Rachel Levine makes history as the first trans official confirmed by the Senate

Dr. Rachel Levine
Rachel Levine during her confirmation hearing on February 25.

  • Dr. Rachel Levine, a trans woman, has been confirmed as assistant secretary of health.
  • In a 52-48 vote Wednesday, the Senate made history by confirming Levine.
  • The confirmation makes Levine the highest-ranking openly trans person in the federal government.
  • See more stories on Insider’s business page.

The Senate made history Wednesday by confirming Dr. Rachel Levine as assistant secretary of health in a 52-48 vote, making her the highest-ranking openly transgender person in the federal government.

All Democrats and independents in the Senate voted to confirm Levine, while Sens. Susan Collins of Maine and Lisa Murkowski of Alaska broke with Republicans to make the confirmation a bipartisan one.

Levine’s confirmation has been praised by LGBTQ advocacy groups.

“President Biden committed to appointing our nation’s most qualified leaders to tackle the pandemic and he delivered in choosing Dr. Levine,” former Mayor Annise Parker of Houston, the president of LGBTQ Victory Institute, said in a statement on Wednesday. “Yet the importance of this moment extends well-beyond the health of our nation alone.”

Parker added: “At a time when hateful politicians are weaponizing trans lives for their own perceived political gain, Dr. Levine’s confirmation lends focus to the contributions trans people make to our nation and deflates absurd arguments calling for their exclusion.”

Levine’s nomination faced opposition from religious-rights groups as well as some Republican senators.

The former Pennsylvania health secretary remained calm amid aggressive questioning during her confirmation hearing last month.

Sen. Rand Paul of Kentucky faced backlash after he asked Levine during the hearing if she was a supporter of the “surgical destruction of a minor’s genitalia” and believed minors could make “such a life-changing decision as changing one’s sex?”

Levine responded by saying: “Transgender medicine is a very complex and nuanced field with robust research and standards of care that have been developed.”

She also told Paul she would discuss the matter further if confirmed.

As assistant secretary of health in the Department of Health and Human Services, Levine will oversee public-health initiatives, and President Joe Biden has said Levine will play an important role in the country’s coronavirus response, according to The Washington Post.

Before serving as Pennsylvania’s health secretary, Levine was the state’s physician general.

In a January statement about her nomination, Biden said she was a “historic and deeply qualified choice to help lead out administration’s health efforts.”

“Dr. Rachel Levine will bring the steady leadership and essential expertise we need to get people through this pandemic – no matter their zip code, race, religion, sexual orientation, gender identity, or disability – and meet the public health needs of our country in this critical moment and beyond,” Biden said in a statement.

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Rand Paul is facing backlash for his anti-trans comments equating gender-affirming surgery to ‘genital mutilation’

Sen. Rand Paul of Kentucky
Sen. Rand Paul (R-Kentucky).

  • Sen. Rand Paul compared gender-affirming surgery for trans people to “genital mutilation” during a hearing for Dr. Rachel Levine.
  • Levine, if confirmed by the Senate, will be the first openly trans official approved by the chamber.
  • Some of Paul’s Democratic colleagues sharply rebuked his remarks. 
  • Visit the Business section of Insider for more stories.

During confirmation hearings for Dr. Rachel Levine for assistant health secretary, Sen. Rand Paul of Kentucky conflated gender-affirming surgery with “genital mutilation.”

Paul on Thursday during a hearing before the Senate’s Health, Education, Labor, and Pensions Committee questioned Levine on her stances regarding healthcare for transgender youth. In doing so, he attempted to correlate transition-related surgery with genital mutilation – a practice health officials have previously called a human rights violation that “has no health benefits.”

“Genital mutilation is considered particularly egregious because … it is nearly always carried out on minors and is a violation of the rights of children,” Paul, a former ophthalmologist, said.

Paul then tried to portray Levine as a supporter of “surgical destruction of a minor’s genitalia,” asking her if she believed minors could make “such a life-changing decision as changing one’s sex?”

“For most of our history, we have believed that minors don’t have full rights and that parents need to be involved,” Paul said. “We should be outraged that someone’s talking to a 3-year-old about changing their sex.”


Levine, a pediatrician and an advocate for hormone therapy, has never said children should receive gender reassignment surgery. 

“Transgender medicine is a very complex and nuanced field with robust research and standards of care that have been developed,” Levine said in response to Paul. Levine also told Paul she’d further discuss the subject with him if confirmed by the Senate. 

Levine, if approved, will become the first openly trans official confirmed by the Senate

Paul’s comments led to immediate backlash from Democratic lawmakers, who supported Levine. 

Sen. Patty Murray, a Democrat from Washington and the chair of the Senate health committee, rebuked Paul’s questions. 

“It is really critical to me that our nominees be treated with respect and that our questions focus on their qualifications and the work ahead of us, rather than on ideological and harmful misrepresentations like those we heard from Senator Paul earlier,” Murray said on Thursday. 

Paul’s office did not immediately respond to Insider’s request for comment.

Levine, 64, is a professor of pediatrics and psychiatry at the Penn State College of Medicine. She also serves as the president of the Association of State and Territorial Health Officials. 

In separate remarks on Thursday, Sen. Majority Leader Chuck Schumer condemned Republican lawmakers speaking out against trans rights.

Republican “attacks on trans people and the transgender community are just mean,” Schumer said during an in-person press briefing. “And show a complete lack of understanding and a complete lack of empathy. They don’t represent our views, and they don’t represent the views of a majority of Americans. Their despicable comments just make my blood boil with anger. If I didn’t have a mask, you could see my teeth gritting.”

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