Admiral Rachel Levine has had a busy year. As the Assistant Secretary for Health for the U.S. Department of Health and Human Services, Levine has spoken to people both in Washington, D.C. and throughout the country — from Floridia to Oregon and several other states in between. Levine, who is the first openly transgender federal official to be confirmed by the U.S. Senate, has done work to address public health issues across the country, including trans health care. Levine took time out of her schedule between speaking engagements to speak with PGN about health care for trans people and trans visibility. Some responses have been edited for length and clarity.
With International Transgender Day of Visibility occurring this past weekend, what do you make of the right-wing discourse surrounding the annual event falling on Easter this year?
I think that it is kind of a false argument. I think that they’re protesting, quote unquote too much. It just happens that Trans Day of Visibility is always on March 31. And Easter happened to fall on that day. So there was no connection between the two. And I think they’re just using it for their own purposes.
In general, what do you think can be done about right-wing attacks against trans people, specifically trans youth in schools?
It’s very challenging right now. I’m a positive and optimistic person and I think that this will change. I think the wheel will turn on this. But it is very difficult now, particularly for vulnerable trans and nonbinary youth and their families and their medical providers in the states that have taken [anti-trans] actions. That’s why I think it is so important that the president, the vice president, our secretary, myself, all throughout HHS and the administration, continue to support them publicly and vocally; and to do our advocacy and work to support them, as well as the legal work that the Department of Justice is doing, that the other divisions are doing, and agencies are doing in terms of rules and regulations. All that work will continue and I think we have to continue to show our support, given the challenges that they face.
Can you talk about the importance of days like International Transgender Day of Visibility?
I think that the Transgender Day of Visibility reminds us that we are a strong, resilient and powerful community. We are a community that fights hate with love. And we continue to live out proud and visible; to live a life of joy in the face of this adversity. We are not cowed by this.
What would you say are the biggest obstacles for trans health care across the country?
I think the biggest obstacles are these laws and actions that many states have taken, that are denying these vulnerable trans and nonbinary youth their access to evidence-based health care. Transgender medicine is an evidence-based standard of care. And it is unconscionable that young people are not being able to access this [care]. If you have a child with a fever, you might take them to see a pediatrician. If you have a child with diabetes, you would see a pediatric endocrinologist. If you have a child with a mental health concern, you would take them to a child psychologist or a child psychiatrist. So if you have a child that has gender questions or gender issues, you’re not going to call your state legislator. You’re going to seek a pediatric and adolescent gender specialist. When the state steps in, I think it is for political and ideological purposes.
What do you think it will take for parents to realize that they need to care for their child rather than reach out to their legislators for issues like this?
I think that many, if not most, parents do want to care for their children. It’s that this care is being questioned and stigmatized. And they’re being targeted. I think the kids, families and medical providers are being targeted. I think this is an issue of the state stepping in where they don’t need to be.
I was with the president of the AMA [American Medical Association], Jesse Ehrenfeld, at a PFLAG event in the Washington area, and we were talking about that. State governments don’t need to step in between a young person — [or] their parents, guardians, family — and their medical providers. They’re doing it in this case, but they don’t do it in almost any other case. So a lot of misinformation and disinformation is being communicated about gender affirming care and it’s potentially very damaging and harmful to these youth. Transgender medicine is medical care. It’s mental health care, and it can be suicide prevention care.
Can you talk a little bit about what the US Department of Health and Human Services is doing to combat this misinformation?
One is through advocacy. I go out to many states. I see many people who come to DC and I talk with them. I [also travel] all throughout the country — east, west, north, south and in the middle — to talk with youth, their families, LGBTQI+ adults, medical providers to provide support and encouragement from myself, from my secretary — Secretary Becerra — and from the Biden-Harris administration.
The second is policy work. The president has had executive orders. We are leading key policy initiatives at HHS. We’re working to end the HIV epidemic. SAMHSA released a report last year about the harms of conversion therapy. ARC has released a sample patient intake form to improve patient care experience for transgender people. Within our own workforce, we have adopted a gender identity, nondiscrimination and inclusion guidance. We’re working to combat syphilis and the outbreak of syphilis throughout the country. So all that work continues. Our Office of Civil Rights is working on promulgating regulations. The Department of Education [and] Department of Justice is working on weighing in on these cases. [We’re doing] everything we can do from all of those different perspectives. And of course, the president supports the Equality Act in Congress. Although, it doesn’t look like it has passed this year.
What do you have to say about the role of narratives perpetuated by groups like Libs of TikTok, stating that LGBTQ+ people are groomers or pedophiles?
I’m not going to comment on any specific organization, or any specific comments they have made. But in general, I think that the laws and actions being taken are being done for political and ideological purposes. And this is part of a specific strategy in the face of marriage equality — to target first the transgender community, and then the broader LGBTQ+ community. That’s generally what I would say.
What can accomplices and allies do to help advocate for and support the trans community?
I think that allies are absolutely critical and I think that we need our allies to advocate with us and to advocate in communities, to advocate in towns, in communities, in states, as well as nationally to address these attacks and to work against this misinformation and disinformation. So we all need to stand together in our broader LGBTQI+ plus community. And we need our allies like President Biden and Vice President Harris and Secretary Becerra, who do stand with us and will continue to.