Dr. Rachel Levine reflects on her service and transgender politics as she retires from HHS: Shot

In 2021, there was one state in the country that banned gender-affirming care for young people: Arkansas. In March of that year, Dr. Rachel Levine won Senate confirmation to lead the U.S. Public Health Service Commissioned Forces as Assistant Secretary of Health. She has the rank of Admiral.

Levine is the highest-ranking transgender person ever to serve in the federal government.

In the nearly four years she has been at the Department of Health and Human Services, anti-trans legislation has exploded. Following Arkansas, 25 additional states have banned gender-affirming care for young people. Other laws focus on restroom use in schools and public buildings, and prohibit transgender children from participating in sports consistent with their gender identity.

In the final stages of the presidential campaign, Republicans used Levine’s image in ads that said “Kamala is for them,” which some experts say helped the party win the presidential election and both houses of Congress. I am doing it.

discreet and practical

During this time, Levine quietly worked at HHS in Washington, D.C., but in late December she gave an exit interview to NPR. She has a friendly, reserved personality and down-to-earth sensibilities. She loved Joni Mitchell and brought lunch from home. Today it’s a turkey wrap.

She is a pediatrician specializing in adolescent medicine and served as Pennsylvania’s public health official before being appointed by the Biden administration. She wears the blue woolen dress uniform of the Department of Public Health, the division of the Uniformed Service she heads.

Levine was excited about a new campaign promoting childhood vaccines called “Let’s Get Real.” Declining childhood vaccination rates are one of the challenges she seeks to address in her role. She is aware that the incoming Trump administration is poised to put an anti-vaccine activist in charge of HHS.

Will the effort last more than a few weeks? “It’s impossible to say what will happen after Inauguration Day,” she says. “This campaign has been planned for more than a year and is now underway.”

Witness the benefits of vaccines

She seems undaunted. Vaccines are an incredible thing, she continued, explaining how she witnessed it firsthand.

“I began my pediatric residency program at Mount Sinai Hospital in New York City in 1983,” she says. That was before the introduction of the HiB vaccine, which protects against a bacterium called Haemophilus influenzae type B. “We were seeing far too many children with very serious bacterial infections, including pneumonia, meningitis and sepsis, caused by this bacteria. And this was only after the vaccine came out.” Although it has been administered for many years, we actually don’t see such infections anymore.

“Of course, I haven’t seen any pediatricians currently in training, but I have,” she says. “This is one example of a vaccine that we don’t talk about very often, but it virtually eliminated serious infections in the children I cared for in the hospital. And it’s one of many examples. This is just one example.”

This is an important part of her job: passionately and clearly explaining why public health measures are important. She speaks proudly of her office’s work on climate change, the HIV epidemic, and the “Food is Medicine” initiative. Although policies will certainly change under the administration appointed by President Trump, she believes public health efforts will continue. “We have great public servants here,” she says.

In that role, Levine traveled around the country visiting local health departments and organizations. She talks about the migrant farm workers she met in Orlando, Florida, and the arctic islands she traveled to in Alaska. Many of the people she met during her travels were probably the first openly transgender people she had ever met.

“I’m a tough guy, so it’s okay.”

She doesn’t usually talk much about her transgender identity. She was born in 1957 and attended an all-boys prep school outside Boston, which she says was “obviously a very interesting experience.” “Remember, this was the early ’70s. I obviously had feelings about my gender. But what were you going to say and who were you going to say it to?”

She came out as transgender decades later. “I don’t think it’s healthy for anyone to have secrets,” she says. “I think changing and coming out and being my authentic self was liberating for me. It was an amazing experience.”

Levine has been targeted by right-wing media not only because she is transgender, but also because she supports gender-affirming care.

She ignores the fact that her image was used in anti-trans ads that dominated the final weeks of the presidential campaign. “It’s been very difficult, but I’m a resilient person so I’m okay.”

She told NPR in 2022 that “there is no debate among medical professionals about the value and importance of gender-affirming care.” Since then, some prominent medical experts, including British pediatrician Hilary Kass, have called for attention to this area of ​​medicine. These doctors’ names are often cited by lawmakers seeking to ban the treatment. Kass was recently mentioned in Supreme Court arguments on whether such bans are constitutional.

“There remains broad agreement about transgender medicine and its medical utility for young people,” Levine argues. “Research to study our medical protocols is always ongoing, and that includes transgender medicine. We should always have robust discussion and analysis of treatment protocols, and they should must be based on.”

She says these standard treatments need to be applied carefully to individual patients. “That’s the way we do pediatrics, and that’s the way it should be,” she says.

She says that’s separate from what’s happening with the proliferation of anti-trans state laws. “This is actually a politically and ideologically motivated effort developed by think tanks in Washington to attack the LGBTQI+ community, including the trans community,” she says. “And unfortunately, it was a huge success.”

She says she chooses to be optimistic that things will get better for transgender people in the United States.

Mr. Levine will resign on the day of his inauguration. She said she plans to return to central Pennsylvania, take some time off, and plan her next steps.