Code.

    • Qualifies: A change to the sex designation on a Washington birth certificate may be to male, female or X.

      What the source says
      Sex designation requested (male, female, or X);
      WAC 246-490-075(4)(g)

    • Qualifies: For a minor, a licensed provider attests that the change is consistent with the minor's identity, so a Washington certificate need not show the sex recorded at birth.

      What the source says
      The sex designation change application of a minor must include a signed statement by the minor's licensed health care provider attesting that: (a) The minor identified on the application is under the care of the provider; and (b) The provider has determined the request to change sex designation on the birth certificate is consistent with the minor's identity.
      WAC 246-490-075(7)
  16. Government Kentucky General Assembly. KRS 156.070

    Kentucky's statute on interscholastic athletics, an example of a state rule that uses the original birth certificate.

    Reliability: Official statute text published by the Legislative Research Commission.

    • Qualifies: Kentucky's law, like other birth-certificate states, names the original certificate issued at birth.

      What the source says
      A student's biological sex as indicated on the student's original, unedited birth certificate issued at the time of birth; or
      KRS 156.070(2)(g)2.a.
  17. FactHub record FactHub Research Team. How state K-12 laws determine sex (saved analysis)

    FactHub's count of state girls'-sports laws by verification method.

    • Qualifies: Of 28 state laws, 11 rely on the birth certificate, 14 state no method, and three use other documents.

  18. video No Hate in WA State Campaign Kickoff (Northwest Progressive Institute, posted June 18, 2026)

    Video of the June 17, 2026 kickoff at which Rep. Jayapal spoke; FactHub quotes her from The Urbanist's report because no transcript was retrievable.

  19. FactHub dataset Initiative 638: the campaigns' claims in their own words
    • Vote No Because Doctors and Nurses Warn It Requires Invasive Genital Exams On Girls
      Committee for the argument against Initiative IL26-638 (Justin Gill, APRN, and five co-authors), Authors of the official voters' pamphlet argument against IL26-638, · In the dataset
    • The WA State Nurses Association, Planned Parenthood Alliance Advocates, and doctors warn this measure would subject girls to medically unnecessary, embarrassing, and potentially harmful genital exams.
      Committee for the argument against Initiative IL26-638 (Justin Gill, APRN, and five co-authors), Authors of the official voters' pamphlet argument against IL26-638, · In the dataset
    • Doctors say this poorly written measure will subject girls to new invasive genital examinations.
      Committee for the argument against Initiative IL26-638 (Justin Gill, APRN, and five co-authors), Authors of the official voters' pamphlet argument against IL26-638, · In the dataset
    • Today girls in elementary, middle, and high school remain fully clothed during sports physicals.
      Committee for the argument against Initiative IL26-638 (Justin Gill, APRN, and five co-authors), Authors of the official voters' pamphlet argument against IL26-638, · In the dataset
    • This measure - the most extreme in the nation - exempts boys, and bans parents from using birth certificates.
      Committee for the argument against Initiative IL26-638 (Justin Gill, APRN, and five co-authors), Authors of the official voters' pamphlet argument against IL26-638, · In the dataset
    • IL26-638 is opposed by pediatricians, nurses, parents, and sexual assault prevention groups because it discriminates against girls and puts them at risk of harm.
      Committee for the argument against Initiative IL26-638 (Justin Gill, APRN, and five co-authors), Authors of the official voters' pamphlet argument against IL26-638, · In the dataset

Update history

  1. First draft.
  2. Version 2. Re-rated four No-campaign pamphlet sentences, rating each whole sentence for what it asserts: 'The WA State Nurses Association, Planned Parenthood Alliance Advocates, and doctors warn ...' Misleading to False; 'Doctors say this poorly written measure will subject girls to new invasive genital examinations' Misleading to False; 'Today girls ... remain fully clothed during sports physicals' Mostly true to Misleading (true today, but the measure doesn't require undressing); 'IL26-638 is opposed by pediatricians, nurses, parents, and sexual assault prevention groups ...' Mostly true to Misleading. The 'most extreme ... birth certificates' sentence stays Misleading, with added context that other states' birth-certificate rules use the original certificate while a Washington certificate's sex can be changed (WAC 246-490-075). Added sources for that and for the Yes argument's authors; conclusion updated. Updated related links to the final versions of sibling articles. Lead claim and rating unchanged.
  3. Updated the links to the latest versions of the campaign-funding and media-coverage fact checks. No other changes.

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  • Briefing wa-i-638 — version 4 (published) cites version 3

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{"@context":"https://schema.org","@type":"ClaimReview","url":"https://facthub.org/n/article/wa-i638-officials-exam-claims/3","datePublished":"2026-10-23","dateModified":"2026-10-23","author":{"@type":"Organization","name":"FactHub","url":"https://facthub.org/"},"claimReviewed":"I-638 won\u2019t create opportunities for girls but it will force them into invasive sex verification exams in order to participate in sports.","reviewRating":{"@type":"Rating","alternateName":"Misleading"},"image":"https://facthub.org/node-assets-v2/article/wa-i638-officials-exam-claims/3/capitol/social-1200x630.jpg"}

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