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At least eleven jurisdictions and two territories have complied with a new directive from the Trump administration to remove references of transgender issues and the presence of trans and non-binary people from a national sexual health program, authorities stated.

The administration established a Monday deadline for stripping these mentions, warning the loss of substantial government funding. Nearly all of the agreeing jurisdictions have GOP-led state legislatures and predominantly GOP state leaders.

Legal Challenges and Funding Conflicts

Sixteen other states and Washington DC have initiated legal action challenging the government's requirement, arguing it violates Congressional authority, which created the $75 million sex education program, known as the PREP initiative.

All states involved in the legal challenge are led by Democrat governors.

In a recent court order, a U.S. judge blocked the HHS agency, which oversees the program, from withholding funding 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 reasonable explanation, other than an excuse, for its decisions,” wrote Ann Aiken, a federal jurist in the state. “The department offers no proof that it made informed determinations or considered the legal goals.”

Program Goals and Federal Review

Prep seeks to educate adolescents on healthy relationships and how to prevent pregnancy and the spread of sexually transmitted infections.

In the spring, the Trump administration required all jurisdictions obtaining program money to submit a copy of their curriculum to the department and its subsidiary, the Administration for Children and Families, for a health content assessment.

Four months later, the administration sent letters to numerous jurisdictions, informing them that, during the evaluation, it had discovered “content in the educational programs that deviate from the scope of Prep’s authorizing statute.”

In particular, the government said it had identified evidence of “gender-related concepts,” 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 exist.

Specific Examples of Requested Changes

The government instructed Illinois to remove a curriculum that stated: “Adolescents may express themselves in ways that don’t conform with their assigned gender.”

It told North Carolina to eliminate a sentence from a educational module that read: “Individuals regardless of identity need to know how to avoid pregnancy and STDs.”

Moreover, health instructors in numerous states could no longer be told to “demonstrate acceptance and respect for all participants, irrespective of personal characteristics, including race, heritage, religion, economic status, sexual orientation or identity,” based on the letters dispatched to jurisdictions.

Government Comments and Jurisdictional Reactions

“Accountability is coming,” declared a federal official, acting assistant secretary of the ACF office, in a statement. “Federal funds will not be used to negatively influence of the next generation or promote dangerous ideological agendas.”

Multiple jurisdictions and territories stated they would eliminate the content or had completed the process. These include Alaska, Georgia, Iowa, Kentucky, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, West Virginia and Wyoming, as well as the U.S. Virgin Islands and the Northern Mariana Islands.

Two other states, the states, reported their educational programs never included the terminology mentioned in the administration’s letters.

Impact on Youth and Mental Health

Collectively, these jurisdictions are inhabited by more than 120k transgender individuals between the ages of 13 and 17, according to projections from a research institute.

“When the aim is to support youth and give them a secure environment, I’m not sure why we are stomping on the at-risk teenagers in the community,” said Cindi Huss, who leads an organization that provides sex education in Tennessee.

“If authorities state that there’s something incorrect about you and the teachers aren’t allowed to provide information or they have to out you to your parents – when you know that that’s not safe – that’s horrible for mental health.”

Almost 50% of trans and non-binary youth seriously considered suicide in the past year, according to a 2024 survey from a mental health organization. Educational backing for these youths is associated with lower rates of attempted suicide, the group found.

Earlier Incidents and Ongoing Disputes

Earlier this year, the federal government ordered a state to cut references to transgender topics from its Prep curriculum.

When the Democratic-led state refused, the government revoked its Prep grant, eliminating about $12 million in federal funding and halting health initiatives in schools, juvenile detention facilities and group homes for foster children.

The California health department is appealing the withdrawal. To date, it has been unsuccessful in replace the lost funding.

The Trump administration has additionally told educators who receive funding from two other federal sex education initiatives, the $50 million Sexual Risk Avoidance Education (SRAE) and the $101m TPPP initiative, that they may not teach about “gender ideology.”

An early October judicial ruling blocked the government from changing TPPP, while the Monday court order stops it from changing SRAE in the suing jurisdictions that challenged Prep.

The ACF office did not provide a prompt reply to a inquiry.