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At least 11 states and two territories have complied with a new directive from the federal government to eliminate mentions of gender identity and the presence of transgender and non-binary individuals from a national sexual health program, officials confirmed.

The government set a Monday deadline for removing these mentions, threatening the withdrawal of substantial government funding. Almost every of the complying states have GOP-led state legislatures and predominantly GOP governors.

Legal Challenges and Funding Disputes

Sixteen other states and Washington DC have filed a lawsuit challenging the administration's demand, arguing it violates Congressional authority, which established the $75m sexual health initiative, known as the Personal Responsibility Education Program (Prep).

All states participating in the lawsuit are governed by Democratic governors.

In a recent court order, a federal judge blocked the Department of Health and Human Services (HHS), which oversees Prep, from cutting financial support to the Democratic states if they refuse to comply.

“HHS fails to show that the new grant conditions are reasonable, nor does it offer any valid reason, other than pretext, for its actions,” wrote the judge, a federal jurist in the state. “HHS provides no evidence that it made informed determinations or considered the statutory objectives.”

Initiative Aims and Federal Review

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

In April, the Trump administration demanded all jurisdictions obtaining program money to submit a version of their curriculum to HHS and its agency, the Administration for Children and Families, for a health content assessment.

Four months later, the government dispatched notices to numerous jurisdictions, informing them that, during the evaluation, it had discovered “material in the curricula that fall outside the purview of Prep’s authorizing statute.”

Specifically, the administration said it had uncovered evidence of “gender-related concepts,” a phrase often used by rightwing groups to describe the notion that identity is a changeable cultural concept and that transgender individuals are real.

Specific Examples of Requested Changes

The administration directed one state to drop a lesson that said: “Young people may express themselves in ways that differ from their biological sex.”

It instructed another state to delete a sentence 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 numerous states could no longer be told to “show tolerance and understanding for all students, irrespective of individual traits, including ethnicity, cultural background, religion, social class, orientation or gender identity,” based on the notices dispatched to states.

Government Comments and State Responses

“Accountability is coming,” declared a federal official, interim leader of the ACF office, in a statement. “Government money will not be used to poison the minds of the next generation or advance dangerous ideological agendas.”

Multiple states and regions stated they would remove the references or had completed the process. These consist of eleven specific states, as well as the two territories.

Another pair of jurisdictions, the states, reported their educational programs never included the language mentioned in the administration’s letters.

Impact on Youth and Psychological Well-being

Collectively, these states are inhabited by over 120k transgender individuals aged 13 to 17, based on estimates from a university department.

“If our goal is to support youth and give them a secure environment, I’m not sure why we are stomping on the most vulnerable youth in the community,” said an advocate, who leads an organization that provides sex education in Tennessee.

“If authorities state that there’s something wrong with 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 transgender adolescents seriously considered suicide in the past year, according to a 2024 survey from a suicide-prevention group. Educational backing for these youths is linked to lower rates of attempted suicide, the organization discovered.

Earlier Incidents and Ongoing Disputes

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

When the jurisdiction declined, the administration withdrew its funding, eliminating about $12 million in government money and halting health initiatives in schools, youth centers and care facilities.

The state agency is challenging the termination. So far, it has been unable to replace the lost funding.

The Trump administration has additionally informed instructors who receive money from two other federal sex education initiatives, the $50 million SRAE program and the $101m Teen Pregnancy Prevention Program (TPPP), that they cannot teach about “gender ideology.”

An recent judicial ruling blocked the government from altering one program, 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 immediately respond to a request for comment.