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Rachel Levine on becoming four-star admiral: ‘It comes from my desire to serve’

Trans official sworn-in to U.S. Public Health Service

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For Rachel Levine, the appointment to her new role as a four-star admiral complementing her existing duties as assistant secretary for health is another way for the first openly transgender Senate-confirmed presidential appointee to serve.

“I think that this just really comes from my desire to serve in all capacities,” Levine said in an interview Tuesday with the Washington Blade. “To serve the first day in my field of academic medicine and pediatrics, but then in Pennsylvania and now in the federal government, and it furthers my ability to do that.”

Levine, 63, also recognized the importance of the appointment as a transgender person within the U.S. Public Health Service, for which she was ceremonially sworn in on Tuesday

“I think for the LGBTQ+ community, it is a further sign of progress and our president’s commitment to equity, to inclusion and diversity,” Levine said. “So I think that it is a very important milestone, and I’m pleased to serve.”

As part of her duties, Levine will lead an estimated 6,000 public health service officers serving vulnerable populations, including deployments inside and outside the country for communities beleaguered with the coronavirus, according to the Department of Health & Human Services. The role involves working closely with U.S. Surgeon General Vivek Murphy, whom Levine called her “friend and colleague.”

The U.S. Public Health Service, Levine said, has deployed “many, many times,” including its greatest number ever of deployments to vulnerable populations during the coronavirus pandemic. Among the places the service has deployed, Levine said, was in her home state of Pennsylvania, where she recently served as secretary of health.

Not only is Levine the first openly transgender person to serve in the uniformed health service as a four-star general, but she’s also the first woman to serve in that capacity.

“We have 6,000 dedicated committed public servants really all focused on our nation’s health, and they serve in details to the CDC and the FDA and the NIH, but also clinically with the Indian Health Service, and the federal prison system,” Levine said. “They’re also detailed and deployed throughout the country, and they deployed like never before for COVID-19 as well as the border, as well as dealing with floods and hurricanes and tornadoes.”

Although the Public Health Service is primarily focused on addressing public health disasters within the United States, Levine said it has a record of deployments overseas, including years ago when it was deployed to Africa under the threat of Ebola.

Secretary of Health & Human Services Xavier Becerra had high praise for Levine in a statement upon news of taking on a leadership position in the service.

“This is a proud moment for us at HHS,” Becerra said. “Adm. Levine — a highly accomplished pediatrician who helps drive our agency’s agenda to boost health access and equity and to strengthen behavioral health — is a cherished and critical partner in our work to build a healthier America.”

Levine, however, was careful to draw a distinction between her appointment within the Public Health Service and being a service member within the U.S. armed forces.

“It is not a military branch, it’s not the armed forces: It’s a uniformed force, so it’s different,” Levine said. “For example, the Army, the Navy, our military, there are two other uniformed branches, and that is ours, the United States Public Health Service Commissioned Corps and NOAA.”

The new role, Levine said, would complement her duties as assistant secretary for health. Although not only secretaries of health have been commissioned to take the uniform, Levine said she wanted to undertake that as part of her role in the Biden administration.

The two appointments were not simultaneous, Levine said, because of a general process she undertook, which was completed just this week.

It hasn’t been an easy road for Levine. During her Senate confirmation process, when she was hounded by anti-transgender attacks in conservative media and rude, invasive questioning by Sen. Rand Paul (R-Ky.) on her gender identity.

Levine, however, said she hasn’t encountered any hostility regarding her new role (as of now) and shrugged off any potential attacks in the future and said the move is about her career “to serve and to help people.”

“I’ve continued that for our nation as the assistant secretary for health and this is just a further demonstration of my commitment to service,” Levine said. “I don’t know what others will say, but that’s the genesis of my wanting to serve in the United States Public Health Service Commissioned Corps, and to place on the uniform.”

Levine’s new appointment comes shortly after a group of Democratic senators led by Sen. Chris Murphy (D-Conn.) sent her a letter dated Sept. 30 calling on her and Miriam Delphin-Rittmon, assistant secretary for mental health and substance use, to issue new guidance for hospital or residential care on mental health needs of transgender people.

