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At least eleven jurisdictions and two territories have agreed to a new demand from the Trump administration to remove references of transgender issues and the existence of transgender and non-binary individuals from a federal sexual health program, authorities stated.

The administration set a recent cutoff for stripping these mentions, threatening the withdrawal of millions in federal funds. Almost every of the complying states have GOP-led lawmaking bodies and mostly Republican governors.

Legal Challenges and Funding Conflicts

Sixteen other states and the nation's capital have initiated legal action challenging the administration's demand, arguing it violates Congressional authority, which created the $75m sexual health initiative, known as the Personal Responsibility Education Program (Prep).

All states participating in the lawsuit are governed by Democrat governors.

In a recent court order, a U.S. judge prevented the Department of Health and Human Services (HHS), which manages the program, from cutting funding to the Democratic states if they do not adhere.

“The agency does not demonstrate that the updated requirements are justified, let alone offer any reasonable explanation, other than pretext, for its actions,” stated Ann Aiken, a U.S. district judge in Oregon. “HHS provides no evidence that it made factual findings or took into account the statutory objectives.”

Program Goals and Federal Review

Prep aims to educate teenagers on healthy relationships and how to avoid pregnancy and the transmission of sexually transmitted infections.

In the spring, the federal government required all jurisdictions obtaining Prep funds to provide a version of their curriculum to HHS and its agency, the ACF office, for a “medical accuracy review”.

By late summer, the government dispatched notices to 46 states and territories, stating that, during the review, it had discovered “material in the educational programs that deviate from the scope of Prep’s authorizing statute.”

In particular, the government said it had uncovered evidence of “gender-related concepts,” a phrase often used by conservative groups to describe the idea that identity is a changeable social construct and that trans and non-binary people exist.

Specific Examples of Required Alterations

The administration directed one state to remove a curriculum that said: “Adolescents may identify in ways that differ from their assigned gender.”

It instructed another state to eliminate a sentence from a middle school lesson that read: “People of all sexual orientations and gender identities need to know how to prevent unplanned pregnancy and infections.”

Additionally, health instructors in numerous states could no longer be instructed to “show tolerance and understanding for all students, irrespective of personal characteristics, including race, cultural background, religion, social class, orientation or identity,” based on the notices dispatched to states.

Official Statements and Jurisdictional Reactions

“Oversight is imminent,” said a federal official, interim leader of the ACF office, in a statement. “Federal funds will not be used to negatively influence of the youth or advance dangerous ideological agendas.”

Several states and regions confirmed they would eliminate the references or had already done so. These consist of Alaska, Georgia, Iowa, Kentucky, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, West Virginia and Wyoming, as well as the two territories.

Another pair of jurisdictions, the states, said their educational programs never included the language mentioned in the government's notices.

Effects on Adolescents and Mental Health

Collectively, these states are inhabited by more than 120,000 trans people between the ages of 13 and 17, based on projections from a university department.

“When the aim is to help adolescents and give them a safe space, I’m not sure why we are targeting the at-risk teenagers in the population,” said Cindi Huss, who heads an organization that offers health instruction in Tennessee.

“If authorities state that there’s something wrong with you and the teachers aren’t allowed to provide information or they have to disclose your identity to family – when you know that that’s not secure – that’s detrimental to psychological well-being.”

Almost 50% of trans and non-binary youth seriously considered suicide in the previous twelve months, according to a 2024 survey from a mental health organization. Educational backing for these youths is associated with reduced numbers of self-harm attempts, the organization found.

Earlier Incidents and Ongoing Disputes

Earlier this year, the Trump administration instructed California to remove mentions to transgender topics from its educational program.

When the jurisdiction declined, the administration withdrew its funding, eliminating approximately $12m in government money and halting sex education programs in schools, juvenile detention facilities and group homes for foster children.

The California health department is appealing the termination. So far, it has been unsuccessful in replace the withdrawn money.

The Trump administration has also informed educators who receive funding from two other federal sex education initiatives, the $50m SRAE program and the $101 million TPPP initiative, that they cannot teach about “gender ideology.”

An early October court order prevented the administration from altering one program, while the Monday court order prohibits it from modifying SRAE in the suing jurisdictions that sued over the initiative.

The Administration for Children and Families did not immediately respond to a inquiry.