The state of Maryland is teaching gender identity in rural schools through a program targeting Western Maryland and the Eastern Shore, which includes telling teachers to refer to girls as “people with vulvas,” according to a Spotlight on Maryland investigation.

The Maryland Department of Health heads the True You Maryland program in Allegany, Washington, Dorchester, Somerset, Wicomico and Worcester counties. The federally funded program aims to lower teen birth and sexually transmitted infections rates through education on contraception methods but includes extensive material on how to teach gender identity topics in schools.

True You lists two dozen partners, most notably the participating counties’ health departments and school districts, as well as Planned Parenthood of Maryland, Johns Hopkins University and Healthy Teen Network, which hosts the program website.

Alicia Miller, a community health educator for the Wicomico County Health Department, led a training session for educators in March 2023 as a part of True You titled “More Than Pronouns: Creating Affirming Spaces During Positive Prevention Plus.” Positive Prevention Plus is the sex education curriculum used by participating schools as a part of True You and includes lessons on different gender identities.

Miller emphasized throughout the training that teachers should use gender-neutral language in sex education.

“For example, instead of saying ‘boys produce sperm,’ say ‘testicles produce sperm.’ Instead of saying ‘menstruation is when a girl sheds the lining of her uterus,’ we can say ‘menstruation is when the lining of the uterus sheds.’ And we’re going to practice a few of those in a minute,” she said.

“Phrases like people with penises and people with vulvas are appropriate when discussing anatomy,” she continued.

Attendees then participated in group projects on how to edit sentences into gender-neutral language. This included edits from “guys should use a male condom” to “a person with a penis should use an external condom.”

Miller displayed an image of a “Gender Unicorn” as a way to teach children the differences between gender identity, gender expression, sex assigned at birth, physical attraction and emotional attraction.

“I love the Gender Unicorn,” she said. “I think it’s a great way to explain sexuality and gender topics.”

One group exercise required attendees to describe what they did on their weekend in gender-neutral terms.

Another True You educators’ training in December 2021 furthered these ideas. Vanessa Geffrard, the vice president of education and outreach at Planned Parenthood Maryland, led a training titled “Teaching Inclusive Sex Ed: A Focus on LGBTQIA+ Youth.”

Geffrard similarly instructed teachers to use gender-neutral language. She dismissed teachers who expressed concern about the practice.

“Over time, and when we’re talking about anatomy, something to keep in mind is that we are focusing on the body parts or function instead of who the body parts belong to,” she said. “So an example of this is rather say that ‘women get periods,’ we can say ‘people with a uterus can get periods’ or ‘people who get pregnant’ or ‘people who menstruate.’ And so, something that comes up when I’m talking to teachers a lot is, ‘Well that’s a mouthful.’ Yeah, but we’re being inclusive, right?”

Geffrard suggested teachers use “unisex” models in sex education lessons.

“I’m going to be really honest with you, it took me a little while to find animated intersex genitals to show in the classroom,” she said. “So, you know what, I’m going to share that with [a coworker] who will send this out to all of y’all.”

Another suggestion from Geffrard to teachers included advocating for their schools to stop separating boys and girls in sex education classes. She provided an example of how to explain sex to a fifth grader in gender-neutral language.

“Usually someone with a penis ejaculates or releases sperm into someone else’s vagina. From there, the sperm goes on our journey to find the egg like we discussed earlier in class. Or sometimes there are people who need help from a doctor to get pregnant by combining the sperm and egg together in a laboratory then putting it in the uterus, and then it starts to form,” she said.

Other True You training videos include “Demystifying Sexual Taboos: Education, Science, and Sex-Positive Christianity,” “Adolescent Health Equity” and “Teen Access to Reproductive Healthcare in Maryland,” which covered abortion laws for minors and was also hosted by Planned Parenthood of Maryland.

