Sen. Rand Paul was criticized for using anti-trans talking points during a Senate confirmation hearing Thursday for transgender Health and Human Services nominee Dr. Rachel Levine.

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The Republican senator quizzed Levine about her views on hormone treatment for trans teens and compared gender reassignment surgery to castration and female genital mutilation.

“You’re willing to let a minor take things that prevent their puberty, and you think they get that back?” Paul asked Levine. “You give a woman testosterone enough that she grows a beard. Do you think she’s going to go back looking like a woman when you stop the testosterone?”

Paul (R-Ky.) said he was “alarmed” that Levine was not advocating that teens should be barred from deciding to undergo treatments to change their gender.

“I’m alarmed that you’re not saying they should be prevented from making decisions to amputate their breasts or genitalia,” Paul said. “We have always said that minors do not have full rights.”

Levine, who is vying to be Assistant Secretary for Health, refused to directly answer Paul’s questions, saying only that transgender medicine is a “complex and nuanced field with robust research and standards of care.”

Related Story: HHS Nominee Dr. Rachel Levine Won’t Say if Parents Can Refuse Child’s Gender Transitioning

If confirmed by the Senate, Levine would become the highest-ranking openly trans official in U.S. history.

Paul (R-Ky.) says he will vote against Levine because he disagrees with her position on treating trans teens.

Sen. Patty Murray (D-Wash.) chastised Paul for failing to treat Levine with respect and wasting the committee’s time with “ideological and harmful misrepresentations.”

Democratic lawmakers and LGBT rights advocates accused the Republican of indulging in barely disguised anti-trans bigotry.

“He explicitly attacked vulnerable trans youth for his own perceived political gain and it was a disgrace,” said Ruben Gonzales of the LGBTQ Victory Institute.

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