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Adm. Levine celebrates trans joy on Transgender Day of Visibility

‘We continue to live a life of joy in the face of adversity’

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Dr. Rachel Levine (Washington Blade photo by Michael Key)

The day after Sunday’s Transgender Day of Visibility observance, the Washington Blade connected with Adm. Rachel Levine, a pediatrician serving as assistant secretary of health at the U.S. Department of Health and Human Services.

“Trans joy means authenticity and being comfortable in your own skin and being able to be who you are,” said Levine, who is the highest-ranking transgender official in U.S. history.

“With my transition, I was able to be my authentic self,” she remembers. “At that time, I was still a professor at the Penn State College of Medicine, and an attending physician at the Penn State Hershey Medical Center in pediatrics and adolescent medicine, but then I had this unique opportunity to become the physician general of Pennsylvania for then-Gov. Tom Wolf, and then two and a half years later to become the Secretary of Health.”

“So it has been a tremendous journey, which has been very rewarding,” Levine said, adding that it has been “an honor” to work for the Biden-Harris administration under HHS Secretary Xavier Becerra — all allies of trans, nonbinary, and gender expansive folks and of the LGBTQ community more broadly.

Levine recounted how Transportation Secretary Pete Buttigieg, himself the first openly gay Senate-confirmed Cabinet secretary, had singled her out as one of the administration’s other high-ranking LGBTQ appointees during a 2021 Pride celebration at the White House.

At that moment, President Joe Biden “looked me in the eye and, you know, kind of gestured for me to stand up for the applause,” she remembered, and “I thought that that was just truly meaningful and shows his compassion and his attention to the people working for him and his administration.”

At the same time, Levine’s tenure has, unfortunately, come with bigoted attacks from the likes of U.S. Rep. Marjorie Taylor Greene (R-Ga.), but she said part of trans joy means “we fight hate with love, and we continue to live a life of joy in the face of adversity.”

“For me personally, I am able to compartmentalize those attacks,” she said. “You know, and I’ve learned this in my clinical work as a pediatrician, where, if you are in the emergency department or in the office or in the hospital and you have a very sick patient in front of you, you have to be able to function as a professional and compartmentalize your feelings and then be able to bring them out later and process them.”

Levine explained, “And so it’s the same thing so that if I am attacked, I’m able to compartmentalize any emotions about that and then I work that through with my friends and my family.”

“In addition, though, I’ve also learned the art of sublimation where, you know, the more people attack me, then I’m able to turn that around and it serves as motivation for me to work harder and advocate more.”

Rather than herself, Levine said, “What I worry about are the most vulnerable in our community, who I think it can be very challenging for, particularly in these times, to vulnerable transgender and nonbinary youth, their families, and even their medical providers in many states across the country.”

Levine shared her thoughts about the public’s eroding faith in science, medicine, and institutional expertise — themes that often arise in the context of debates over gender affirming healthcare, as guideline-directed and medically necessary interventions that are supported by every mainstream medical society have come under fire from right-wing politicians.

“There is a lot of misinformation and overt disinformation about transgender medicine,” she said. “You know, transgender medicine is an evidence-based standard of care, which continues to benefit from continued research and evolution from, you know, standards 10 or more years ago to the current standards now published.”

Levine added, “Transgender medicine is absolutely necessary for transgender and gender diverse people including youth — and transgender medicine is medical care, but it’s also mental health care, and it’s literally suicide prevention care” that has “been shown in study after study to improve the quality of life and can literally save lives.”

Transgender medicine “for young people [is often] conducted at many of our nation’s expert children’s hospitals,” Levine said. “Let me put it this way: if you have a child with a fever, you would take your child, perhaps, to a pediatrician. If they had severe diabetes, you would take them to a pediatric endocrinologist. If they had a mental health condition, you might take them to a child psychiatrist or psychologist.”

“So,” she said, “if you have a child with gender questions or gender issues then you’re going to take them to the pediatric and adolescent gender specialist, and it’s often a team — including the same endocrinologist and it might be the same psychiatrist or psychologist.”

“You’re not going to think, ‘oh, I’m going to call my state legislator.'”

Nevertheless, Levine said, “These issues have been politicized for political and ideological reasons” over the objections of physicians like Jesse Ehrenfeld, president of the American Medical Association, who during a panel discussion with Levine for the PFLAG National convention in November, agreed that politicians should not get between patients, their families, and their healthcare providers.

“We see other areas where there’s misinformation and disinformation,” Levine said, perhaps partly a consequence of the politicization of the public health response to the COVID pandemic, which has led to vaccine hesitancy for COVID as well as childhood immunizations.

Ultimately, she said, “physicians and other medical and public health professionals are trying to help people,” which is “what I tried to do when I was in academic medicine” where “I really worked to help people, the patients and families that I saw as well as teaching as well as clinical research — and I think, overall, that’s what most physicians and medical professionals and public health professionals are doing.”

