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The Trump administration is endangering at-risk youth, experts say.
“If it’s a day ending in y, President Trump is attacking kids’ safety, health, and access to education as part of his culture war,” a spokesperson for Gov. Gavin Newsom told The Advocate.
The Trump administration is stripping funding from a program that helps California’s most vulnerable young people because the program includes services for transgender kids.
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On Thursday, the Department of Health and Human Services’ Administration for Children and Families terminated California’s grant for the Personal Responsibility Education Program, a congressionally authorized initiative that helps teens in foster care, homeless shelters, and rural communities learn about contraception, abstinence, and healthy relationships.
PREP, not to be confused with the HIV-prevention medications PrEP, is an educational program that's part of the Affordable Care Act and has been implemented in California since 2012, reaching tens of thousands of youth across 20 counties with the highest need. Its curricula are evidence-based and have been shown to delay sexual activity, increase condom use, and reduce teen pregnancies, according to the California Department of Public Health.
Related: Health experts warn Trump’s new policies for HHS teen pregnancy program could reverse decades of progress
In a six-page letter, ACF informed California officials that all PREP awards for fiscal years 2023 through 2025 were being canceled immediately. The agency said California’s curriculum included “gender ideology” outside the program’s statutory mandate, and that the state had refused to comply with a June directive ordering such content stripped out.
“California’s refusal to comply with federal law and remove egregious gender ideology from federally funded sex-ed materials is unacceptable,” Acting Assistant Secretary Andrew Gradison declared in a press release. “The Trump Administration will not allow taxpayer dollars to be used to indoctrinate children. Accountability is coming for every state that uses federal funds to teach children delusional gender ideology.”
The letter states the agency found “multiple examples of gender ideology content, including lessons teaching students that gender identity is distinct from biological sex and that boys can identify as girls and vice versa.” According to the Trump administration, transgender people don’t exist. That’s not true. Nonetheless, President Donald Trump decreed in January that the federal government would only acknowledge a binary definition of sex.
California had defended its program in an August 19 letter, arguing the materials were medically accurate, had been previously approved by ACF, and fell squarely within PREP’s statutory focus on adolescent development and healthy relationships. The state also challenged HHS’s authority to impose the conditions.
Related: Trump threatens to yank California’s federal funding over one transgender student’s sports participation
A spokesperson for Democratic Gov. Gavin Newsom put it bluntly. “If it’s a day ending in y, President Trump is attacking kids’ safety, health, and access to education as part of his culture war,” the spokesperson told The Advocate.
The California Department of Public Health also defended the program. “California’s students deserve access to educational information and materials that help them make healthy decisions about sexual activity, including the decision to delay sexual activity, while honoring and respecting their dignity, including gender identity,” CDPH wrote in a statement to The Advocate. “California maintains its position that the California Personal Responsibility Education Program (CA PREP) curriculum is medically accurate, comprehensive, and age-appropriate. CA PREP curriculum was previously determined to comply with federal statute and were reviewed and approved by the Administration for Children and Families (ACF).”
The agency emphasized that CA PREP provides “comprehensive sexual health education to adolescents via effective, evidence-based or evidence-informed curricula models” that promote healthy relationships, reduce STIs, and prevent unintended pregnancies. Each year, the program reaches roughly 13,000 youth through 20 local agencies, offering services in juvenile justice facilities, homeless shelters, foster care group homes, and schools.
Under California law, school districts are required to provide comprehensive sexual health and HIV prevention education, including lessons about gender identity and the harms of negative gender stereotypes.
Adrian Shanker, who served as deputy assistant secretary for health policy at HHS during the Biden administration, called the termination an abuse of power.
“The American people have reason to believe that when Congress allocates funding to federal programs, the funding will be provided equitably and without political interference,” he said. “The opposite of that is what the Trump administration has done by cutting off sexual health and teen pregnancy prevention funding to the entire state of California over political disagreements on trans inclusion.”
The stakes, he argued, are not abstract. “California deserves appreciation for holding its ground and saying they are not going to end its trans-inclusive models of sexual health and prevention work,” Shanker continued. “Unfortunately, the Trump administration is penalizing the entire state, and their actions are likely to lead to increased teen pregnancy rates, increased STI rates, and potentially new HIV infections because of their ridiculous anti-trans attacks.”
Rebecca Jones Gaston, who led the Administration on Children, Youth, and Families at HHS as the division’s commissioner until January, described PREP as a “feel-good grant,” the kind of program that, while rarely in the headlines, quietly shapes lives.