True You Lists two dozen partners on its website: Adolescent Health Initiative, Allegany County Health Department, Allegany County Public Schools, Dorchester County Health Department, Dorchester County Public Schools, Girls Inc. of Washington County, Healthy Teen Network, Johns Hopkins Center for Adolescent Health, MDH, Maryland Rural Health Association, Maryland State Department of Education (MSDE), OnTrack Washington County, Planned Parenthood of Maryland, Salisbury University, Somerset County Health Department, Somerset County Public Schools, University of Maryland Eastern Shore, Washington County Health Department, Washington County Public Schools, Wicomico County Health Department, Wicomico County Public Schools, Worcester County Health Department, Worcester County Public Schools, and YMCA of Cumberland.

The health departments for Washington, Dorchester, Wicomico and Somerset Counties referred inquiries to Chase Cook, the director of communications for MDH. Allegany County Public Schools referred to the Cumberland YMCA, which then referred the inquiry to Cook.

Cook did not respond to questions about how True You partners coordinate, if it enforces gender neutral language policies in classrooms and how Positive Prevention Plus is used in participating schools.

The Wicomico County Health Department initially said its health educator, Miller, was available for an interview, but quickly clarified she was in a meeting and that questions should be sent to the MDH. Miller hosted the True You training on pronouns.

Paul Butler, the director of communications for Wicomico County Public Schools, claimed his district does not participate in True You. He hypothesized that the district is mistakenly listed as a partner because it participated in some program seminars.

“We’re surprised that we are listed as a partner on this site since we don’t use their material,” Butler told . “It appears that all the county health departments that are listed also have the same county school system listed. So, we’re thinking that is why we are also listed on the site. I spoke with our Health Instruction Department, and they say we are not partnered with True You Maryland.”

“So, in 2020 MSDE and True Maryland held a Professional Development seminar with several health departments and several school districts including Wicomico on what they were about,” he continued. “We’ve never partnered with them, but we feel this is how they are using Wicomico Schools on their website.”

A spokeswoman for the Maryland State Department of Education told it “does not actively participate in True You Maryland, nor does the agency collect data on its effectiveness. When re-emphasized that the agency is listed as a partner in the program, the spokeswoman responded, “True You Maryland provides some LEAs [Local Education Agencies] with optional services and instructional materials aligned with our State Framework.”

Spotlight on Maryland reviewed a True You meeting dated October 2020 that focused on how to implement Positive Prevention Plus. The meeting included a presentation from Maryland State Department of Education employee Lea Jaspers, whose LinkedIn shows she worked at the agency from 2014 to 2022.

Stacey Bishop, the director of outreach for Girls Inc. Washington County, told she works with True You to teach some of the PPP lessons to 10th graders.

The remaining True You partners did not respond to questions about the program’s operations.

MDH received $7.2 million since 2020 from the federal Department of Health and Human Services for the True You program, formerly known as the Maryland Optimal Adolescent Health Program.

The federal grant description for funding years 2020 through 2022 mentioned the use of the PPP curriculum and stated the program grantees “will offer sexual education programming to teens 14-19 living in areas of the state with high rates of teen birth and sexually transmitted infections.”

The new federal grant period starting in 2023 stated that PPP was successfully implemented in four unnamed local school districts. It stated plans to expand programming into middle schools.

True You hosted a meeting on implementing PPP in October 2020 that emphasized the curriculum was necessary to ensure schools are aligned with the then-new Maryland Comprehensive Health Education Framework.

The framework, published by the Maryland State Department of Education, established standards for health courses. The Family Life and Human Sexuality section of the standards includes a requirement to teach kindergartners about different gender identities.

True You partners emphasized during their October 2020 meeting that PPP covers the Family Life and Human Sexuality requirement on gender identity lessons. The PowerPoint presentation stated the curriculum defines terms such as gender identity, gender expression, cisgender, transgender, nonbinary and gender expansive.

Maryland parents have the option to opt their children out of education related to the Family Life and Human Sexuality requirement.

The Healthy Teen Network website, which hosts the True You resources, deleted mentions of PPP, an archived version of the webpage shows.

The Healthy Teen Network also hosts the UChoose sex education program in Baltimore, which refers minors to abortion and transgender clinics, as previously reported by Spotlight on Maryland.

Spotlight on Maryland is a joint venture by FOX45 News and The Baltimore Sun. Have a news tip? Contact Patrick Hauf at pjhauf@sbgtv.com.