ATLANTA (AP) — After losing the White House and both houses of Congress, Democrats are grappling with how to handle transgender politics and policy following a campaign that featured withering and often misleading GOP attacks on the issue.

There is plenty of second-guessing after President-elect Donald Trump anchored his victory over Vice President Kamala Harris with sweeping promises on the economy and immigration. But Democrats also will not soon forget the punchline in anti-transgender Trump ads that became ubiquitous by Election Day: “Kamala is for they/them; President Trump is for you.”

“Week by week when that ad hit and stuck and we didn’t respond, I think that was the beginning of the end,” former Democratic Pennsylvania Gov. Ed Rendell said of the 30-second spot that was part of $215 million in anti-transgender advertising by Trump and Republicans, according to tracking firm AdImpact.

“They painted her as something I don’t think she is,” Rendell said. “They painted her as a far-left liberal.”

The fallout leaves some progressive and moderate Democrats struggling between the party’s modern identity as a champion of civil rights and its electoral fortunes across swaths of America with whom those attacks resonated.

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“There are just a number of issues where we’re out of touch,” Rep. Seth Moulton, a moderate Massachusetts Democrat said in an interview, days after he set off recriminations within his party for saying he didn’t want his daughters playing in sports against biological males. Critics said Moulton echoed Trump’s talking points about liberals allowing “men to compete in women’s sports.”

“I think that Republicans have a hateful position on trans issues,” Moulton told The Associated Press, but insisted that Democrats still lose voters because of the party’s “attitude.”

“Rather than talk down to you and tell you what to believe,” he argued, Democrats should “listen to hard-working Americans.”

LGBTQ+ advocates, meanwhile, are arguing that the 2024 election turned more on economic issues than Trump’s transgender rhetoric. They’re urging political leaders to counter misinformation that they say threatens the health and safety of transgender Americans, who make up less than 1% U.S. population.

“Trans people have been existing and co-existing,” receiving health care and participating in society for years, said Sarah Kate Ellis, CEO of GLAAD, a leading LGBTQ+ advocacy group. “Nothing new happened,” Ellis said, other than Republicans singling them out in a presidential campaign year.

“It didn’t change one vote,” Ellis argued. “But it did make the world way more dangerous for trans people.”

Another Democratic Massachusetts lawmaker, Rep. Ayanna Pressley, didn’t name Moulton, but said some reactions to the election “scapegoated and dehumanized” transgender people. “This Congresswoman sees you and loves you,” Pressley wrote on the social media platform X.

Certainly it’s difficult, if not impossible, to pinpoint single issues that can tip a national election, and there are mixed findings on what voters think about transgender rights.

According to AP VoteCast, a survey of more than 120,000 people who cast ballots this fall, 54% of voters overall said support for transgender rights in government and society has gone too far. About 2 in 10 said support has not gone far enough and another 2 in 10 said it’s about right. But among Trump voters, 85% said transgender support had gone too far.

Still, slightly more than half of all voters, 52%, oppose banning gender affirming medical treatment such as hormone therapy and puberty blockers, while 47% support such proposals.

About one-quarter of Harris voters said support for transgender rights in government and society has gone too far. About 4 in 10 said it’s been about right and about 4 in 10 said it hasn’t gone far enough.

Trump and Republicans were relentless in trying to capitalize on the issue. They piled on transgender athletes, with Trump falsely labeling two Olympic boxers as transgender women. They used Harris’ comments as a presidential candidate in 2019 — before she became vice president — effectively to blame her for laws granting transgender health care to federal prisoners and detainees.

And Trump repeatedly and falsely claimed that “your kid goes to school and comes home a few days later with an operation” changing their sex.

In reality, the Biden administration has held that Title IX bars discrimination based on sexual orientation and gender identity — but Education Department rules do not explicitly address transgender athletes. Federal law that Trump ads cited does require people in U.S. government custody to have access to gender-affirming medical treatments. Those policies were in place throughout Trump’s 2017-21 term; they are not something Biden’s administration instituted specifically.

And it is not legal in any state for a school to determine and carry out surgical treatment for minor students.

“You gotta fight back” with those explanations, Moulton said, adding that the silence compounds the negative effects for transgender people. “What did we show about our willingness to stand up for trans people by just being silent and ignoring the issue and ignoring the attack?”

Still, Moulton said Democratic leaders on Capitol Hill and in statehouses should give individual elected officials and voters the space to take more conservative positions, and he defended his own comments that he doesn’t want his daughters competing in athletics against men.

“I don’t want them getting run over on a playing field by a male or formerly male athlete, but as a Democrat I’m supposed to be afraid to say that,” Moulton told The New York Times last week.

Before he resigned his post as Texas Democratic chairman, Gilberto Hinojosa said supporting transgender rights doesn’t necessarily have to include public funding for gender reassignment surgery.

“We can say, ’OK, we respect people’s right to say, we don’t want my taxpayer money to be used for that,’” Hinojosa told Texas Public Radio. Hinojosa later apologized via social media, saying LGBTQ Americans “deserve to feel seen, valued and safe in our state and our party.”

Ellis, the CEO of GLAAD, pointed to Delaware voters choosing to make state Sen. Sarah McBride the first transgender member of Congress as evidence that Americans “don’t hate trans people.”

For her part, McBride, a Democrat from Delaware, noted that she did not run on her identity – though it was not a secret – and instead talked to voters about “affordable health care, housing and child care” for everyone.

“The party that was focused on culture wars, the party that was focused on trans people was the Republican Party,” McBride told reporters on Capitol Hill after her victory. “It was Donald Trump,” she added, who “was trying to divide and distract from the fact that he has absolutely no policy solutions for the issues that are actually keeping voters up at night.”

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Levy reported from Harrisburg, Pennsylvania. Associated Press writer Farnoush Amiri in Washington contributed to this report.