The singer sang Toxic during her charity concert Friday in Miami Beach to help raise funds for the first Pediatric Surgery & Intensive Care Unit in Malawa, where he son, David, is from. The night, called "Night of Art, Mischief & Music," raised $7.5 million and also featured Ariana Grande and ex-husband Sean Penn, as well as an auction of personal items. The event coincided with this year's Art Basel Miami Beach from Thursday through Sunday.
Her song was a stripped-down version of 2003 hit by Britney Spears, who turned 35 Friday. Madonna sat alone in a chair on stage, wearing a tiny top hat, pink top with oversized tulle collar and sleeves and black-and-white striped leggings, while images of Trump and post-election protests playing behind her.
She said the words, "You know that you're toxic" as an image of Trump projected behind her.
The show was part of a more sedate version of her cabaret Tears of Clown tour.
"Everything OK guys, so far?" she asked the audience after the song. "I'm not being too opinionated? Too extreme? I'm not insulting anyone? I must not be doing something right."
Billboard's Women of the Year said in an interview she felt a combination of "heartbreak and betrayal" when Trump was announced as the president-elect last month.
"It felt like someone died," she told Billboard. "It felt like a combination of the heartbreak and betrayal you feel when someone you love more than anything leaves you, and also a death."
Every morning she wakes up and remembers that Trump "is still the president."
"It wasn't a bad dream that I had," she added.
Madonna, who campaigned for Hillary Clinton, said she can't understand why women voted for Trump.
"It feels like women betrayed us," she said. "The percentage of women who voted for Trump was insanely high."
She said, "Women hate women. That's what I think it is. Women's nature is not to support other women. It's really sad. Men protect each other, and women protect their men and children. Women turn inward and men are more external. A lot of it has do with jealousy and some sort of tribal inability to accept that one of their kind could lead a nation. Other people just didn't bother to vote because they didn't like either candidate, or they didn't think Trump had a chance in the world. They took their hands off the wheel and then the car crashed."
Regarding friends who voted for Trump she said, "They would rather have a successful businessman running the country than a woman who lies. Just absurd.... In a way, it makes sense that Donald Trump is the president. Because money rules. Not intelligence, not experience, not a moral compass, not the ability to make wise decisions, not the ability to think of the future of the human race."