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No fewer than eleven jurisdictions and two territories have agreed to a new demand from the federal government to remove mentions of gender identity and the presence of transgender and non-binary individuals from a national sexual health program, officials confirmed.

The administration set a recent cutoff for removing these references, threatening the withdrawal of millions in federal funds. Almost every of the agreeing jurisdictions have GOP-led state legislatures and mostly GOP governors.

Court Battles and Financial Disputes

An additional sixteen jurisdictions and Washington DC have initiated legal action against the administration's demand, arguing it violates legislative power, which created the $75 million sexual health initiative, known as the Personal Responsibility Education Program (Prep).

All states involved in the legal challenge are led by Democratic state executives.

In a late Monday judicial ruling, a federal judge blocked the HHS agency, which oversees Prep, from cutting financial support to the Democratic states if they do not adhere.

“The agency does not demonstrate that the new grant conditions are reasonable, let alone offer any valid reason, other than an excuse, for its actions,” stated the judge, a U.S. district judge in the state. “The department offers no proof that it made informed determinations or took into account the legal goals.”

Initiative Aims and Federal Review

The program seeks to educate teenagers on positive interactions and how to avoid pregnancy and the spread of STIs.

In April, the federal government required all states and territories obtaining program money to submit a version of their curriculum to HHS and its agency, the Administration for Children and Families, for a “medical accuracy review”.

By late summer, the government sent letters to 46 states and territories, informing them that, during the evaluation, it had discovered “content in the curricula that fall outside the scope of the program's legal framework.”

In particular, the administration said it had uncovered evidence of “gender ideology,” a phrase often used by rightwing factions to describe the notion that gender is a fluid cultural concept and that trans and non-binary people are real.

Specific Examples of Required Alterations

The government instructed one state to drop a lesson that said: “Young people may express themselves in ways that differ from their biological sex.”

It instructed another state to delete a line from a middle school lesson that read: “Individuals regardless of identity need to know how to avoid unplanned pregnancy and infections.”

Moreover, sex educators in numerous states could no longer be told to “demonstrate acceptance and respect for all students, irrespective of personal characteristics, including ethnicity, heritage, religion, social class, sexual orientation or identity,” based on the notices sent to jurisdictions.

Official Statements and Jurisdictional Reactions

“Accountability is coming,” said Andrew Gradison, interim leader of the ACF office, in a statement. “Federal funds will not be used to negatively influence of the youth or promote harmful political doctrines.”

Several jurisdictions and territories stated they would remove the references or had completed the process. These consist of eleven specific states, as well as the two territories.

Another pair of jurisdictions, Alabama and South Dakota, said their educational programs never contained the terminology referenced in the administration’s letters.

Effects on Adolescents and Psychological Well-being

Together, these jurisdictions are home to more than 120k trans people aged 13 to 17, according to estimates from a research institute.

“When the aim is to support youth and give them a safe space, I’m not sure why we are targeting the at-risk teenagers in the community,” said Cindi Huss, who heads an organization that provides sex education in one state.

“When the government says that there’s something incorrect about you and the teachers aren’t allowed to tell you things or they have to out you to your parents – when you know that that’s not secure – that’s detrimental to psychological well-being.”

Nearly half of transgender adolescents seriously considered suicide in the previous twelve months, according to a 2024 survey from a mental health organization. School support for these youths is associated with lower rates of self-harm attempts, the organization found.

Previous Actions and Ongoing Disputes

Earlier this year, the Trump administration instructed California to remove references to transgender topics from its Prep curriculum.

When the Democratic-led state declined, the government withdrew its funding, eliminating about $12 million in federal funding and halting sex education programs in schools, youth centers and care facilities.

The California health department is challenging the termination. To date, it has been unable to replace the lost funding.

The government has also told instructors who obtain money from two other federal sex education initiatives, the $50m Sexual Risk Avoidance Education (SRAE) and the $101 million TPPP initiative, that they may not teach about “gender-related concepts.”

An recent judicial ruling blocked the administration from altering one program, while the latest ruling prohibits it from modifying SRAE in the suing jurisdictions that sued over Prep.

The ACF office did not immediately respond to a inquiry.