Pride Month is off to a rocky start for LGBT activists as President Donald Trump and his administration successfully press another children’s hospital to halt gender transition procedures. The Department of Justice (DOJ) announced last week that the Cleveland Clinic Foundation has entered into an agreement with the federal government, pledging to perform detransitioning procedures and agreeing not to continue gender transition procedures for minors.

The agreement includes paying a $308,000 fine, committing more than $2 million to detransitioning procedures, and “a decades-long commitment to not perform or offer sex-rejecting procedures — which includes the administration of puberty blockers and cross-sex hormones — for minors,” according to the DOJ.

In addition to conducting gender transition procedures on children, the Cleveland Clinic was accused of false claims health care fraud, submitting falsified billings to programs like Medicare and Medicaid, as well as commercial private health insurance companies to cover the gender transition procedures conducted on children. In one of the first executive orders he issued upon returning to the White House in 2025, “Protecting Children from Chemical and Surgical Mutilation,” Trump effectively banned the practice of carrying out gender transition procedures on minors, pledging to prosecute organizations and institutions that continued the practice in violation of applicable laws.

“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. This dangerous trend will be a stain on our Nation’s history, and it must end,” the president stated in his executive order. “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.”

The Trump administration placed heavy restrictions on Medicare and Medicaid funding provided to institutions that conduct gender transition procedures on children and the DOJ subsequently launched a series of investigations under the False Claims Act, targeting institutions like hospitals and university medical centers that attempted to hide their continued practice of carrying out gender transition procedures on children by falsifying insurance claims and classifying gender transition procedures conducted on children as different medical procedures in order to obtain insurance payments.

The DOJ’s announced agreement with the Cleveland Clinic comes on the heels of a similar settlement brokered with the Texas Children’s Hospital (TCH), which agreed to never again carry out gender transition procedures on children and to open and fully fund the nation’s first clinic for detransitioners. TCH agreed to pay a staggering $10 million to cover its false billing and to fire at least five staff members responsible for conducting the harmful surgical and chemical procedures on children. The hospital also pledged to amend its bylaws to prevent staff and doctors from carrying out gender transition procedures on children and penalize any who persist in doing so.

“The Department of Justice is steadfastly committed to protecting America’s children,” said Associate Attorney General Stanley Woodward in a statement regarding the settlement with the Cleveland Clinic. “Just as the resolution with Texas Children’s, today’s resolution with Cleveland Clinic furthers that commitment and puts these providers on notice that this Department will vigorously enforce federal law where children are put at risk.”

“These historic commitments pair the cessation of these dangerous practices masquerading as medical treatment with substantial investments in remediating the destruction they cause and restoring the health of the victims,” the DOJ said, referring to the significance of the settlements with the hospitals. Brett Shumate, Assistant Attorney General for the DOJ’s Civil Division, said, “I am grateful that institutions like Cleveland Clinic and Texas Children’s have decided to be part of the solution, not part of the problem.”

He added, “I am grateful for this resolution with Cleveland Clinic, but our work is far from over, and our division will continue to work tirelessly to protect America’s children and hold accountable those [who] have preyed on vulnerable children, whether they be pharmaceutical companies or medical providers.”