Voting mostly along party lines, the U.S. Senate on Wednesday confirmed former Pennsylvania Health Secretary Rachel Levine to be the nation’s assistant secretary for health. She is the first openly transgender federal official to win Senate confirmation. The final vote was 52-48.
Levine had been serving as Pennsylvania’s top health official since 2017, and emerged as the public face of the state’s response to the coronavirus pandemic. She is expected to oversee Health and Human Services offices and programs across the U.S.
President Joe Biden cited Levine’s experience when he nominated her in January.
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,” Biden said.
Transgender-rights activists have hailed Levine’s appointment as a historic breakthrough. Few trans people have ever held high-level offices at the federal or state level. However, the confirmation vote came at a challenging moment for the transgender-rights movement as legislatures across the U.S.—primarily those under Republican control—are considering an unprecedented wave of bills targeting trans young people.
One type of bill, introduced in at least 25 states, seeks to ban trans girls and young women from participating in female scholastic sports. Another, introduced in at least 17 states, seeks to outlaw or restrict certain types of medical care for transgender youths. None of these measures has yet won final approval.
Sen. Rand Paul confronted Levine about medical treatments for transgender young people—include hormone treatment and puberty blockers—during her confirmation hearing Feb. 25. Levine replied that transgender medicine “is a very complex and nuanced field with robust research and standards of care” and said she would welcome discussing the issues with him.
In the past, Levine has asserted that hormone therapy and puberty-blocking drugs can be valuable medical tools in sparing some transgender youth from mental distress and possible suicide risk.
Read more: Elliot Page Is Ready for This Moment
A pediatrician and former Pennsylvania physician general, Levine was appointed as Pennsylvania’s health secretary by Democratic Gov. Tom Wolf in 2017. She won confirmation by the Republican-majority Pennsylvania Senate.
However, Sen. Pat Toomey, a Pennsylvania Republican, voted against Levine’s confirmation Wednesday.
“In Pennsylvania, the pandemic struck seniors in nursing homes disproportionately hard compared to other states,” Toomey said. “This was due in part to poor decisions and oversight by Dr. Levine and the Wolf administration.” He also said an extended lockdown advocated by Levine “was excessive, arbitrary in nature, and has led to a slower recovery.”
A graduate of Harvard and of Tulane Medical School, Levine is president of the Association of State and Territorial Health Officials. She’s written in the past on the opioid crisis, medical marijuana, adolescent medicine, eating disorders and LGBTQ medicine.