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No fewer than eleven jurisdictions and two territories have complied with a new directive from the federal government to remove references of gender identity and the presence of transgender and non-binary individuals from a national sex education initiative, officials confirmed.

The government set a recent cutoff for stripping these mentions, warning the loss of millions in federal funds. Almost every of the agreeing jurisdictions have Republican-controlled state legislatures and mostly Republican governors.

Legal Challenges and Financial Disputes

Sixteen other states and Washington DC have filed a lawsuit challenging the government's requirement, arguing it violates Congressional authority, which created the $75 million sexual health initiative, known as the PREP initiative.

All jurisdictions involved in the legal challenge are governed by Democrat governors.

In a recent court order, a federal judge prevented the HHS agency, which manages the program, from cutting financial support to the Democratic states if they refuse to comply.

“HHS fails to show that the updated requirements are justified, let alone offer any valid reason, other than pretext, for its decisions,” wrote Ann Aiken, a U.S. district judge in Oregon. “The department offers no proof that it made informed determinations or considered the statutory objectives.”

Initiative Aims and Government Scrutiny

The program aims to inform adolescents on healthy relationships and how to avoid pregnancy and the spread of STIs.

In April, the Trump administration demanded all states and territories obtaining program money to submit a version of their educational materials to HHS and its subsidiary, the Administration for Children and Families, for a “medical accuracy review”.

Four months later, the administration dispatched notices to numerous jurisdictions, stating that, during the review, it had found “material in the curricula that deviate from the purview of Prep’s authorizing statute.”

In particular, the government said it had identified evidence of “gender-related concepts,” a term often used by rightwing groups to refer to the idea that identity is a changeable social construct and that transgender individuals are real.

Specific Examples of Requested Changes

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

It told North Carolina to delete a line from a educational module that stated: “People of all sexual orientations and gender identities need to know how to avoid unplanned pregnancy and infections.”

Moreover, sex educators in many jurisdictions could no longer be instructed to “demonstrate acceptance and respect for all students, regardless of individual traits, including race, cultural background, religion, social class, sexual orientation or identity,” according to 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 announcement. “Federal funds will not be used to poison the minds of the next generation or advance harmful political doctrines.”

Several jurisdictions and territories confirmed they would remove the content 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.

Two other states, Alabama and South Dakota, reported their Prep curricula never contained the language referenced in the administration’s letters.

Impact on Youth and Mental Health

Together, these states are home to over 120,000 trans people aged 13 to 17, according to estimates from a research institute.

“If our goal 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 population,” said an advocate, who leads Rise that provides sex education in one state.

“When the government says that there’s something wrong with you and the educators aren’t allowed to tell you things or they have to out you to your parents – when you know that that’s not secure – that’s horrible for mental health.”

Nearly half 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 reduced numbers of self-harm attempts, the group discovered.

Previous Actions and Continuing Conflicts

Previously, the Trump administration instructed California to cut mentions to transgender topics from its educational program.

When the jurisdiction declined, the administration revoked its funding, cutting about $12 million in federal funding and stopping health initiatives in schools, juvenile detention facilities and care facilities.

The California health department is challenging the termination. So far, it has been unsuccessful in make up for the lost funding.

The Trump administration has additionally informed instructors 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-related concepts.”

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

The ACF office did not provide a prompt reply to a request for comment.