FILE PHOTO: A person walks outside of the U.S. Department of Health and Human Services building after it was reported that the HHS will cut about 10,000 full-time jobs and close half of its regional offices, a major overhaul of the department under Health Secretary Robert F. Kennedy Jr., in Washington, D.C., U.S., March 27, 2025. REUTERS/Leah Millis/File Photo

By Sneha S K

(Reuters) -The U.S. Department of Health and Human Services on Tuesday asked 46 states and territories to remove all references to "gender ideology" from a federally funded program that provides sexual health education, or risk losing millions in funding.

The directive, issued through the agency's Administration for Children and Families gives the states and territories 60 days to revise materials used in the Personal Responsibility Education Program.

The program educates young people on abstinence and contraception to prevent pregnancy and sexually transmitted infections, with particular focus on children who are homeless or living in foster care or in areas with high teen birth rates.

The states and territories include Alabama, Massachusetts, New York, Puerto Rico, Guam and Washington, D.C.

"Accountability is coming," said Andrew Gradison, acting assistant secretary at ACF.

Last week, the HHS terminated California's federal PREP grant, citing the state's refusal to remove "radical gender ideology" from its curricula.

The PREP statute "includes no mention of gender ideology, which is ... irrelevant to teaching abstinence and contraception," the ACF said in its letter to California.

Failure to comply with the directive could result in similar enforcement actions, including suspension or termination of federal PREP funding, the HHS said on Tuesday.

Overall, the 46 states and territories have about $81 million in remaining funds.

"HHS is leaning hard on bias instead of science. The simple truth is, every family should have access to local programs that help them be healthy and succeed," said a spokesperson for GLAAD, a non-profit LGBTQ advocacy organization.

In a series of executive orders, Republican President Donald Trump has banned transgender people from serving in the military, barred transgender girls and women from competing in female sports and ordered an end to federal funding for school programs that include "gender ideology."

(Reporting by Sneha S K in Bengaluru, additional reporting by Sriparna Roy in Bengaluru; Editing by Alan Barona)