GOP ad says Janelle Stelson wants taxpayers to pay for transgender inmates' surgery. Her campaign says it's false.

A 15-second ad in support of Republican U.S. Rep. Scott Perry's reelection bid claims that his Democratic opponent, Janelle Stelson, stands with Vice President Kamala Harris in the belief that "taxpayers should fund sex-change operations for prisoners, illegal aliens, and even minor children."

The ad concludes, "That's crazy."

It's part of a trend: Republicans using gender-affirming care as a wedge issue in the lead-up to the Nov. 5 election. LGBTQ rights advocates say these ads stoke fear about a vulnerable community.

Stelson's representatives dispute the assertions made in the ad, for which House Freedom Action, the political arm of the hard-right House Freedom Caucus, claims responsibility. Perry, who represents Pennsylvania's 10th Congressional District, once served as chairman of the caucus.

"We don't know what they're citing," said Alma Baker, Stelson's campaign manager.

J.J. Balaban, a partner at Technicolor Political, the firm making the ads for Stelson's campaign, said, "Team Stelson has no idea what Scott Perry's close allies are talking about."

Representatives for House Freedom Action as well as Perry's campaign did not respond to requests for comment. The ad was not mentioned during a debate between Stelson and Perry on Tuesday, although Stelson was asked whether she supports the military "paying for gender reassignment." She answered no.

Ads such as these tap into lingering fears many people have about transgender people, said Crystal Cheepudom, 49, of East Kensington, a Philadelphia Democratic committee person and an associate at a cancer nonprofit. She was part of a rally Thursday night in Center City organized by the Human Rights Campaign, Out for Harris-Walz, and Pennsylvania Democrats to turn out voters dedicated to promoting LGBTQ rights.

"Everyone is afraid of trans people," she said, because "you don't know them" and see them as "the other." Once you know a transgender person, though, Cheepudom continued, "you're less likely to say they're bad."

Another TV ad referencing gender-affirming surgery is currently circulating in the political arena, this one featuring former Pennsylvania Secretary of Health Rachel Levine, the first openly transgender person confirmed by the Senate to a federal position. Levine is currently assistant U.S. secretary of health.

The 30-second ad from the Trump campaign falsely implies that Levine is an inmate who underwent surgery in prison.

The ad is meant to rile and offend voters, deriving from "the extreme-right playbook," said Matt Jordan, a misinformation expert at Pennsylvania State University. "Blow up a microscopic thing into a huge culture war."

The catalyst for both ads was a statement based on Harris' response to a 2019 American Civil Liberties Union questionnaire in which she endorsed policies ensuring that incarcerated transgender individuals have access to medically necessary treatments, including gender-affirming surgeries.

Harris said: "It is important that transgender individuals who rely on the state for care receive the treatment they need, which includes access to treatment associated with gender transition."

During the Philadelphia debate between Harris and former President Donald Trump on Sept. 10, Trump seized on Harris' questionnaire answers and appeared to embellish them, saying: "Now she wants to do transgender operations on illegal aliens that are in prison. This is a radical left liberal that would do this."

The Harris campaign said last month that the ideas expressed in the questionnaire are not what the vice president is proposing in this election, and that they're not part of her platform.

A 'Frankenstein of an ad'

Harris' likeness appears in the House Freedom Action ad, juxtaposed with a photo of Stelson as though they are standing together. There are also images of medical personnel, as well as other individuals whose relationship to the congressional race is not clear.

"They've mashed together elements of immigration, health care, and LGBTQ imagery to make a Frankenstein of an ad that they just want people to be afraid of," said political scientist Sarah Niebler, an election expert at Dickinson College in Carlisle, which is in the 10th Congressional District.

"It's a common tactic to tie local candidates to national ones like Harris. When [President Joe] Biden ran in 2020, we saw ads in Central Pennsylvania that flashed pictures of liberals like U.S. Rep. Alexandria Ocasio-Cortez [D., N.Y.] and Sen. Bernie Sanders [Ind., Vt.].

"The thinking is, if they're all Democrats, they all have the same views."

Harrisburg-based Susquehanna Polling shows Stelson leading Perry 46% to 39%, with a 5% margin of error, in the race for the 10th District, which includes Democratic Dauphin County, home to Harrisburg, along with mostly Republican York and Cumberland Counties.

Perry, running for his seventh term, is a Trump ally and election denier who tried to halt certification of Pennsylvania's 2020 electoral votes,

Stelson is a Republican-turned-Democrat and a widely recognized, but politically untested, former news anchor for NBC affiliate TV station WGAL.

The contest is on the Democratic Congressional Campaign Committee's radar. Perry may be vulnerable in the Central Pennsylvania district, according to national congressional ratings outlets, and therefore worthy of a nationally financed campaign to help tip the GOP-controlled House into Democratic hands.

Said Niebler: "This is one of a handful of U.S. congressional seats that Democrats believe are flippable."

Staff writer Jesse Bunch contributed to this article.