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At least 11 states and a pair of regions have complied with a new directive from the federal government to remove references of gender identity and the presence of trans and non-binary people from a national sex education initiative, officials confirmed.

The administration established a recent cutoff for stripping these mentions, threatening the loss of millions in federal funds. Nearly all of the complying states have Republican-controlled lawmaking bodies and predominantly Republican state leaders.

Legal Challenges and Financial Conflicts

Sixteen other states and Washington DC have initiated legal action against the administration's demand, arguing it violates legislative power, which created the $75 million sexual health initiative, known as the PREP initiative.

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

In a recent court order, a U.S. judge blocked the Department of Health and Human Services (HHS), which oversees the program, from cutting financial support to the suing jurisdictions if they refuse to comply.

“HHS fails to show that the updated requirements are justified, let alone offer any reasonable explanation, other than an excuse, for its actions,” stated the judge, a federal jurist in the state. “The department offers no proof that it made informed determinations or took into account the legal goals.”

Program Goals and Federal Review

The program seeks to inform teenagers on positive interactions and how to avoid pregnancy and the transmission of STIs.

In the spring, the federal government required all jurisdictions receiving program money to provide a copy of their educational materials to HHS and its subsidiary, the ACF office, for a health content assessment.

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

In particular, the administration said it had uncovered evidence of “gender-related concepts,” a phrase often used by rightwing groups to describe the idea that gender is a fluid cultural concept and that trans and non-binary people are real.

Notable Cases of Requested Changes

The administration instructed one state to drop a curriculum that said: “Adolescents may express themselves in ways that differ from their biological sex.”

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 avoid unplanned pregnancy and infections.”

Additionally, health instructors in many jurisdictions could no longer be instructed to “show tolerance and understanding for all participants, irrespective of individual traits, including race, heritage, faith, social class, sexual orientation or gender identity,” according to the notices dispatched to jurisdictions.

Government Comments and State Responses

“Oversight is imminent,” said Andrew Gradison, interim leader of the Administration for Children and Families, in a statement. “Government money will not be used to poison the minds of the next generation or promote harmful political doctrines.”

Multiple states and territories stated they would remove the content or had completed the process. These include eleven specific states, as well as the two territories.

Another pair of jurisdictions, Alabama and South Dakota, said their Prep curricula never included the language referenced in the administration’s letters.

Effects on Adolescents and Mental Health

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 an advocate, who leads an organization that offers health instruction in one state.

“If authorities state that there’s something incorrect about 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 safe – that’s horrible for mental health.”

Nearly half of transgender adolescents contemplated self-harm in the past year, according to a recent study from a mental health organization. School support for these adolescents is associated with lower rates of self-harm attempts, the organization found.

Earlier Incidents and Continuing Conflicts

Previously, the federal government instructed California to remove mentions to gender identity 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 educational institutions, youth centers and care facilities.

The state agency is challenging the withdrawal. So far, it has been unsuccessful in replace the withdrawn money.

The Trump administration has additionally told instructors who obtain funding from two other federal sex education initiatives, the $50m SRAE program and the $101m Teen Pregnancy Prevention Program (TPPP), that they cannot teach about “gender-related concepts.”

An early October court order blocked the government from changing TPPP, while the latest ruling prohibits it from modifying the other program in the Democratic states that challenged the initiative.

The ACF office did not immediately respond to a request for comment.