President Donald Trump used an anti-transgender slur to attack the Democratic nominee running against Darline Graham in South Carolina’s Senate race.

Trump lashed out at Dr. Annie Andrews, a mother and pediatrician who is not transgender, in a lengthy Truth Social post, where he referred to her as a “trannie” three times. Trump has thrown his weight behind Graham, the sister of the late South Carolina Sen. Lindsey Graham, who is running for his Senate seat after his sudden death in July.

“Annie ‘Trannie’ Andrews is running against our wonderful Darline Graham for the Senate in South Carolina,” Trump posted Monday on Truth Social. “Darline is a High Quality person, maybe the Highest, and Annie Trannie is not, in particular, as it pertains to representing the Values of the Great People of South Carolina.”

The president went on to attack Andrews and claimed she was “in favor of Transgender for Everyone, Open Borders, Defunding the Police, High Taxes, a Weak Military, and will absolutely fight to take your guns away.”

He concluded the post by declaring: “Trannie is not for South Carolina, and South Carolina must show, in the upcoming Election, that it is not for her.”

Andrews responded by saying that she was “in this race to fight for my patients, my three kids and South Carolina,” without mentioning Trump.

“I’m going to work with anyone to put South Carolina first, because lowering costs and making life better for families across our state is going to take all of us working together,” Andrews said in a post on X. “If you care more about your bills than the politics in Washington, this campaign is for you.”

The Human Rights Campaign labeled Trump’s comments as “sad, disgusting, pathetic diatribes” before calling him a “lame duck president with record-low approvals.”

“So low, in fact, he’s having to campaign in deep red territory in a desperate attempt to shore up support ahead of the midterms,” spokesperson Ramiro Sarmiento said in a statement.

Former South Carolina Gov. David M. Beasley, a Republican, also condemned Trump’s post as “abhorrent.”

“Elections don’t have to be about cruelty and lies. South Carolina deserves better,” Beasley said in a post on X. “I urge voters to look at the merits of each candidate and cast their vote accordingly. We must reject politics based on division and hate.”

Senate Minority Leader Chuck Schumer said the attack was “despicable.”

“Annie Andrews is a mom and pediatrician who’s always put her community first — and she’s exactly who South Carolina needs representing them in the Senate,” Schumer wrote.

Andrews recently outlined that she does not support transgender athletes participating in women’s sports, nor does she support gender-affirming surgery for minors.