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No fewer than 11 states and a pair of regions have agreed to a new demand from the federal government to eliminate references of gender identity and the presence of transgender and non-binary individuals from a national sex education initiative, authorities stated.

The government set a Monday deadline for removing these references, threatening the loss of substantial government funding. Almost every of the complying states have Republican-controlled state legislatures and mostly Republican governors.

Court Battles and Funding Disputes

An additional sixteen jurisdictions and Washington DC have initiated legal action against the government's requirement, arguing it violates Congressional authority, which established the $75m sex education program, known as the PREP initiative.

All states involved in the legal challenge are governed by Democratic state executives.

In a recent judicial ruling, a federal judge prevented the Department of Health and Human Services (HHS), which oversees the program, from cutting financial support to the suing jurisdictions if they do not adhere.

“HHS fails to show that the updated requirements are reasonable, let alone offer any reasonable explanation, 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 took into account the statutory objectives.”

Initiative Aims and Government Scrutiny

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

In the spring, the Trump administration required all states and territories receiving program money to submit a copy of their educational materials to HHS and its subsidiary, the Administration for Children and Families, for a health content assessment.

Four months later, the administration dispatched notices to 46 states and territories, stating that, during the review, it had found “content in the curricula that deviate from the purview of the program's legal framework.”

Specifically, the administration said it had uncovered evidence of “gender-related concepts,” a phrase often used by rightwing groups to refer to the idea that gender is a changeable 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 said: “Young people may express themselves in ways that don’t conform with their assigned gender.”

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

Additionally, sex educators in numerous states could no longer be told to “show tolerance and understanding for all students, irrespective of individual traits, including race, heritage, religion, economic status, sexual orientation or gender identity,” according to the letters sent to jurisdictions.

Official Statements and State Responses

“Accountability is coming,” said a federal official, acting assistant secretary of the Administration for Children and Families, in a announcement. “Federal funds will not be used to negatively influence of the youth or promote dangerous ideological agendas.”

Multiple states and territories confirmed they would eliminate the references or had completed the process. These include eleven specific states, as well as the U.S. Virgin Islands and the Northern Mariana Islands.

Another pair of jurisdictions, Alabama and South Dakota, said their educational programs never contained the terminology referenced in the government's notices.

Effects on Adolescents and Psychological Well-being

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

“When the aim is to help adolescents and give them a safe space, I’m not sure why we are targeting the at-risk teenagers in the population,” commented an advocate, who heads an organization that provides sex education in one state.

“If authorities state that there’s something wrong with you and the teachers aren’t allowed to tell you things or they have to disclose your identity to family – when you know that that’s not safe – that’s detrimental to psychological well-being.”

Nearly half of trans and non-binary youth contemplated self-harm in the past year, according to a 2024 survey from a mental health organization. Educational backing for these adolescents is associated with lower rates of attempted suicide, the group discovered.

Previous Actions and Ongoing Disputes

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

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

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 instructors who receive funding from two other federal sex education initiatives, the $50m Sexual Risk Avoidance Education (SRAE) and the $101m TPPP initiative, that they cannot teach about “gender-related concepts.”

An early October court order blocked the administration from altering TPPP, while the latest ruling prohibits it from modifying the other program in the Democratic states that sued over the initiative.

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