Republican Senator Rand Paul is facing backlash over his transphobic attacks against Rachel Levine during her historic confirmation hearing to become assistant health and human services secretary. On Thursday, Senator Paul repeatedly compared hormone therapy and transition surgery for trans people with genital mutilation. Levine responded, “Transgender medicine is a very complex and nuanced field with robust research and standards of care.” If appointed, Levine would be the first out trans official to be confirmed by the Senate.

This comes as far-right Republican Congressmember Marjorie Taylor Greene is being condemned for hanging a poster outside her office that reads, “There are TWO genders: Male & Female. Trust The Science!” Greene displayed the poster after Democratic Congresswoman Marie Newman of Illinois raised a transgender pride flag outside her office, which is directly across from Greene’s. Newman’s daughter is transgender.