10/30/2026
The claim tracks a real frustration on the right, but the specifics need tightening.
What Youngkin actually did (and did not do)
Glenn Youngkin’s administration (2022–early 2026) never enacted a statutory ban on gender-affirming medical interventions for minors in Virginia the way many red states did. There was no Youth Health Protection Act or equivalent that criminalized or fully prohibited puberty blockers, cross-s*x hormones, or surgeries for those under 18.
What they did pursue:
• 2023 model school policies emphasizing biological s*x for bathrooms, locker rooms, pronouns, and sports (many localities, especially Northern Virginia, largely ignored them).
• Late-term (October 2025) direction to the Board of Health to develop rules restricting biological males in girls’ sports and private facilities. Spanberger’s administration later quietly killed that rulemaking process.
• Pressure that contributed to major children’s hospitals (UVA, VCU/Children’s Hospital of Richmond, CHKD) pausing new youth gender clinics in 2025 after the Trump executive order and related federal threats. Youngkin publicly praised UVA’s Board of Visitors for stopping the treatments for minors.
Virginia never banned the procedures themselves under state law while Republicans held the governorship. Democrats in the legislature blocked or diluted stronger measures. That gap is exactly what critics on the populist/right flank (including Rutledge-style messaging) have hammered: the Youngkin-aligned establishment talked parental rights and “protecting women and girls” but stopped short of the medical side that many base voters considered non-negotiable.
The turnout piece
2025 gubernatorial data shows lower relative turnout in historically Republican localities compared with 2021, while Democratic-leaning areas held steady or rose. Overall statewide turnout was roughly comparable (~54%), but the geographic pattern hurt Republicans and helped produce the Spanberger sweep. 
There is no clean public data set proving “a million Republicans stayed home” specifically over gender-affirming care. The number is campaign rhetoric more than a precise figure. Still, the broader point lands with a segment of the base: repeated disappointment on cultural issues (schools, sports, medicalization of minors) after 2021 contributed to demoralization, weaker enthusiasm, and soft support once the Youngkin team was no longer the insurgent force.
Current reality (October 2026)
Under Spanberger, Virginia’s Medicaid/CHIP stopped covering gender dysphoria services for minors after the federal Trump-era rule took effect. Spanberger blames Washington; the ACLU notes the state could have chosen to fund it with state dollars (as some other states have). Hospitals have kept youth programs paused since 2025. The political fight continues, but the medical restrictions that finally arrived came more from federal action and hospital risk calculations than from anything Youngkin locked in permanently.
Rutledge’s line is classic base-versus-establishment framing: the people who had power and the platform to stop it earlier chose half-measures, the base noticed, enthusiasm cratered, and the same circle now wants loyalty again. Whether that fully explains the 2025 numbers is debatable; that it resonates with a meaningful share of Virginia Republicans who sat out or stayed home is not.