Rachel Levine — the Biden administration’s pick to be assistant secretary of Health and Human Services — was grilled during her confirmation hearing by Sen. Rand Paul about trans health care. The Kentucky Republican falsely equated transgender youth seeking medical care to “genital mutilation.”

If confirmed, Levine would be the highest-ranking transgender political appointee in the federal government.

Paul did not ask similar questions of Vivek Murthy, who was also testifying before the Senate HELP Committee on Thursday to be surgeon general.

Watch the video for more on Thursday’s events, including comments from Gillian Branstetter, spokeswoman for the National Women’s Law Center. She described the line of questioning as “dishonorable” and “obscene,” noting the medical community’s consensus in support of gender-affirmative health care for transgender youth.

The incident came one day after GOP Rep. Marjorie Taylor Greene of Georgia posted a transphobic sign outside of her Capitol Hill office, and on the same day that the House passed a sweeping LGBTQ anti-discrimination bill.