President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr. attend an event introducing a new Make America Healthy Again Commission report in the East Room of the White House on May 22, 2025 in Washington, DC.
The Department of Health and Human Services issued an ultimatum to 46 states.
The Trump administration has escalated its campaign against trans-inclusive sex education, ordering nearly every U.S. state and territory to remove references to “gender ideology” from federally funded programs or risk losing millions of dollars.
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The move, announced Tuesday by the Department of Health and Human Services’ Administration for Children and Families, builds on last week’s revocation of California’s grant and signals a nationwide rollback of longstanding public health initiatives.
What is the program?
At stake is the Personal Responsibility Education Program or PREP, not to be confused with the HIV prevention medication PrEP, created in 2010 with bipartisan support to provide medically accurate instruction on contraception, abstinence, and healthy relationships for at-risk youth, including those in foster care, juvenile detention, homeless shelters, and rural communities with high teen birth rates.
Related: Why experts say Trump’s revocation of California grant funds over trans inclusion endangers all at-risk kids
The August 26 letters sent to 46 state PREP officials explicitly assign blame to inclusive content. They state that certain materials, including lessons defining gender identity as distinct from sex or offering pronoun guidance, “do not adhere to the PREP statute,” which “includes no mention of gender ideology” and focuses solely on facilitating abstinence and contraceptive education.
Roughly $81 million in funding could be withheld, suspended, or terminated if states do not comply by October 8 at midnight.
