Former President Trump, in a video released Tuesday on his social media platform, vowed to punish doctors who provide gender-affirming health care to minors if he is reelected next year, wading into a contentious debate that has captured the attention of state and federal lawmakers on both sides of the aisle.

In the nearly four-minute-long, straight-to-camera video, Trump outlined his plan to “protect children from left-wing gender insanity,” unveiling a slate of extreme policy proposals targeting transgender identities, including a federal law that recognizes only two genders and bars transgender women from competing on women’s sports teams.

“No serious country should be telling its children that they were born with the wrong gender,” Trump said in the video before falsely claiming that being transgender is a concept that the “radical left” manufactured “just a few years ago.”

“Under my leadership, this madness will end,” he said.

Trump, who officially announced his 2024 presidential bid in November, added that, if he is reelected, federal agencies will be instructed to immediately cease programs that promote the concept of gender transition “at any age” and promised to prohibit federal tax dollars from being used to help pay for gender-affirming interventions.

The former president said he also plans to pass a law barring minors from receiving gender-affirming health care “in all 50 states” and intends to direct the Justice Department to investigate the pharmaceutical industry and individual hospitals to determine whether they “deliberately covered up horrific long-term side effects of sex transitions in order to get rich.”

Doctors who treat transgender youth will be booted from Medicaid and Medicare under his leadership, Trump said Tuesday, and a private right of action will be established for patients who later regret having received gender-affirming health care as minors to sue their physicians.

Gender-affirming health care — for both youths and adults — is considered safe, medically necessary and often life-saving by most professional medical organizations, including the American Medical Association and American Academy of Pediatrics.

While the former president has not previously weighed in on gender-affirming health care for transgender minors, he has targeted transgender individuals more generally, evidenced in part by his administration’s 2017 ban on transgender people serving in the military, which he said in a series of tweets would burden the government with “tremendous medical costs and disruption.”

Last year, during a campaign rally in Texas, Trump said transgender women should be barred from playing on women’s sports teams, vowing to “ban men from participating in women’s sports” if he is reelected.

At least 18 states have enacted laws that bar transgender athletes from competing on sports teams consistent with their gender identity, and top Republicans in Congress, including Speaker Kevin McCarthy (Calif.), have backed federal legislation to that effect.

Florida Gov. Ron DeSantis, seen as a top GOP contender for the 2024 presidential election, in 2021 signed a law barring transgender athletes from sport, and last year publicly refused to recognize Lia Thomas, a transgender swimmer at the University of Pennsylvania, as the NCAA women’s 500-yard champion, declaring Florida-native Emma Weyant, the second-place finisher, the race’s “rightful winner.”

DeSantis’s administration has also approved a number of controversial health and education policies that target transgender people, including a state rule that prohibits transgender individuals from using Medicaid to help pay for gender-affirming health care and a law barring talk of gender identity and sexual orientation in public school classrooms.

Trump on Tuesday said his proposed policy changes would similarly extend to education, and school officials that suggest a child “could be trapped in the wrong body” will be faced with “severe consequences” if he is reelected next year, including potential civil rights violations for sex discrimination and the elimination of federal funding for schools.

A new credentialing body for teachers, Trump said, would promote “positive education about the nuclear family, the roles of mothers and fathers and celebrating rather than erasing the things that make men and women different and unique.”