Student athletes in Washington state schools who want to compete in girls' sports would likely have to obtain genital exams to participate, if a controversial ballot initiative passes in November.

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Language in the initiative claims that kids are already required to undergo verification of their “biological sex” before they can play sports. But KUOW spoke with medical professionals and a school sports official who said otherwise. Paperwork used by medical professionals in sports physicals also shows that the initiative would be a departure from current state requirements for athletic participation.

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.

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Conservative hedge fund manager Brian Heywood and his political action committee Let’s Go Washington are backing the measure. Heywood said he’s concerned with fairness and safety in girls’ sports, insisting that transgender girls have physical advantages over cisgender girls.