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No fewer than 11 states and a pair of regions have agreed to a new directive from the federal government to eliminate references of gender identity and the existence of trans and non-binary people from a national sexual health program, officials stated.

The administration set a recent cutoff for stripping these mentions, threatening the withdrawal of millions in federal funds. Nearly all of the complying states have GOP-led state legislatures and mostly Republican governors.

Legal Challenges and Financial Disputes

Sixteen other states and the nation's capital have initiated legal action against the government's requirement, claiming it infringes on legislative power, which created the $75m sexual health initiative, known as the PREP initiative.

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

In a late Monday judicial ruling, a federal judge blocked 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,” stated the judge, a U.S. district judge in Oregon. “The department offers no proof that it made factual findings or considered the legal goals.”

Program Goals and Government Scrutiny

The program aims to inform adolescents on positive interactions and how to avoid unplanned parenthood and the spread of sexually transmitted infections.

In April, the federal government demanded all jurisdictions receiving program money to provide a version of their curriculum to the department and its agency, the Administration for Children and Families, for a “medical accuracy review”.

By late summer, the government sent letters to numerous jurisdictions, informing them that, during the review, it had found “material in the curricula that fall outside 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 describe the notion that gender is a fluid social construct and that transgender individuals are real.

Notable Cases of Required Alterations

The government directed one state to remove a curriculum that said: “Adolescents may identify in ways that don’t conform with their assigned gender.”

It instructed North Carolina to delete a line from a educational module that read: “Individuals regardless of identity need to know how to avoid pregnancy and STDs.”

Additionally, health instructors in numerous states could no longer be told to “demonstrate acceptance and respect for all participants, regardless of individual traits, including ethnicity, heritage, religion, social class, orientation or gender identity,” according to the notices dispatched to jurisdictions.

Official Statements and State Responses

“Accountability is coming,” said a federal official, interim leader of the ACF office, in a statement. “Federal funds will not be used to negatively influence of the youth or promote harmful political doctrines.”

Several states and territories stated they would remove the references or had already done so. These include eleven specific states, as well as the U.S. Virgin Islands and the Northern Mariana Islands.

Two other states, Alabama and South Dakota, said their educational programs never included the language referenced in the administration’s letters.

Effects on Adolescents and Psychological Well-being

Together, these jurisdictions are home to more than 120,000 trans people between the ages of 13 and 17, according to estimates from a research institute.

“When the aim is to support youth and give them a secure environment, I’m not sure why we are targeting the at-risk teenagers in the community,” commented an advocate, who leads Rise that offers health instruction in Tennessee.

“When the government says that there’s something incorrect about you and the teachers 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 transgender adolescents seriously considered suicide in the past year, according to a recent study from a suicide-prevention group. School support for these youths is associated with reduced numbers of attempted suicide, the organization found.

Previous Actions and Ongoing Disputes

Earlier this year, the federal government ordered California to cut mentions to transgender topics from its Prep curriculum.

When the Democratic-led state refused, the administration revoked its Prep grant, eliminating about $12 million in federal funding and halting health initiatives in schools, youth centers and group homes for foster children.

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

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

An early October court order blocked the administration from changing TPPP, while the latest ruling prohibits it from modifying SRAE in the Democratic states that challenged Prep.

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