Exciting work ahead at HHS

When it comes to the work in which her agency is engaged, Levine said “health equity is fundamental to everything that we’re doing at HHS under Secretary Becerra and so many of our key policy initiatives relate to health equity.”

“So,” she said, “that includes health equity for the LGBTQI+ community, working to end the HIV epidemic in the United States with a focus on health equity, working to safeguard LGBTQI+ youth from the harms of conversion therapy, promoting data equity for our community, SAMHSA’s work on on conversion therapy, ARC’s work in terms of a sample patient intake form to improve the patient care experience for LGBTQI+ people, and more.”

“We have an office of climate change and health equity with a sister office of environmental justice,” Levine added. “We’re working on health equity in terms of reproductive health and reproductive rights, in the face of the Dobbs decision,” which revoked the constitutional right to abortion.

“We’re working in terms of health equity in regards to food and nutrition,” she said, “in terms of long COVID, and more.”

As with many initiatives under Biden’s presidency, “There is a tremendous emphasis on breaking down silos within divisions at HHS and between departments,” Levine said.

She shared a few examples: “One is our work on long COVID. We have an office of long COVID research and practice, which is really working across the administration with that whole of government approach. Another is in terms of our work on climate change and health equity with the EPA, and the White House Climate Council.”

“And then another actually would be our work on syphilis,” Levine said. “We run — and I chair — a syphilis and congenital syphilis federal government task force, which includes all the divisions at HHS, but also includes the VA and the Department of Defense, trying to address the significant increases in syphilis and congenital syphilis that we’ve seen the United States.”

And then, “Another example within the LGBTQ space is a global interagency action plan about conversion therapy, which includes HHS, the Department of State, the Department of the Treasury, and USAID.”

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Federal Government

White House finds Calif. violated Title IX by allowing trans athletes in school sports

Education Department threatens ‘imminent enforcement action’

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California Gov. Gavin Newsom (D) (Washington Blade photo by Michael Key)

The Trump-Vance administration announced on Wednesday that California’s Interscholastic Federation and Department of Education violated federal Title IX rules for allowing transgender girls to compete in school sports.

In a press release, the U.S. Department of Education’s Office of Civil Rights threatened “imminent enforcement action” including “referral to the U.S. Department of Justice” and the withholding of federal education funding for the state if the parties do not “agree to change these unlawful practices within 10 days.”

The agency specified that to come into compliance; California must enforce a ban excluding transgender student athletes and reclaim any titles, records, and awards they had won.

Federal investigations of the California Interscholastic Federation and the state’s Department of Education were begun in February and April, respectively. The Justice Department sued Maine in April for allowing trans athletes to compete and refusing a similar proposal to certify compliance within 10 days.

Broadly, the Trump-Vance administration’s position is that girls who are made to compete against trans opponents or alongside trans teammates are unfairly disadvantaged, robbed of opportunities like athletics scholarships, and faced with increased risk of injury — constituting actionable claims of unlawful sex discrimination under Title IX.

This marks a major departure from how the previous administration enforced the law. For example, the Department of Education issued new Title IX guidelines in April 2024 that instructed schools and educational institutions covered by the statute to not enforce categorical bans against trans athletes, instead allowing for limited restrictions on eligibility if necessary to ensure fairness or safety at the high school or college level.

Sports aside, under former President Joe Biden the department’s Office of Civil Rights sought to protect against anti-LGBTQ discrimination in education, bringing investigations and enforcement actions in cases where school officials might, for example, require trans students to use restrooms and facilities consistent with their birth sex or fail to respond to peer harassment over their gender identity.

Much of the legal reasoning behind the Biden-Harris administration’s positions extended from the 2020 U.S. Supreme Court case Bostock v. Clayton County, which found that sex-based discrimination includes that which is based on sexual orientation or gender identity under Title VII rules covering employment practices.

A number of high profile Democrats, including California Gov. Gavin Newsom, have recently questioned or challenged the party’s position on transgender athletes, as noted in a statement by Education Secretary Linda McMahon included in Wednesday’s announcement.

“Although Gov. Gavin Newsom admitted months ago it was ‘deeply unfair’ to allow men to compete in women’s sports, both the California Department of Education and the California Interscholastic Federation continued as recently as a few weeks ago to allow men to steal female athletes’ well-deserved accolades and to subject them to the indignity of unfair and unsafe competitions.”

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Trump’s dismantling of US foreign aid derails HIV prevention effort in Africa

FDA approved breakthrough preventative drug lenacapavir earlier this month

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President Donald Trump (Washington Blade photo by Michael Key)

On June 18, the Food and Drug Administration approved a long-acting injectable for the prevention of HIV that could have a transformational impact on decades-long efforts to end the epidemic in the U.S. and abroad.

Offering robust protection with just two doses per year, lenacapavir has the potential to dramatically improve uptake and adherence compared to daily oral PrEP regimens like Truvada or Descovy, particularly for high risk populations living in places with poor health infrastructure or where stigma about HIV discourages frequent testing and clinic visits.

