The move is the latest in a line of efforts since Trump returned to the White House in January to recognize people as only male or female and to eliminate what he calls “gender ideology.”

“Federal funds will not be used to poison the minds of the next generation or advance dangerous ideological agendas,” Acting Assistant Health and Human Service Secretary Andrew Gradison said in a statement.

That position contradicts what the American Medical Association and other mainstream medical groups say: that extensive scientific research suggests sex and gender are better understood as a spectrum than as an either-or definition.

The funds in question in the Personal Responsibility Education Program total over $81 million for the 40 states plus the District of Columbia and five territories where officials were also sent the letter. The officials were told they have 60 days to change the lessons or could lose their grants.

California was warned previously, and the $12 million grant for that state was stripped on Aug. 21.

Now, other states will have until late October to decide whether to comply or give up the funding.

Connecticut Attorney General William Tong also suggested there could be legal challenges to the administration’s effort. “Threatening to defund our schools over this is completely unhinged and we’re not going to let Trump steal money from our kids,” he said in a statement.

The grants are used to teach adolescents about abstinence and contraception. They target education for those who are homeless, in foster care, living in rural areas or places with high teen birth rates — and minority groups, including LGBTQ+ populations.

Alison Macklin, spokesperson for SIECUS: Sex Ed for Social Change, said the grant money is used for things like training sex education instructors and for groups that present lessons in schools or after-school groups.

“This money is essential to states and territories to support sex education,” she said. “They build critical life skills for young people.”

She noted that some states have laws requiring education about lesbian, gay and transgender people.

In the letters, the federal Administration for Children and Families pointed to specific examples in textbooks and curricula that they find objectionable.

For instance, a curriculum used in Alabama encourages the instructor to ask participants to share the pronouns they use.

It also tells the instructor to tell the class that people “may identify as gay, lesbian, bisexual or straight. Some may identify as male, female or transgender. All of these differences make us unique. Regardless of how you see yourself, your background, previous relationships or experience, each of you has a place in this group.”

South Carolina Gov. Henry McMaster applauded the warnings during a question-and-answer period with reporters this week.

“The things they describe there really have got no business being in there,” he said. “Somebody has gone crazy somewhere trying to put all this stuff” in lessons.

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Associated Press reporters Jeffrey Collins in Columbia, South Carolina, and Susan Haigh in Hartford, Connecticut, contributed to this article.