Trump calls Democrat Annie Andrews a bigoted anti-trans slur at South Carolina rally for Darline Graham

President Donald Trump used an anti-transgender slur to demean a Democrat running for the U.S. Senate in South Carolina.

Trump visited the state on Thursday to campaign for Republican Sen. Darline Graham, who was appointed to serve the remainder of her late brother, Sen. Lindsey Graham’s term. Darline Graham is now seeking a full term against Annie Andrews, who had been challenging her brother.

“Darline’s running against a radical left lunatic named tr***y Annie Andrews,” Trump said at the rally. A clip shows supporters laughing at the slur and then booing Andrews’ name.

Related: Trump hurls anti-trans slur at South Carolina Democrat Annie Andrews. The White House won’t explain why

Andrews is cisgender and has drawn criticism from LGBTQ+ advocates for releasing an advertisement in which she says she opposes gender-affirming surgery for minors and transgender women’s and girls’ participation in women’s and girls’ sports.

“My career as a pediatrician has always been about taking care of kids, and I’ve got three of my own,” Andrews says to the camera in the 30-second spot. “So, I want you to hear me loud and clear. I don’t support ‘biological men’ playing women’s sports, and I don’t support and haven’t ever performed gender surgery for minors.”

In an open letter, 20 LGBTQ+ groups in South Carolina condemned “fear-based political messages that have been used by local, state and national politicians,” according to The State. The groups objected in particular to describing transgender women and girls as “biological men.”

Related: After Trump called Annie Andrews an anti-trans slur, the Democrat now calls trans women ‘biological men’

“These are not neutral descriptions when deployed to stigmatize transgender people,” the letter said. “They are rhetorical devices that reinforce harmful stereotypes and encourage suspicion and hostility toward an already vulnerable community.”

Andrews’ position aligns with the stance she took during her 2022 congressional campaign. Her ad comes as some Democrats distance themselves from transgender rights ahead of the midterm elections.

Those positions did not spare Andrews from Trump’s use of an anti-transgender slur to attack her.

Andrews addressed Trump’s remarks in an interview with SCETV.

“It’s not presidential,” she said. “If name-calling would help lower gas prices and grocery prices, he can call me all the names he wants, but I don’t think that’s going to get the job done. South Carolinians deserve more from everybody in elected office.”