Vice President Harris has struggled to combat former President Trump’s anti-transgender attacks, which are a major part of the former president’s closing argument.

The Trump campaign has flooded the airwaves with advertisements that paint Harris as extreme for her past support for trans-inclusive policies, including a response recorded on an ACLU candidate questionnaire during her 2019 presidential run that she would guarantee transgender people in prison and immigration detention have access to gender-affirming care.

The Supreme Court has held for nearly half a century that denying incarcerated people medically necessary health care is a violation of their constitutional rights, and federal prisons offered transition-related care, including surgery, under the Trump administration. The first person to receive gender-affirming surgery while in federal custody first sued for care in 2019, and a federal court granted her access in 2022.

The vice president has skirted explicit questions about transgender rights in recent interviews and has fallen short of offering a forceful rebuttal to the Trump campaign’s ads. On gender-affirming health care, Harris has said it is settled law that individuals should have access to medically necessary care, and treatment should be left to doctors and their patients.

“I’m not going to put myself in the position of a doctor,” Harris said this week in an interview with NBC’s Hallie Jackson.

Republicans see Harris’s responses as proof that the Trump campaign’s messaging is working, while some Democrats and LGBTQ advocates argue Harris’s caution on the topic is strategic.

“The Trump campaign understands that transgender care is not a top issue for voters – that’s not the point,” said one former Trump administration aide. “This is a stark reminder for the remaining undecided and low propensity voters in battleground states that Harris is no moderate.”

“Not only does this messaging fire up Trump’s base to maximize turnout on Election Day, it’s also a direct........

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