California is going to war with President Donald Trump and his administration over gender transition procedures for children. Rady Children’s Hospital reached an agreement with California Attorney General Rob Bonta (D) on Wednesday to continue conducting gender transition procedures on children, in defiance of the president’s orders.

Almost immediately upon returning to office last year, the president issued an executive order barring hospitals that conduct gender transition procedures on children from receiving federal Medicare or Medicaid reimbursements. “Across the country today, medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions,” the president wrote in his executive order. “This dangerous trend will be a stain on our Nation’s history, and it must end,” he continued. “Accordingly, it is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”

Rady Children’s Hospital terminated its gender transition program for children in response to the executive order, but was sued by Bonta for doing so. The California Democrat argued that halting gender transition procedures on children violated the terms of a merger between Rady Children’s Hospital of San Diego and the Children’s Hospital of Orange County. According to Courthouse News Service, the agreement between the hospital and the state ensures that children will still be prescribed puberty blockers.

The agreement between Rady Children’s Hospital and California comes just weeks after the Trump administration agreed to settlements with the Cleveland Clinic and Texas Children’s Hospital, in which both hospital organizations agreed to stop conducting gender transition procedures on children, fired staff responsible for doing so, and pledged millions of dollars towards opening clinics to reverse gender transition procedures.

Rady Children’s Hospital has also been sued by four patients in a class action lawsuit aimed at ensuring continued gender transition procedures conducted on minors. The plaintiffs in that case have argued that their lawsuit should proceed, regardless of any agreements between the hospital and the state, claiming that their legal arguments are significantly different from those proffered by Bonta.