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Transgender Federal Official Sworn In as 4-Star Admiral

Assistant Secretary for Health Rachel Levine is the nation's highest-ranking openly trans official

Former Pennsylvania Health Secretary and now U.S. Assistant Secretary for Health Rachel Levine speaks to the media after touring the FEMA vaccination clinic at the Philadelphia Convention Center in Philadelphia, Thursday, April 29, 2021. Inset image is official h h s portrait of Rachel in uniform.
Former Pennsylvania Health Secretary and now U.S. Assistant Secretary for Health Rachel Levine speaks to the media after touring the FEMA vaccination clinic at the Philadelphia Convention Center in Philadelphia, Thursday, April 29, 2021.
Jose F. Moreno/The Philadelphia Inquirer via AP / Courtesy HHS

| The nation's highest-ranking openly transgender federal official has made history again upon being sworn in as a four-star admiral.

Pediatrician Rachel Levine, the assistant secretary of health at the U.S. Department of Health and Human Services, became the U.S. Public Health Service Commissioned Corps' first ever-female four-star officer upon being sworn in Oct 19. The 6,000-person U.S. Public Health Service Commissioned Corps is one of the nation's eight uniformed services and works to advance public health issues and provide health-related disaster relief.

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After being sworn in, Levine, 63, said she was "ready to be a beacon in these dark days of COVID-19" and noted the importance of her achievement.

"This is a momentous occasion and I am honored to take this role for the impact that I can make and for the historic nature that it symbolizes," Levine said. "I stand on the shoulders of those LGBTQ-plus individuals who came before me, both those known and unknown."

LGBTQ advocacy organizations and health leaders lauded the historic event. Levine’s “appointment represents an important step towards a more inclusive future, and her service will undoubtedly advance the USPHS Commissioned Corps’ mission to protect, promote, and advance the health and safety of our nation,” said a statement from U.S. Surgeon General Vivek Murthy, a vice admiral in the corps.

Levine this year became the first openly transgender federal official to be confirmed by the U.S. Senate, prompting elation from many in the LGBTQ community.

A journey of leadership

Levine, 63 grew up in Massachusetts and received her medical degree from the Tulane University School of Medicine in New Orleans. She completed a residency in pediatrics at New York City's Mount Sinai Medical Center and a few years later began working at the Penn State Milton S. Hershey Medical Center. There, she facilitated LGBTQ groups and was instrumental in the formation of the hospital's adolescent treatment division and eating disorders clinic.

Levine had a flourishing career in Pennsylvania, a wife and two kids. But in interviews she has said she felt something was missing. Levine began taking steps to transition from male to female, first coming out publicly as transgender in 2011 and divorcing several years later.

In 2014, Levine was chosen by Pennsylvania's governor to be the state's physician general and later became the state's secretary of health. While leading the Keystone State's response to COVID-19, Levine rose in prominence via daily pandemic news briefings to become one of the country's highest-profile transgender government officials.

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Confirmed March 24 by a bipartisan vote of the U.S. Senate as assistant secretary of health at the Department of Health and Human Services, Levine acknowledged the historic significance of her position as a transgender woman.

"I recognize that I may be the first,” she said in a statement to The New York Times, “but I am heartened by the knowledge that I will not be the last.”

Reasons for hope

Many in the LGBTQ community hailed Levine's confirmation as a step toward creating a world where people can make career choices without worry about being adversely judged for their gender identity or expression.

That sentiment was echoed by the nation's first transgender trial judge, Victoria Kolakowski, 59, of Alameda County, California. “Those of us who are transgender professionals are increasingly being recognized for our qualifications in our fields of expertise, which is encouraging a new generation of transgender youth to pursue their professional passions,” she says.

Others see the moment in LGBTQ history as a harbinger of increased acceptance.

For some leaders, Levine's story signifies a battle won in the struggle for acknowledgment and achievement. Mary Anne Adams, 66, the executive director of Atlanta, Georgia–based ZAMI NOBLA (National Organization of Black Lesbians on Aging), believes Levine's elevation proves that being open about who you are doesn't have to be a barrier.

"This seminal appointment provides a beacon of hope to anyone daring to live their lives authentically,” she says. “The never-ending fight for civil and human rights needs advocates both in and outside of the Beltway.”

But not everyone is quite so optimistic.

Julia Serano, 53, a biologist and transgender activist from Oakland, California, acknowledged the symbolism of Levine's appointment. “When someone becomes the ‘first ever’ person from a historically marginalized group to achieve something, it is viewed as a sign of progress,” she says.

Yet, Serano also noted that the threat of a backlash against transgender people and their rights remains. “It is difficult for me to see this as a wholly positive ‘turning point’ moment,” she says.

For Pastor Tony Amato, 53, of Kingston, New York, a transgender man who often works with the LGBTQ community, Levine's confirmation could prove a balm for the insecurity and violence faced by many.

He recounted how after a severe automobile accident, a trans male friend refused an ambulance, fearing the EMTs would discover his chest binders and harass him. Many trans people, Amato stressed, have shown the same reticence about seeking medical treatment for COVID-19. He believes that with Levine's confirmation, the government sends a signal: The trans community not only has a right to exist, but will be cared for.

Court Stroud is a contributing writer who covers media, entertainment and diversity, including LGBTQ issues. He has also written for The New York Times, The Washington Post and Forbes.

Editor's note: This article was originally published on April 27, 2021 and has been updated with news of Rachel Levine being sworn in to her official role.