Rachel Levine, who Pennsylvania secretary of health guided her state through the coronavirus, has been tapped to become assistant secretary for health under the Biden administration, setting her up to become the first openly transgender U.S. Senate-confirmed federal official.
The Biden transition team on Tuesday, the day before Joe Biden's inauguration as president, announced in a statement Levine was chosen for the senior health role, which is the No. 3 leadership position at the Department of Health & Human Services.
Biden hailed Levine in a statement announcing her nomination, which builds on several openly LGBTQ appointments, including Pete Buttigieg as transportation secretary and Ned Price as State Department spokesperson.
"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. "She is a historic and deeply qualified choice to help lead our administration's health efforts."
No openly transgender person has ever sought or obtained confirmation by the Senate in U.S. history. In the Obama administration, Dylan Orr at Department of Labor and Amanda Simpson at the departments of energy and defense made history as the first openly transgender presidential appointees, but their roles didn't require Senate approval. Trump, whose administration was marked by open hostility to the transgender community, had no openly transgender appointments.
Vice President-elect Kamala Harris also hailed the nomination in a statement, saying Levine would contribute to the new administration's effort to contain the raging coronavirus epidemic.
"Dr. Rachel Levine is a remarkable public servant with the knowledge and experience to help us contain this pandemic, and protect and improve the health and well-being of the American people," Harris said. "President-elect Biden and I look forward to working with her to meet the unprecedented challenges facing Americans and rebuild our country in a way that lifts everyone up."
The assistant secretary of health oversees the department's key public health offices, a number of presidential and secretarial advisory committees, 10 regional health offices across the nation, and the Office of the Surgeon General and the U.S. Public Health Service Commissioned Corps.
Biden's appointment of Levine represents a stark contrast to the approach to transgender health issues compared to Trump, whose administration deleted from U.S. government websites guidance on transgender health and rescinded Obama-era regulations under Section 1557 of the Affordable Care Act barring discrimination against transgender people in health care.
Although speculation had persisted throughout the 2016 election Levine could be up for a position at the HHS if Biden won the election, she downplayed any prospect of leaving her position in Pennsylvania. During a conference call last week hosted by the Center for American Progress, Levine sidestepped a question from the Washington Blade about possibly obtaining an appointment as a senior health official.
"I am obviously very busy and really totally consumed with my current position, which is protecting the public health of Pennsylvania in the midst of the biggest global pandemic since 1918," Levine said. "So, I've always been proud and privileged to serve in Gov. Wolf's administration, and I'm fully committed to my current mission."
As Pennsylvania secretary of health, Levine faced intense hostility from right-wing critics for her health restrictions and forced closures in Pennsylvania amid the coronavirus epidemic, but her policies were similar to those in other jurisdictions. The criticism was largely a manifestation of hostility towards her for being transgender, for which she was also explicitly criticized.
Levine, who was confirmed twice by a Republican-controlled state Senate in Pennsylvania for her role in that state, is also a professor of pediatrics and psychiatry at the Penn State College of Medicine.
Wolf named her a member of his team in January 2015 as the Physician General of the Commonwealth of Pennsylvania. Levine was named acting secretary of health in July 2017 and confirmed as secretary of health in March 2018.
Amid consternation among LGBTQ advocates states weren't collecting data early last year on sexual orientation or gender identity, Levine took the lead and announced in March 2020 her state would begin collecting the data, making Pennsylvania the first state in the country to collect LGBTQ demographic information on the coronavirus.
The executive director of the LGBTQ Cancer Network, who goes by the single-name moniker Scout, praised the news Levine obtained the nomination as assistant secretary of health.
"As another trans leader in public health, I am thrilled to see such a revered member of my own community be this successful, yet it is my greatest wish that the U.S. Senate base their approval on her qualifications," Scout said. "The fact that she is trans is an inspiration for the many of us who have never had a role model this senior before. The fact that she is supremely qualified means her trans status, while historic and inspirational, should not be a factor in her confirmation."
The wins by two Democrats in the Georgia run-off, which gave Democrats a narrow majority in the U.S. Senate, significantly bolsters the prospect of Levine's confirmation in the Senate. It takes a simple majority of senators to confirm presidential appointments under Senate rules.
Annise Parker, CEO of the LGBTQ Victory Institute, said in a statement the United States is "fortunate to have Dr. Rachel Levine nominated for a position so important to ending this pandemic and her experience on the frontlines in Pennsylvania will prove invaluable as assistant secretary."
"Her nomination is groundbreaking and shows the Biden administration will choose the most qualified individuals to lead our nation regardless of sexual orientation or gender identity," Parker said. "Dr. Levine is making history and will transform Americans' perceptions of trans people when she takes office and begins to work on their behalf."
Levine will likely take her approach as Pennsylvania secretary of state to her new role at HHS amid high hopes the Biden administration will take a different approach to Trump administration, which was criticized for failures in containing the coronavirus and the rollout for the vaccine.
In the Center for American Progress conference call last week, Levine said she was hoping for change, including making the Office of Conscience & Religious Freedom Division "either disbanded or certainly redirected." The HHS division has been criticized for leading the way in the Trump administration for allowing anti-LGBTQ discrimination in health care.
"I actually had the opportunity to speak with [Director] Roger Severino as they entered office to talk with them about LGBTQ medicines, transgender medicine in particular, and the importance of continuing the interpretation of Section 1557 of the ACA, that has under the Obama administration that included sexual orientation and gender identity and protected the opportunity for transgender individuals to seek broad medical care," Levine said. "Unfortunately they didn't listen to us."
Alphonso David, president of the Human Rights Campaign, said in a statement Levine's nomination represents real change in the U.S. government approach to the coronavirus and LGBTQ health issues.
"Dr. Rachel Levine, a highly experienced and qualified public health leader, has led Pennsylvania's public health response to the COVID-19 pandemic superbly," David said. "At a time when access to health care is a growing crisis for transgender people made worse by anti-LGBTQ legislation and legislators across the nation, Dr. Levine has the empathy to understand the health needs of our diverse country and the skillset to improve them."
This article originally appeared in the Washington Blade and is made available in partnership with the National LGBT Media Association.