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No fewer than eleven jurisdictions and a pair of regions have agreed to a recent demand from the Trump administration to eliminate mentions of gender identity and the existence of trans and non-binary people from a national sexual health program, authorities confirmed.

The government set a Monday deadline for removing these references, warning the withdrawal of substantial government funding. Almost every of the agreeing jurisdictions have GOP-led state legislatures and mostly GOP governors.

Court Battles and Financial Conflicts

An additional sixteen jurisdictions and Washington DC have filed a lawsuit challenging the administration's demand, claiming it infringes on Congressional authority, which established the $75m sex education program, known as the PREP initiative.

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

In a late Monday court order, a federal judge blocked the Department of Health and Human Services (HHS), which manages Prep, from cutting funding to the Democratic states if they do not adhere.

“HHS fails to show that the updated requirements are reasonable, let alone offer any reasonable explanation, other than an excuse, for its decisions,” wrote the judge, a federal jurist in the state. “HHS provides no evidence that it made factual findings or considered the statutory objectives.”

Program Goals and Federal Review

Prep seeks to inform teenagers on positive interactions and how to avoid pregnancy and the transmission of STIs.

In April, the federal government demanded all states and territories receiving program money to provide a copy of their curriculum to the department and its agency, the ACF office, for a “medical accuracy review”.

By late summer, the administration sent letters to 46 states and territories, stating that, during the review, it had discovered “material in the curricula that deviate from the scope of Prep’s authorizing statute.”

Specifically, the government said it had uncovered evidence of “gender-related concepts,” a phrase often used by rightwing groups to describe the notion that gender is a fluid cultural concept and that transgender individuals exist.

Notable Cases of Required Alterations

The administration instructed one state to drop a lesson that stated: “Adolescents may express themselves in ways that don’t conform with their assigned gender.”

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

Moreover, health instructors in many jurisdictions could no longer be told to “show tolerance and understanding for all students, regardless of personal characteristics, including ethnicity, heritage, religion, social class, orientation or gender identity,” according to the notices sent to states.

Official Statements and State Responses

“Oversight is imminent,” declared Andrew Gradison, interim leader of the Administration for Children and Families, in a announcement. “Federal funds will not be used to negatively influence of the youth or advance dangerous ideological agendas.”

Several jurisdictions and territories confirmed they would eliminate the content or had already done so. These consist of eleven specific states, as well as the U.S. Virgin Islands and the Northern Mariana Islands.

Two other states, Alabama and South Dakota, reported their Prep curricula never included the language referenced in the government's notices.

Impact on Youth and Mental Health

Together, these jurisdictions are inhabited by over 120k trans people between the ages of 13 and 17, based on projections from a research institute.

“If our goal is to help adolescents and give them a secure environment, I’m not sure why we are targeting the most vulnerable youth in the population,” said an advocate, who heads Rise that provides sex education in Tennessee.

“When the government says that there’s something wrong with 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 safe – that’s detrimental to psychological well-being.”

Nearly half of transgender adolescents contemplated self-harm in the past year, according to a 2024 survey from a suicide-prevention group. School support for these adolescents is linked to reduced numbers of attempted suicide, the organization found.

Earlier Incidents and Continuing Conflicts

Previously, the Trump administration instructed a state to remove references to transgender topics from its educational program.

When the Democratic-led state declined, the government revoked its funding, eliminating about $12 million in federal funding and halting health initiatives in educational institutions, youth centers and care facilities.

The state agency is challenging the withdrawal. To date, it has been unable to make up for the withdrawn money.

The Trump administration has additionally told educators who obtain money from two other federal sex education initiatives, the $50m Sexual Risk Avoidance Education (SRAE) and the $101 million Teen Pregnancy Prevention Program (TPPP), that they cannot teach about “gender ideology.”

An recent court order prevented the administration from altering one program, while the latest ruling prohibits it from changing the other program in the Democratic states that challenged the initiative.

The ACF office did not immediately respond to a inquiry.