Republican women senators whose disapproval of the Republican health-care effort has at times endangered its progress are facing an increasingly pointed backlash from men in their own party, including a handful of comments that invoked physical retaliation.

In the last week, Sen. Susan Collins has been challenged by a male lawmaker to a duel. She and Sen. Lisa Murkowski, Alaska, were told they and others deserve a physical reprimand for their decisions not to support Republican health-care proposals. Murkowski, who voted with Collins against starting the health-care debate this week, was specifically called out by President Donald Trump on Twitter and told by a Cabinet official that Alaska could suffer for her choice, according to a colleague.

The language of retribution increasingly adopted by Republican men reflects Trump’s influence and underscores the challenges GOP women can face when opposing the consensus of their party, which remains dominated by men, outside experts said. A videotape of Trump surfaced during the campaign revealing him bragging in vulgar terms about groping women and some believed that opened the gates for further insults and degrading behavior toward women.

“Masculine dominance in the Republican Party is not only in numbers but in culture,” said Kelly Dittmar, a scholar at the Center for American Women and Politics at Rutgers University and the author of “Navigating Gendered Terrain: Stereotypes and Strategy in Political Campaigns.”

“When the person who is supposed to be the leader of the party shows it’s OK to use those sorts of attacks, whether they are specifically gendered or not, that is something that catches on at other levels. “We see it in the 1/8elected officials3/8 who feel it’s OK to say things like this.”

Collins and Murkowski have been among the Senate’s most consistently skeptical voices as Republicans accelerate their effort to amend the Affordable Care Act. In contrast with conservative critics like Sen. Rand Paul, R-Ky., both have criticized Republican health-care proposals for aggressively cutting funds to Medicaid and Planned Parenthood, which provide medical care to hundreds of thousands of people in their states. Both have raised concerns about lack of transparency in the process of crafting Republican legislation.

They are not the only critics who have faced political attack over health care, but the criticisms have not been so aggressive.

Notably, the pro-Trump political outfit America First Policies targeted Sen. Dean Heller, R-Nev., with $1 million in TV and radio ads last month after he announced opposition to one ACA overhaul bill. The group canceled its campaign after senior Republicans intervened on Heller’s behalf.

Trump himself has also threatened electoral consequences against Republican senators who oppose the party consensus on health care. “Look, he wants to remain a senator, doesn’t he?” Trump said recently of Heller, who was seated next to him at a lunch event. “I think the people of your state . . . 1/8are3/8 going to appreciate what you hopefully will do.”

Still, the most colorful and threatening comments have targeted Collins and Murkowski.

Rep. Blake Farenthold, Texas, in an apparent reference to Collins, told a local radio host Friday that if she were a “guy from south Texas, I might ask him to step outside and settle this Aaron Burr-style,” invoking the 1804 duel in which Alexander Hamilton was killed.

“Like the president, I am sick and tired of the left-wing biased media trying to make something out of nothing,” he said in a follow-up statement. “This was clearly tongue in cheek. That being said, I’m extremely frustrated with Senate Republicans who are breaking their promise to the American people to repeal and replace Obamacare.”

Collins was caught on a hot mic responding, when Sen. Jack Reed, D-R.I., said she could beat Fahrenthold in such a duel. Collins called Farenthold “huge” and “extremely unattractive.” They later apologized to each other, CNN reported.

Rep. Earl “Buddy” Carter, R-Ga., told MSNBC Wednesday that someone should “go over there to that Senate and snatch a knot in their a–,” a regional phrase that refers to punishment, usually of disobedient children. MSNBC reporter Ali Velshi had asked Carter what he thought of Trump’s tweet chastising Murkowski for opposing the start of the health-care debate.

Carter later said the comment was directed at all those senators who, like Murkowski, stood in the way of easy victory on health care.

“Rep. Carter’s comment was in no way directed toward Senator Murkowski specifically,” Carter spokeswoman Mary Carpenter wrote in an email. “His words speak for themselves that he was not speaking about a single senator. This is a southern phrase used frequently throughout Rep. Carter’s lifetime which simply means get your act together.”

The comments are particularly poignant given that Senate Republican women were excluded from the chamber’s original working group on health care.

“It’s too bad some folks are spending so much time creating cute catchy phrases in order to take potshots at colleagues,” Julie Conway, executive director of VIEW PAC, which recruits and trains Republican women candidates, wrote in an email.

“I wish they would spend as much time and energy sitting down with these women lawmakers to help finds solutions and a strategy to get real health-care reform that Americans can feel good about.”

Dittmar argued these kinds of comments undermine women leaders in the long run.

“The fact they call out specific women marks those women as outside of the norm. For those who may question women’s capacity to be just as qualified as elected officials, it mines that vein of doubt or underlying bias,” she said.

Trump’s rhetoric has been almost calm by comparison.

“Senator lisamurkowski of the Great State of Alaska really let the Republicans, and our country, down yesterday. Too bad!” he tweeted Wednesday morning.

But later in the day, according to the Alaska Dispatch News, Interior Secretary Ryan Zinke called Murkowski and Sen. Dan Sullivan, R-Alaska, to say Murkowski’s vote against opening the health-care debate could have repercussions for federal policy affecting Alaska.

“The message was pretty clear,” Sullivan told the news outlet.

The next day, a nominations markup in the Senate Energy and Natural Resources Committee was postponed, leading some observers to speculate Murkowski – the panel’s chairman – had deferred it in retaliation for Zinke’s call. A spokeswoman for the committee told The Post the meeting was postponed due to the uncertainty of the Senate schedule.

Murkowski told the Alaska Dispatch News that Republican officials should remember she sometimes votes against the majority of her party.

“I base my votes on what I believe is in Alaska’s best interest,” she told the outlet. “I don’t think it should come as any surprise that there have been occasions that I have not followed the lead of the party.”

Spokeswomen for Murkowski and Collins did not respond to requests for additional comment.

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