The Department of Health and Human Services' Administration for Children and Families warned California that either it eliminates "egregious" gender ideology teaching in its sex education program or it will lose federal funding.

The agency questioned how California school administrators are using federal funding to provide information to students ages 10-19 on topics ranging from delaying the onset of sexual activity to the prevention of transmitting sexually transmitted diseases.

In a letter to California, ACF said the state has gone beyond the intended bounds of the teaching to include prohibited gender ideology instruction.

The letter referenced unacceptable subjects and language in curricula and program materials, including these sentences from the high school curriculum:

• "Remind students that some men are born with female anatomy, some women are born with male anatomy."
• "Genderqueer, gender non-conforming, and gender expansive are more terms that people use to describe their experience of being non-binary."

An ACF press release about warning described California's program material as "riddled with gender-ideology."

The Los Angeles Times reported in 2019 that California state education system leaders were moving more openly to present sex-related information to the state's students in all grades. The Times reported the new sex education framework was approved, but not without debate over whether the content available to teachers was too explicit and graphic.

The U.S. Supreme Court on Wednesday upheld Tennessee's right to block irreversible gender transition procedures. Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, told Newsmax the decision should be a "clarion call" to put an end nationwide to what he called harmful surgeries and therapies being performed on minors.