Trump said if re-elected he would stop gender-affirming care for minors, which he described as “child abuse” and “chemical, physical and emotional mutilation.”

The Republican promised that on the first day in office he would revoke the gender-affirming policies of President Joe Biden‘s administration, a measure he would follow with an executive order prohibiting federal agencies from promoting “the concept of sex and gender transition at any age.”

Congress will also be asked, he said, to pass a law banning gender-affirming care for minors nationwide and a bill “establishing that the only genders recognized by the United States’ government are male and female and they are assigned at birth.”

He also vowed to terminate Medicaid and Medicare accreditation for hospitals and healthcare providers that offer such care, while promising to support the creation of a mechanism to sue doctors who perform gender affirming-procedures on minors.

Under a Trump administration, the former President promised the Department of Education would level “severe consequences” including civil rights violations and funding freezes on states and schools if “any teacher or school official suggests to a child that they could be trapped in the wrong body.”

His plan would also promote the nuclear family and the traditional roles of mothers and fathers while “celebrating rather than erasing the things that make me and women different and unique.”

Under his plan, biological men would be banned from women’s sports, Trump added.

“No serious country should be telling its children that they were born with the wrong gender, a concept that was never heard of in all of human history — nobody’s ever heard of this what’s happening today,” he said. “It was all when the radical left invented it just a few years ago.”

The controversial proposals are expected to be fiercely rebutted by Democrats, and LGBTQ advocates as well as health practitioners who have repeatedly voiced support over the years for widely accepted gender-affirming care for minors.

The American Medical Association, the nation’s largest medical group, has a policy of supporting gender-affirming care, and has repeatedly called on politicians to stop interfering in the healthcare of transgender children.

The American Academy of Pediatrics has similarly said its organizations “strongly oppose” any legislation that limits access to gender-affirming care while urging for better services for minors.

Trump’s campaign pledge was made as the race for the Republican nomination for the 2024 presidential election heats up and the party wades into controversial social issues.

Terry Schilling, president of the populist right-wing American Principle Project, described Trump’s announcement as an “important shift in GOP politics,” stating that in 2019 when the group began running ads against gender-affirming care it couldn’t find a Republican to champion and now several including Florida Gov. Ron DeSantis and Virginia Gov. Glenn Youngkin have taken up the cause.

“After four years, and APP election involvement across the country injecting these issues into campaign, the tide has officially turned,” he said. “Fighting the exploitative transgender industry is now Republican orthodoxy embraced by the party’s most popular leaders, and we expect this issue will only gain more visibility as the 2024 campaign shifts into full gear.”

The announcement also comes on the heels of a year that saw hundreds of bills targeting LGBT people entered into state legislatures.

According to the Human Rights Campaign, the United States largest LGBTQ advocacy group, state legislators introduced a record 315 bills it described as attacking LGBTQ people. The bills, it said, particularly targeted transgender youth.

Though more than 90% of those bills failed to become law, last year saw the highest number of such legislation being passed in recent history, it said.

“These bills are terrible public police, and we are also deeply cognizant of how every harmful anti-LGBTQ+ bill that is signed into law has a devastating impact on the lives and well-being of LGBTQ+ people, particularly children,” JoDee Winterhof, HRC senior vice president of policy and political affairs, said in a statement on Thursday.

“The legislative assault and hateful rhetoric towards our community has also led to more stigma, discrimination and ultimately suicide and deadly violence — particularly against the transgender community.”

Earlier this month, the Trevor Project, a suicide prevention organization for LGBTQ youth, released the results of a new poll that found 86% of transgender and nonbinary youth say recent debates surrounding such legislation has negatively impacted their mental health.

These policies and debates in the past year have also resulted in 45% of trans youth stating they have experienced cyberbullying and one in three reported not feeling safe to visit a doctor or hospital when sick or injured.

Kasey Suffredini, vice president of advocacy and government affairs at The Trevor Project, said that the impact that these “ugly public debates” have on the mental health and well-being of LGBT youth must be considered.

“LGBTQ young people are watching, and internalizing the anti-LGBTQ messages they see in the media and from their elected officials,” Suffredini said in a statement. “And so are those that would do our community harm.”