Asked about the letter, Levine said mental health issues are under the authority of Delphin-Rittmon and the two “will work together and we will respond.”

Specifically, the senators in the letter call on the Behavioral Health Coordinating Council, or BHCC, and experts in the field of adolescent trans care to offer guidance on best practices for inpatient mental health care among these youth.

Asked what the response will look like, Levine said, “We’re going to work on that.”

“We will be looking at what they’re asking for and the requirements, and we’ll talk with them and the stakeholders and we’ll look to issue appropriate guidance,” Levine said.

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U.S. Federal Courts

Lesbian mother from El Salvador released from ICE custody

Jessica Barahona-Martinez arrested on June 26, 2017

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(Bigstock photo)

A federal judge last week ordered the release of a lesbian mother from El Salvador who had been in U.S. Immigration and Customs Enforcement custody since June 2017.

Jessica Patricia Barahona-Martinez and her three children entered the U.S. on May 31, 2016. A court filing notes she fled “persecution she faced in El Salvador as a lesbian, and because the government had falsely identified her as a gang member.”

Barahona-Martinez lived with her sister and other relatives in Woodbridge, Va., until ICE arrested and detained her on June 26, 2017. She was housed at two ICE detention centers in Virginia until her transfer to the South Louisiana ICE Processing Center, a privately-run facility the GEO Group, a Florida-based company, operates in Basile, La., in October 2020. 

An immigration judge in November 2019 granted Barahona-Martinez asylum for the second time. The government appealed the decision and the Board of Immigration Appeals, which the Justice Department oversees, ruled in their favor.

The American Civil Liberties Union and the ACLU of Louisiana last month filed a writ for habeas corpus petition in the U.S. District Court for the Western District of Louisiana’s Lafayette Division that asked for Barahona-Martinez’s release. U.S. District Judge Terry A. Doughty on Sept. 27 ruled in her favor.  

“Petitioner (Barahona-Martinez) ultimately argues that her prolonged detention violates due process; she moves that this court issues a temporary restraining order, requests release, a bond hearing, an expedited hearing and costs and attorney fees,” wrote Doughty.

“This court finds that petitioner has plausibly alleged her prolonged detention violates due process,” added Doughty.

An ACLU spokesperson on Monday told the Blade that ICE has released Barahona-Martinez and she is once again in Virginia with her children and sister. 

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State Department

State Department hosts intersex activists from around the world

Group met with policy makers, health officials, NGOs

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The State Department last week hosted a group of intersex activists from around the world. (Courtesy photo)

The State Department last week hosted five intersex activists from around the world.

Kimberly Zieselman, a prominent intersex activist who advises Jessica Stern, the special U.S. envoy for the promotion of LGBTQ and intersex rights abroad, brought the activists to D.C.

• Morgan Carpenter, co-founder and executive director of Intersex Human Rights Australia

• Natasha Jiménez, an intersex activist from Costa Rica who is the general coordinator of Mulabi, the Latin American Space for Sexualities and Rights

• Julius Kaggwa, founder of the Support Initiative for People with Atypical Sex Development Uganda

• Magda Rakita, co-founder and executive director of Fujdacja Interakcja in Poland and co-founder of Interconnected UK

• Esan Regmi, co-founder and executive director of the Campaign for Change in Nepal.

Special U.S. Envoy for Global Youth Issues Abby Finkenauer and Assistant Health Secretary Rachel Levine are among the officials with whom the activists met.

Zieselman told the Washington Blade on Sept. 21 the activists offered State Department officials an “intersex 101” overview during a virtual briefing.

More than 60 Save the Children staffers from around the world participated in another virtual briefing. Zieselman noted the activists also met with Stern, U.N. and Organization of American States officials, funders and NGO representatives while in D.C.

“The people we met were genuinely interested,” Rakita told the Blade.

Stern in an exclusive statement to the Blade said “the visiting intersex activists clearly had an impact here at State, sharing their expertise and lived experience highlighting the urgency to end human rights abuses, including those involving harmful medical practices against intersex persons globally.” Andrew Gleason, senior director for gender equality and social justice at Save the Children US, in a LinkedIn post he wrote after attending his organization’s meeting with the activists echoed Stern.

