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No fewer than 11 states and two territories have agreed to a new directive from the Trump administration to remove references of transgender issues and the existence of trans and non-binary people from a national sexual health program, authorities confirmed.

The government established a Monday deadline for removing these references, threatening the withdrawal of millions in federal funds. Almost every of the agreeing jurisdictions have GOP-led state legislatures and mostly Republican state leaders.

Legal Challenges and Funding Conflicts

Sixteen other states and the nation's capital have initiated legal action against the administration's demand, claiming it violates Congressional authority, which established the $75 million sexual health initiative, known as the Personal Responsibility Education Program (Prep).

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

In a late Monday judicial ruling, a federal judge blocked the Department of Health and Human Services (HHS), which manages the program, from cutting financial support to the Democratic states if they refuse to comply.

“The agency does not demonstrate that the new grant conditions are reasonable, nor does it offer any valid reason, other than pretext, for its decisions,” stated Ann Aiken, a federal jurist in the state. “HHS provides no evidence that it made factual findings or took into account the legal goals.”

Program Goals and Government Scrutiny

Prep seeks to educate adolescents on healthy relationships and how to avoid pregnancy and the spread of STIs.

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

Four months later, the administration sent letters to numerous jurisdictions, stating that, during the review, it had discovered “content in the educational programs that fall outside the scope of the program's legal framework.”

In particular, the government said it had uncovered evidence of “gender ideology,” a phrase often used by conservative groups to refer to the notion that gender is a fluid social construct and that transgender individuals are real.

Notable Cases of Required Alterations

The administration instructed Illinois to remove a lesson that said: “Young people may express themselves in ways that differ from their biological sex.”

It instructed North Carolina to delete a line from a educational module that read: “People of all sexual orientations and gender identities need to know how to prevent pregnancy and STDs.”

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

Official Statements and State Responses

“Oversight is imminent,” declared Andrew Gradison, acting assistant secretary of the Administration for Children and Families, in a statement. “Federal funds will not be used to negatively influence of the next generation or promote harmful political doctrines.”

Several jurisdictions and territories stated they would eliminate the content 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, the states, said their educational programs never contained the language mentioned in the administration’s letters.

Impact on Youth and Mental Health

Together, these jurisdictions are home to more than 120,000 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 community,” said Cindi Huss, who heads an organization that offers health instruction in Tennessee.

“When the government says that there’s something incorrect about you and the educators aren’t allowed to tell you things or they have to disclose your identity to family – when you know that that’s not secure – that’s detrimental to psychological well-being.”

Nearly half of transgender adolescents seriously considered suicide in the past year, according to a recent study from a suicide-prevention group. Educational backing for these adolescents is associated with lower rates of self-harm attempts, the group discovered.

Previous Actions and Continuing Conflicts

Earlier this year, the Trump administration instructed California to cut mentions to transgender topics from its Prep curriculum.

When the jurisdiction refused, the administration withdrew its funding, cutting about $12 million in federal funding and halting health initiatives in schools, juvenile detention facilities and care facilities.

The California health department is challenging the withdrawal. To date, it has been unable to replace the withdrawn money.

The Trump administration has additionally informed instructors who obtain funding from two other federal sex education initiatives, the $50 million Sexual Risk Avoidance Education (SRAE) and the $101m TPPP initiative, that they may not teach about “gender-related concepts.”

An recent judicial ruling blocked the administration from changing one program, while the latest ruling stops it from changing SRAE in the Democratic states that sued over the initiative.

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