According to the New York Times, however, the rollout of lenacapavir for HIV prevention overseas has been stymied by the gutting of agencies, staff, programs, and funding dedicated to foreign aid and public health during President Donald Trump’s second term.

Among other moves, the administration has frozen or withdrawn nearly all U.S. foreign development assistance, dismantled the U.S. Agency for International Development and reduced the size of its workforce by more than 95 percent, and shuttered key public health units housed under the U.S. Department of Health and Human Services, the National Institutes of Health, the Centers for Disease Control and Prevention, and the FDA.

As a result, the Times reports, HIV programs across the African continent have been “scrambling to procure drugs that the United States once supplied, replace lost nurses and lab technicians, and restart shuttered programs to prevent new infections.”

Experts fear HIV infection rates are climbing in some of the hardest-hit countries, but since the U.S. pulled funding for data collection and monitoring, there is no way to know for sure.

Historically, the U.S. has provided about 75 percent of all global spending on efforts to fight the epidemic, a reflection of the extent to which there was broad bipartisan support for the allocation of resources for this purpose through programs like the President’s Emergency Plan for AIDS Relief. Trump continued this legacy in his first term, launching the ambitious Ending the HIV Epidemic initiative that was continued under former President Joe Biden.

After returning to the White House, however, the president and his administration have justified their slash-and-burn cuts to the federal government’s work in international development and public health by arguing that funds and resources sent to overseas nations are too often pilfered by corrupt foreign state actors or wasted on ineffectual programs.

Trump and his allies also believe the U.S. should no longer be expected to shoulder such a disproportionate share of the responsibility for foreign aid, and that other countries are likelier to step up and contribute more in response to America’s retreat.

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So far, virtually no acknowledgement of Pride month by federal gov’t

Trump-Vance administration proclaimed ‘no more drag shows’ at Kennedy Center

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President Donald Trump (Washington Blade photo by Michael Key)

Just a few days from the start of June, there has been virtually no acknowledgment of Pride month by federal government agencies this year, a striking departure from recent policy and practice under the Biden-Harris administration and even under President Donald Trump’s first term.

Some limited and more localized observances have been preserved or renewed in 2025, for example by the U.S. courts’ webpage celebrating history-making LGBTQ jurists like Judges Deborah A. Batts and J. Paul Oetken of the U.S. District Court for the Southern District of New York, and by the Metropolitan Washington Airports Authority, which notes on its website plans to actively participate in WorldPride 2025.

The paltriness of Pride this year comes pursuant to several policy changes under Trump 2.0 such as executive orders narrowing the definition of gender to exclude trans and nonbinary people and banning activities related to diversity, equity, and inclusion, which have led to agency-wide changes including the removal of LGBTQ focused website content and dissolution of “affinity groups.”

Many of these actions came to light in the first few months of Trump’s second term. For example, in January the Associated Press reported a memo from the U.S. Defense Intelligence Agency indicating that observances related to Martin Luther King Jr. Day, Pride Month, Holocaust Days of Remembrance, and other cultural or historical annual events would be paused.

While it remains to be seen whether and to what extent the White House, federal government, and Congress will acknowledge Pride month in 2025, in 2024:

  • • At the end of May, President Joe Biden issued a proclamation declaring June LGBTQ Pride Month, as he had done for the previous three years of his administration
  • • The U.S. Senate, then under Democratic control, introduced a resolution recognizing June 2024 as LGBTQ Pride Month
  • • Federal agencies across the whole of government participated in Pride activities, and at a high level — for instance, then-U.S. Secretary of State Antony Blinken hosted a Pride month convening focused on U.S. foreign policy, national security, inclusive development, and human rights
  • • Actions in June, which in many cases were coordinated via LGBTQ employee resource groups or affinity groups, included celebrations of LGBTQ individuals — for example, the U.S. Department of Commerce’s Economic Development Administration toasted those who made significant contributions to economic growth, while the U.S. Patent and Trademark Office hosted a “Proud Innovation 2024” event, highlighting the accomplishments of LGBTQ innovators, entrepreneurs, and small business owners who utilize intellectual property to grow their businesses and mentor others in their communities.
  • Agencies also provided support indirectly — for example, the U.S. Federal Trade Commission sponsored attorneys who wished to represent the FTC at LGBTQ Pride events organized by various bar associations

The Washington Post pointed to some of the challenges facing organizers of WorldPride as they plan festivities in D.C. throughout early June: “This year, the LGBTQ+ celebration is being held in the backyard of a government that has targeted transgender rights and made major cuts to HIV prevention programs. At the Kennedy Center, President Donald Trump has promised â€œNO MORE DRAG SHOWS, OR OTHER ANTI-AMERICAN PROPAGANDA.”

On June 14, Trump is set to preside over a military parade in Washington commemorating the 250th anniversary of the U.S. Army, his 79th birthday, and Flag Day, in a celebration that will feature 6,600 soldiers from at least 11 corps and divisions nationwide and 150 military vehicles, including 28 M1 Abrams tanks.

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