Story at a glance

  • President Biden has nominated Pennsylvania Health Secretary Rachel Levine as assistant secretary of Health and Human Services.
  • The Senate has never approved a transgender federal official in United States history.
  • Levine has faced transphobia in her past and again during her confirmation hearing.

President Biden’s nominee for assistant secretary of Health and Human Services is poised to take a historic position in the current administration after fending off “transphobic” questions during her Senate confirmation hearing. 

"At its core, my career has been about helping people live healthy lives. As the assistant secretary for health, I would be committed every day to helping the people of our nation and improving our public health. I am both humbled by the opportunity, and ready for the job," Pennsylvania Health Secretary Rachel Levine said in her opening statement during a confirmation hearing Thursday.


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If confirmed, she would be the first transgender federal official approved by the Senate — a move that isn’t merely symbolic. Despite facing unique and specific health risks and inequities, transgender people have been ignored both in medical research and practices, leaving critical knowledge gaps in mortality and morbidity as well as risk of mental illness, disease, diabetes and cancer. Even their population size, estimated to be nearly 1 million adults in the United States, is unknown, because that information is not officially collected. 

"Agencies must have leadership and staff employees with the lived experiences necessary to ensure policies are effective and inclusive and it is time for that leadership to include a trans person," said Ruben Gonzales, Executive Director of LGBTQ Victory Institute, in a statement. 

Levine’s lived experience includes handling Pennsylvania’s response to both the opioid epidemic and the coronavirus pandemic in recent years. The state has enacted a stricter lockdown than others, but outbreaks in prisons and a recent surge in cases have tested its resources. In the face of transphobic attacks, Levine has been confirmed three times by a Republican-led state legislature, suggesting that her appeal holds on both sides of the aisle. 


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“Dr. Levine's management of Pennsylvania's pandemic response saved countless lives and became a model for the nation — and that experience and her incontestable qualifications demand her swift confirmation. Any senator who votes against Dr. Levine is motivated not by an honest review of her qualifications or concern for the nation's health, but instead by cynical partisan politics or outright bigotry," said Mayor Annise Parker, President & CEO of LGBTQ Victory Institute, in a statement. 

But during her confirmation hearing on Thursday, Kentucky Sen. Rand Paul (R), who imprecisely likened transgender surgery to "genital mutilation," asked a series of inflammatory questions that included misinformation (and misgendering) about transgender health care that other lawmakers condemned as transphobic.

Levine responded that there was no blanket answer to the question and said, "Transgender medicine is a very complex and nuanced field with robust research and standards of care that have been developed. And if I'm fortunate enough to be confirmed as the assistant secretary of health I look forward to working with you and your office and coming to your office and discussing the particulars of the standards of care for transgender medicine."


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Published on Feb 26, 2021