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No fewer than eleven jurisdictions and two territories have complied with a recent directive from the federal government to eliminate references of transgender issues and the existence of transgender and non-binary individuals from a federal sexual health program, officials confirmed.

The administration set a Monday deadline for removing these mentions, warning the withdrawal of substantial government funding. Nearly all of the complying states have Republican-controlled lawmaking bodies and predominantly Republican state leaders.

Court Battles and Funding Disputes

An additional sixteen jurisdictions and the nation's capital have initiated legal action challenging the government's requirement, claiming it infringes on legislative power, which established the $75 million sex education program, known as the Personal Responsibility Education Program (Prep).

All jurisdictions participating in the legal challenge are led by Democratic state executives.

In a recent judicial ruling, a federal judge prevented the Department of Health and Human Services (HHS), which manages the program, from cutting funding to the Democratic states if they refuse to comply.

“The agency does not demonstrate that the updated requirements are justified, let alone offer any reasonable explanation, other than pretext, 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 statutory objectives.”

Initiative Aims and Federal Review

Prep seeks to inform adolescents on positive interactions and how to prevent pregnancy and the spread of sexually transmitted infections.

In April, the Trump administration demanded all jurisdictions receiving Prep funds to provide a copy of their educational materials to the department and its agency, the ACF office, for a health content assessment.

By late summer, the government sent letters to 46 states and territories, stating that, during the evaluation, it had found “material in the educational programs that fall outside the scope of the program's legal framework.”

Specifically, the administration said it had uncovered evidence of “gender ideology,” a term often used by rightwing factions to describe the idea that identity is a fluid social construct and that trans and non-binary people exist.

Notable Cases of Requested Changes

The government instructed Illinois to drop a lesson that said: “Young people may identify in ways that don’t conform with their assigned gender.”

It told North Carolina to eliminate a line 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.”

Moreover, sex educators in many jurisdictions could no longer be told to “demonstrate acceptance and respect for all students, irrespective of personal characteristics, including race, cultural background, faith, economic status, orientation or gender identity,” based on the letters dispatched to jurisdictions.

Official Statements and Jurisdictional Reactions

“Oversight is imminent,” said Andrew Gradison, acting assistant secretary of the ACF office, in a announcement. “Federal funds will not be used to negatively influence of the youth or advance harmful political doctrines.”

Multiple jurisdictions and territories confirmed they would eliminate the content 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, Alabama and South Dakota, said their Prep curricula never included the terminology referenced in the administration’s letters.

Impact on Youth and Psychological Well-being

Collectively, these jurisdictions are inhabited by over 120,000 trans people between the ages of 13 and 17, based on estimates from a university department.

“When the aim is to help adolescents and give them a secure environment, I’m not sure why we are targeting the at-risk teenagers in the community,” commented Cindi Huss, who leads Rise that offers health instruction in one state.

“If authorities state that there’s something wrong with you and the educators 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 horrible for mental health.”

Almost 50% of trans and non-binary youth seriously considered suicide in the previous twelve months, based on a 2024 survey from a suicide-prevention group. Educational backing for these youths is linked to lower rates of self-harm attempts, the organization discovered.

Previous Actions and Continuing Conflicts

Earlier this year, the Trump administration instructed a state to remove mentions to transgender topics from its Prep curriculum.

When the jurisdiction refused, the administration withdrew its Prep grant, eliminating approximately $12m in government money and halting health initiatives in schools, youth centers and group homes for foster children.

The California health department is challenging the withdrawal. To date, it has been unsuccessful in make up for the lost funding.

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

An recent judicial ruling blocked the administration from changing TPPP, while the Monday court order 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.