“There are many learnings to recount from today’s discussion, but one thing is clear, this is unequivocally a child rights issue, and one that demands attention and action at the intersection of LGBTQI+ rights, reproductive rights and justice, disability justice and more,” wrote Gleason. “Gratitude to the panelists for sharing such poignant testimonies and providing insights into what organizations like ours can do to contribute to the broader intersex movement; and thank you to Kimberly for your leadership and bringing this group together.”

The activists’ trip to D.C. coincided with efforts to end so-called sex “normalization” surgeries on intersex children.

Greek lawmakers in July passed a law that bans such procedures on children under 15 unless they offer their consent or a court allows them to happen. Doctors who violate the statute face fines and prison.

Germany Iceland, Malta, Portugal and Spain have also enacted laws that seek to protect intersex youth. 

A law that grants equal rights and legal recognition to intersex people in Kenya took effect in July 2022. Lawmakers in the Australian Capital Territory earlier this year passed the Variation in Sex Characteristics (Restricted Medical Treatment) Bill 2023.

Intersex Human Rights Australia notes the law implements “mechanisms to regulate non-urgent medical care to encourage child participation in medical decisions, establish groundbreaking oversight mechanisms and provide transparency on medical practices and decision making.” It further points out the statute “will criminalize some deferrable procedures that permanently alter the sex characteristics of children” and provides “funding for necessary psychosocial supports for families and children.”

“It’s amazing,” Carpenter told the Blade when discussing the law and resistance to it. “It’s not perfect. There was some big gaps, but physicians are resisting every step of the way.”

The State Department in April 2022 began to issue passports with an “X” gender marker.

Dana Zzyym, an intersex U.S. Navy veteran who identifies as non-binary, in 2015 filed a federal lawsuit against the State Department after it denied their application for a passport with an “X” gender marker. Zzyym in October 2021 received the first gender-neutral American passport.

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Federal Government

Federal government prepares for looming shutdown

White House warns of ‘damaging impacts across the country’

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U.S. Capitol Building (Washington Blade photo by Michael Key)

However remote they were on Monday, odds of avoiding a government shutdown were narrowed by Thursday evening as House Republicans continued debate over their hyper-partisan appropriations bills that stand no chance of passage by the Upper Chamber.

As lawmakers in the Democratic controlled Senate forged ahead with a bipartisan stop-gap spending measure that House GOP leadership had vowed to reject, the federal government began bracing for operations to grind to a halt on October 1.

This would mean hundreds of thousands of workers are furloughed as more than 100 agencies from the State Department to the Advisory Council on Historic Preservation roll out contingency plans maintained by the White House Office of Management and Budget. On Thursday the Office of Personnel Management sent out memos to all agencies instructing them to ready for a shutdown on Sunday.

Before 1980, operations would continue per usual in cases where Congress failed to break an impasse over spending, as lapses in funding tended to last only a few days before lawmakers brokered a deal.

Since then, the government has shut down more than a dozen times and the duration has tended to become longer and longer.

“Across the United States, local news outlets are reporting on the harmful impacts a potential government shutdown would have on American families,” the White House wrote in a release on Thursday featuring a roundup of reporting on how the public might be affected.

“With just days left before the end of the fiscal year, extreme House Republicans are playing partisan games with peoples’ lives and marching our country toward a government shutdown that would have damaging impacts across the country,” the White House said.

The nature and extent of that damage will depend on factors including how long the impasse lasts, but the Biden-Harris administration has warned of some consequences the American public is likely to face.

Transportation Secretary Pete Buttigieg, for example, warned: “There is no good time for a government shutdown, but this is a particularly bad time for a government shutdown, especially when it comes to transportation.”

Amid the shortage of air traffic controllers and efforts to modernize aviation technology to mitigate flight delays and cancellations, a government shutdown threatens to “make air travel even worse,” as Business Insider wrote in a headline Thursday.

Democratic lawmakers including California Congresswoman Barbara Lee and Maxine Waters, meanwhile, have sounded the alarm in recent weeks over the consequences for the global fight against AIDS amid the looming expiration, on Oct. 1, of funding for PEPFAR, the President’s Emergency Plan for AIDS Relief.

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