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At least eleven jurisdictions and a pair of regions have agreed to a recent directive from the federal government to remove references of transgender issues and the existence of trans and non-binary people from a federal sexual health program, authorities confirmed.

The government set a Monday deadline for stripping these mentions, threatening the withdrawal of millions in federal funds. Almost every of the agreeing jurisdictions have GOP-led state legislatures and predominantly GOP state leaders.

Court Battles and Financial Conflicts

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

All states involved in the lawsuit are led by Democratic state executives.

In a recent judicial ruling, a U.S. judge prevented the Department of Health and Human Services (HHS), which oversees the program, from withholding funding to the suing jurisdictions if they refuse to comply.

“The agency does not demonstrate that the new grant conditions are justified, let alone offer any reasonable explanation, other than pretext, for its actions,” wrote Ann Aiken, a federal jurist in Oregon. “The department offers no proof that it made informed determinations or took into account the statutory objectives.”

Initiative Aims and Government Scrutiny

Prep seeks to educate adolescents on positive interactions and how to prevent unplanned parenthood and the spread of STIs.

In the spring, the Trump administration demanded all states and territories receiving Prep funds to submit a version of their curriculum to the department and its subsidiary, the ACF office, for a “medical accuracy review”.

By late summer, the administration sent letters to numerous jurisdictions, informing them that, during the evaluation, it had found “material in the curricula that deviate from the scope of Prep’s authorizing statute.”

Specifically, the administration claimed it had uncovered evidence of “gender ideology,” a phrase often used by rightwing groups to describe the idea that gender is a changeable cultural concept and that trans and non-binary people are real.

Specific Examples of Required Alterations

The government instructed Illinois to remove a curriculum that stated: “Young people may express themselves in ways that differ from their biological sex.”

It instructed another state to eliminate a line from a educational module that stated: “Individuals regardless of identity need to know how to prevent unplanned pregnancy and infections.”

Additionally, health instructors in numerous states could no longer be told to “show tolerance and understanding for all students, irrespective of individual traits, including ethnicity, heritage, religion, social class, orientation or identity,” based on the notices dispatched to states.

Government Comments and Jurisdictional Reactions

“Oversight is imminent,” declared Andrew Gradison, acting assistant secretary of the ACF office, in a announcement. “Federal funds will not be used to poison the minds of the next generation or promote dangerous ideological agendas.”

Multiple states and regions stated they would eliminate the references or had already done so. These consist of eleven specific states, as well as the U.S. Virgin Islands and the Northern Mariana Islands.

Two other states, the states, reported their educational programs never included the terminology referenced in the administration’s letters.

Effects on Adolescents and Psychological Well-being

Together, these states are inhabited by more than 120,000 transgender individuals aged 13 to 17, based on estimates from a research institute.

“If our goal is to support youth and give them a safe space, I’m not sure why we are targeting the at-risk teenagers in the community,” said Cindi Huss, who leads Rise that offers health instruction in one state.

“When the government says that there’s something wrong with 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 secure – that’s detrimental to psychological well-being.”

Nearly half of transgender adolescents contemplated self-harm in the past year, based on a 2024 survey from a suicide-prevention group. Educational backing for these adolescents is associated with lower rates of attempted suicide, the organization found.

Previous Actions and Ongoing Disputes

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

When the jurisdiction refused, the administration revoked its funding, cutting approximately $12m in federal funding and stopping health initiatives in educational institutions, youth centers and group homes for foster children.

The California health department is appealing the termination. So far, it has been unable to replace the lost funding.

The government has also told educators who obtain funding from additional national programs, the $50m SRAE program and the $101m TPPP initiative, that they may not teach about “gender ideology.”

An early October court order blocked the administration from altering TPPP, while the Monday court order prohibits it from changing the other program in the Democratic states that sued over Prep.

The ACF office did not provide a prompt reply to a inquiry.