“It’s focused on youth and healthy choices, based on evidence-based practice around helping young people learn what healthy relationships are and how to avoid abusive situations,” she told The Advocate in an interview. “It’s really a whole-person approach to sexual health, and young people absolutely need that. For queer and trans youth, who are already navigating additional challenges, it’s critical. But this loss affects all kids.”
Related: Trump pressured Gavin Newsom over trans teen athlete. Then California changed its track championship rules
For Jones Gaston, the decision was not just misguided but dangerous. “Anytime politics is getting into health and the wellbeing of our kids, that’s problematic,” she said. “We’re talking about adolescents who are still developing. If we’re pouring politics into whether they have access to resources and support, that’s extremely unfortunate. This feels like weaponry against anything outside of what the administration itself deems acceptable, not based on science, not based on evidence, and not based on what communities say they need.”
And the damage, she added, extends beyond LGBTQ+ young people. “It goes beyond impacting trans youth to impacting youth in general who would be getting supports and services through these programs,” she said. “It’s about helping young people recognize domestic violence, make healthy choices, and engage their families and communities in that decision-making. That’s what’s being stripped away.”
The latest move comes just weeks after the administration announced sweeping changes to the separate $100 million Teen Pregnancy Prevention Program, explicitly barring federal funds from supporting materials deemed to promote “radical ideology,” including references to gender identity and LGBTQ+ themes. That July 1 guidance also prohibited instruction on sexual pleasure, masturbation, and non-penetrative sexual activities, measures public health experts warned would reverse decades of progress in reducing teen pregnancies and sexually transmitted infections.
Former Assistant Secretary for Health Dr. Rachel Levine, the first out transgender official confirmed by the U.S. Senate, told The Advocate last month that such changes jeopardize one of public health’s quiet victories. “One of the victories of public health in the last 40 years has been the consistent decline in the adolescent pregnancy rate. That is because of programs like Title X and TPP, and dedicated work to prevent unintended pregnancies in general and to prevent pregnancies in adolescence,” Levine said.
Experts have warned that abstinence-only models failed in the past to prevent STIs and pregnancy and will fail again. Former Deputy Assistant Secretary for Population Affairs Lynn Rosenthal said that the new policy undermines more than a decade’s worth of evidence-based work. “When you restrict what can and can’t be said, what communities can and can’t address, it undermines this really important comprehensive work that’s been underway,” Rosenthal told The Advocate in July.
Related: Trump admin lawsuit against California seeks end to trans-inclusive sports policy
The PREP cancellation marked an escalation: for the first time, HHS moved to terminate an entire state’s funding over political disagreements about transgender inclusion, effectively cutting off support because acknowledging trans youth was deemed out of bounds.
Equality California, the state’s largest LGBTQ+ civil rights group, said the funding loss will reverberate across every community PREP serves.
“This would affect California youth in a lot of different ways and not just LGBTQ+ youth, but at-risk youth in general,” Jorge Reyes Salinas, the organization’s communications director, told The Advocate in an interview. He listed PREP’s reach: “youth in homeless shelters, youth who are emancipated from the foster care system, youth in juvenile justice systems, continuation school students, LGBTQ+ youth, youth receiving mental health and substance abuse treatments, those with special needs, migrant farmworker families, and expecting parenting [pregnant people] up to the age of 21. Truly a lot of the demographics the Trump administration hates, to be quite honest.”
Reyes Salinas said targeting gender identity was a thin pretext. “Talking about gender identity and the push to remove it creates ignorance and increases bullying,” he said. “We may not feel it right away, but this program has significantly reduced teen pregnancies, STI numbers, and suicide risk in vulnerable populations. Ending it will have long-term consequences.”
He added that California must resist pressure to erase trans and nonbinary youth from its curriculum. “California will not back down and will refuse to erase trans and nonbinary youth from this program,” he said.
The consequences are already being felt in the community, he noted. “Distress and uncertainty have tripled from what it was in previous years,” Reyes Salinas said. “We’re seeing bullying increase in schools, hateful rhetoric spreading online, and young people who feel attacked almost every week by a new headline. Our message is clear: they are not alone. Equality California will never stop fighting for their right to thrive.”
Where past administrations sought to expand evidence-based education, this one is narrowing programs to align with executive orders mandating a binary definition of sex and prohibiting what it calls “radical ideology.”
Jones Gaston said tying the fate of youth programs to ideological litmus tests corrodes public trust. “It’s unfortunate that longstanding resources provided to states and communities are now so dependent on whether the person at 1600 Pennsylvania Avenue agrees with it,” she said. “The implications could be dire for young people trying to access the supports they need, from learning about healthy relationships to simply having a caring adult to help navigate challenges.”
California has 30 days to appeal the termination to HHS’s Departmental Appeals Board.
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