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No fewer than eleven jurisdictions and a pair of regions have complied with a recent demand from the federal government to remove mentions of transgender issues and the existence of trans and non-binary people from a federal sexual health program, officials stated.

The government established a Monday deadline for removing these mentions, warning the withdrawal of millions in federal funds. Nearly all of the agreeing jurisdictions have Republican-controlled lawmaking bodies and mostly Republican state leaders.

Court Battles and Funding Disputes

Sixteen other states and Washington DC have initiated legal action against the administration's demand, claiming it violates Congressional authority, which established the $75 million sex education program, known as the PREP initiative.

All states participating in the legal challenge are governed by Democratic governors.

In a recent court order, a federal judge blocked the Department of Health and Human Services (HHS), which manages the program, from withholding funding to the suing jurisdictions if they do not adhere.

“HHS fails to show that the new grant conditions are justified, let alone offer any reasonable explanation, other than an excuse, for its decisions,” wrote the judge, a U.S. district judge in Oregon. “HHS provides no evidence that it made factual findings or considered the legal goals.”

Initiative Aims and Government Scrutiny

Prep aims to inform teenagers on positive interactions and how to prevent unplanned parenthood and the spread of STIs.

In April, the Trump administration required all states and territories receiving Prep funds to provide a copy of their educational materials to HHS and its agency, the ACF office, for a “medical accuracy review”.

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

Specifically, the government said it had uncovered evidence of “gender ideology,” a phrase often used by conservative groups 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 one state to remove a lesson that stated: “Adolescents may identify in ways that differ from their biological sex.”

It told North Carolina to eliminate a sentence from a educational module that stated: “Individuals regardless of identity need to know how to prevent unplanned pregnancy and infections.”

Additionally, health instructors in many jurisdictions could no longer be told to “show tolerance and understanding for all students, regardless of individual traits, including race, heritage, faith, social class, sexual orientation or gender identity,” based on the notices sent to jurisdictions.

Government Comments and Jurisdictional Reactions

“Oversight is imminent,” said a federal official, acting assistant secretary of the ACF office, in a announcement. “Federal funds will not be used to negatively influence of the next generation or advance dangerous ideological agendas.”

Multiple states and regions stated they would eliminate the references or had completed the process. 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 Prep curricula never included the terminology referenced in the administration’s letters.

Impact on Youth and Mental Health

Collectively, these jurisdictions are inhabited by over 120,000 trans people aged 13 to 17, according to estimates from a university department.

“If our goal is to support youth and give them a safe space, I’m not sure why we are targeting the most vulnerable youth in the community,” commented Cindi Huss, who heads Rise that provides sex education in one state.

“If authorities state that there’s something incorrect about you and the educators 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 transgender adolescents seriously considered suicide in the previous twelve months, based on a 2024 survey from a mental health organization. School support for these youths is linked to reduced numbers of attempted suicide, the group found.

Previous Actions and Continuing Conflicts

Previously, the federal government ordered a state to remove mentions to transgender topics from its Prep curriculum.

When the Democratic-led state declined, the government revoked its Prep grant, eliminating about $12 million in government money and halting health initiatives in schools, youth centers and group homes for foster children.

The state agency is challenging the termination. To date, it has been unsuccessful in make up for the lost funding.

The Trump administration has also told instructors who obtain money from additional national programs, the $50 million SRAE program and the $101 million TPPP initiative, that they may not teach about “gender-related concepts.”

An recent judicial ruling prevented the government from altering one program, while the latest ruling stops it from modifying the other program in the Democratic states that sued over the initiative.

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