Dr. Rachel Levine has had a momentous and precedent-setting year. In 2020, she oversaw Pennsylvania’s COVID-19 response as the state’s top health official while dealing with transphobic harassment. Undeterred, Dr. Levine accepted the Biden administration’s nomination to be the next Assistant Secretary for the Department of Health and Human Services earlier this year — and in March, she made history as the first openly transgender official to be confirmed by the Senate. In that position, she has helped oversee the federal response to the pandemic and spoken out against a wave of anti-LGBTQ+ legislation around the country.

This year, them. is honoring Dr. Levine as part of our annual Now List. Below, she tells contributor Samantha Riedel about the power of perseverance at a crisis point for trans rights.


I was asleep when the Biden transition team first reached out via text to ask if I would be interested in serving as the Assistant Secretary for the U.S. Department of Health and Human Services. The notification actually woke me up. So much for getting any more sleep that night.

It continues to be the honor of a lifetime to serve in this role. I am humbled to be the first openly transgender individual to serve in a Senate-confirmed position, and I’m hopeful for what that milestone will symbolize for our community. As Vice President Kamala Harris has said, I recognize that I may be the first, but I am heartened by the knowledge that I will not be the last. I hope that as more cisgender Americans get to know me, they will see that trans people are just like them.

I transitioned over a decade ago, and I consider myself very privileged to have had a successful transition with the support of my family and community. I recognize that my success is partly due to the fact that I am an educated, white medical professional who had access to resources at an academic medical center. Unfortunately, most people are not as lucky — especially transgender immigrants and Black, Latinx, and Native American trans people, who experience disproportionately high amounts of violence, harassment, and discrimination. It’s a tough road to navigate, and there are ups and downs.

I wish I could go back and say to my younger self during my own down times that it will be all worth it — there will be a day where I can be confident in who I am, and that I will be in a position to help the health of so many people. I stand on the shoulders of those who came before me, including those whose names we will never know because they were forced to live and work in the shadows. Those people inspire me to persevere. I tell myself to just keep moving and remember the words of Michelle Obama: “When they go low, we go high.”

In the Office of the Assistant Secretary for Health, we are addressing health equity for all on the COVID-19 Health Equity Task Force, and looking to apply the lessons we learned from the pandemic to medical practice moving forward. What most excites me are the meaningful policy changes that we are working on: We recently announced that individuals in covered health programs or activities cannot be discriminated against on the basis of their sexual orientation or their gender identity. We have also reformed the HHS LGBTQ+ coordinating committee, which is now looking across the agency to see what more we can do.

I believe the federal government must continue to lead by example and showcase the importance of full federal equality for LGBTQ+ communities. True change happens when we all work together, from the local level to the state level all the way to the federal level. Remember that acceptance starts at home, among your own community. That’s the key to the future.

I would also like to use this opportunity to ask the LGBTQ+ community to get a COVID-19 vaccine, and to help those around you get vaccinated. It is vital so we can return to normal. I know the LGBTQ+ community is sometimes reluctant to get medical care for fear of discrimination. But we need as many people as possible to get vaccinated. We can do this together.

Finally, I want to echo the words President Biden said in his first joint address to Congress: “To all transgender Americans watching at home, especially the young people, you’re so brave. I want you to know your president has your back.”

I want you to know that I have your back, too.

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