A LiFT workshop on the Navajo Nation in Arizona. The evidence-based course has teens bring a trusted adult with them to learn about relationships, safe sex and pregnancy prevention. Hózhǫ́ Horizons hide title toggle title Hózhǫ́ Horizons For stories of life in our changing world, subscribe here to the global health newsletter. Last July, the
A LiFT workshop on the Navajo Nation in Arizona. The evidence-based course has teens bring a trusted adult with them to learn about relationships, safe sex and pregnancy prevention.
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Last July, the Trump administration issued a notice to the dozens of organizations that receive grants from the Teen Pregnancy Prevention Program.
“Program materials are awaited. [to] “Reflect the immutable biological reality of sex, not radical gender ideology, and cannot promote anti-American ideologies such as discriminatory equity ideology,” the document says, listing five executive orders that organizations must comply with to keep their grants. “Programs with unauthorized content are not eligible for federal funding.”
Beneficiaries were quick to adapt to the new requirements. One of them, Healthy Futures of Texas, provides sexual health education in community centers, school districts, and faith-based and juvenile justice communities in San Antonio, Dallas, and the Rio Grande Valley of Texas.
“We basically had to adapt and revise all the approved curricula to align with the executive orders, so for us we adapted 11 different programs,” explains Ginger Mullaney, president and CEO of the organization.
The process lasted months. “After all that work, we were rewarded again and all of our programs were deemed compliant,” he says. “We have submitted progress reports so far and our programs were still aligned even until recently; in November, we submitted another accommodation for a program and were approved.”
So two weeks ago, when the organization’s $2 million annual grant was canceled, effective immediately, Mullaney was stunned.
In fact, in late June, the federal Department of Health and Human Services canceled all but a dozen Teen Pregnancy Prevention Program grants totaling $66 million to recipients nationwide. Recipients included a wide range of organizations, from public health departments and universities to affiliates of Planned Parenthood and Bethany Christian Services. The five-year grants had two years left to end.
According to a list of firings obtained by NPR, the reason given was: “Misalignment with the agency’s priority, specifically normalizing minor sexual activity.”
For Mullaney, the sudden funding cut means 13 employees are losing their jobs and may have to reduce their services.
“I feel frustrated because these are lives that are being changed; there is a generational impact and social and economic mobility for our communities using programs that have been proven to be effective,” she says.
A history of ‘rigorous’ evaluation
The teen pregnancy rate has declined dramatically in the United States since the 1990s, but rates remain higher than in peer countries. The cost to young parents is high: They are less likely to earn a high school diploma and more likely to have lower lifetime incomes. One study estimated that the costs to taxpayers would be $9 billion per year.
Before the Teen Pregnancy Prevention funding stream was established in 2010, “a number of programs were being evaluated through randomized controlled trials, which are really the gold standard for understanding the effectiveness of public policies,” explains Nicholas Mark, a sociologist at the University of Wisconsin Madison.
Congress then established the funding stream “to implement programs that had been shown to be effective in reducing teen pregnancy, increasing healthy behaviors, and decreasing unhealthy sexual behaviors among teens,” it says. “So the entire foundation of the program was effective, rigorously evaluated programs.”
But the grants have long been a target of the Trump administration and some conservative groups like the Heritage Foundation. All grants were terminated by the Trump administration during the president’s first term, although funding was restored after recipients sued.
Even before the administration canceled the grants, President Trump’s recent budget request called for eliminating the Teen Pregnancy Prevention program. “There is no evidence that these specific programs have contributed to this historic decline in teen pregnancy, which is now at an all-time low. Additionally, the TPP provides grants to problematic organizations such as abortion clinics that waste American taxpayer dollars on abortion services and promote radical leftist ideology,” the document reads.
However, Trump also signed into law $101 million in funding for the program earlier this year, a point raised by Senate and House Democrats in a pair of letters sent to Health Secretary Robert F. Kennedy Jr. last week, demanding that the funding be restored.
The Department of Health and Human Services did not respond to multiple requests for comment from NPR about why the grants were canceled.
‘Normalize the sexual activity of minors’
Paige Preston just turned 18 years old. He lives in Tuba City, Arizona, part of the Navajo Nation. Earlier this year, she attended a LiFT workshop, one of the evidence-based programs supported by federal grants, hosted by Hózhǫ́ Horizons at the Johns Hopkins Center for Indigenous Health.
Paige Preston was willing to volunteer to help other teens in the LiFT workshop after she completed it herself. It has been canceled after federal funding cuts.
Jolene Robertson
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Jolene Robertson
“It connects you with your trusted adult, so in my case I went with my sister and she’s the person I go to for everything,” Preston says. “She was learning how to create a safe space for me and make me feel heard. And then what I learned was how to show my affection for other people and how to be safe if we ever come to the conclusion that there is some activity that we want to participate in.” She says she also learned about contraceptive options beyond condoms, like the pill and IUDs.
Preston says she knows this information is important: Several of her classmates got pregnant in high school. Nationally, American Indians and Alaska Natives have the highest teen pregnancy rate among racial and ethnic groups. “I know it’s a big problem in my community,” he says.
Preston is now the president of the Hózhǫ́ Horizons Youth Council and was ready to help with another LiFT workshop later this summer. It was canceled when funding was cut.
“Honestly, I’m very sad and disappointed,” she says. She believes the workshop provides information to young people who may not learn at home or in school. “When you participate and learn from people like you, like in indigenous communities, that means a lot more because it shows you that someone like you has a lot of knowledge about a topic and is really passionate about it and that makes you want to hear more.”
Nicholas Mark of the University of Wisconsin argues that the reason the agency gave for canceling these grants – “normalizing minor sexual activity” – is a “bizarre” framework.
“In a world where teenagers have smartphones, teenagers are surrounded by sex and such easy access to sex and sexual images, sexual iconography,” he says. “It seems silly to think that having a verifiable and reliable source of information about safe sex would be worse than the information environment that people are already immersed in.”
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