Rachel Levine, MD, was sworn in as Assistant Secretary for Health on March 26, 2021.
Rachel Levine, MD, a longtime leader in public health, was sworn in as Assistant Secretary for Health in the Department of Health and Human Services in March 2021—making history as the first openly transgender federal official to be confirmed by the U.S. Senate. Dr. Levine, who began her medical career at Mount Sinai, recently took part in an interview with Mount Sinai Today about her years of training and the road ahead.
Dr. Levine took on her new post after nearly 40 years in adolescent health and public health, most recently serving as Pennsylvania’s Secretary of Health. At her confirmation, she said, “I am both humbled by the opportunity and ready for the job.”
As a young physician at Mount Sinai, was becoming a national leader in public health one of your goals?
I received fantastic training in pediatrics and adolescent medicine at Mount Sinai, and at the time I really saw my career in academic medicine. I did my residency program at Mount Sinai from 1983 to 1986. I was chief resident from 1986 to 1987. I did my fellowship from 1987 to 1988, and then I was part of the voluntary faculty and kept my association with Mount Sinai through 1993, when I left to go to the Penn State College of Medicine. It was 10 years of association with Mount Sinai, and I found it to be absolutely wonderful. But I actually did not see myself in the type of role that I have now.
Were there experiences at Mount Sinai that you found especially formative?
Serving as Chief Resident of Pediatrics at The Mount Sinai Hospital was really one of the formative leadership experiences of my life. I had a tremendous amount of responsibility in terms of leading 25 to 30 residents, helping them with all the patients on all the floors, dealing with emergencies, and taking on administrative responsibilities for the unit—all under the mentorship of Kurt Hirschhorn, MD, then the Chair of Pediatrics, and Alexander Hyatt, MD, the Vice Chair. In years since, I think the job has been divided among two or three people, so the Chief Resident in 1986 had a lot of responsibility. I kind of joke that only now have I finally found a job that equals being Chief Resident of Pediatrics at The Mount Sinai Hospital.
Dr. Levine was the keynote speaker at Mount Sinai’s White Coat Ceremony in 2015.
Could you talk about a few of your mentors at Mount Sinai?
Probably the biggest mentor I have had in medicine is Dr. Hirschhorn, Professor Emeritus of Pediatrics, Genetics, and Medicine, and Chairman Emeritus of Pediatrics. He is just an outstanding academic medicine physician, and he was a great chair and mentor. One of my most vivid memories of Mount Sinai was morning reports, where we would present the cases that came in the night before, and Dr. Hirschhorn was always there. We would discuss the admissions and then the diagnoses and the challenges, and it was a fantastic formative learning experience.
There are so many other mentors I could name, including Dr. Hyatt; Scott Barnett, MD; Les Jaffe, MD, who was head of the adolescent program during my entire time at Mount Sinai, and Angela Diaz, MD, PhD, MPH, Director of the Mount Sinai Adolescent Health Center. Dr. Diaz was a third-year resident when I was an intern and an attending in the adolescent clinic when I was a fellow. That may not seem like much of a difference, but she was senior to me, always a couple of years ahead. What I remember most from those days was her great compassion and dedication. Then and now, she is passionate about adolescent medicine and taking care of teens in the community.
The COVID-19 response was one of your top priorities as Pennsylvania’s Secretary of Health and in your federal position now. What are the biggest challenges in the pandemic now?
Our main focus now is the vaccination program. For months it was supply and the challenge of distribution and administration. But I think we are exactly at that tipping point where the most important challenge is vaccine hesitancy. Through the efforts of the Biden-Harris administration, we now have adequate supply of three safe and effective vaccines, but we now need to work past people’s hesitancy about the vaccines. One role that I hope to play is helping with this messaging as the vaccines receive Emergency Use Authorization for adolescents and perhaps younger children.
What are your other top priorities as Assistant Secretary for Health?
Addressing the continuing issue of the opioid crisis and overdoses is an important priority. We are also focusing on the public health impacts of environmental health and climate change. In an executive order, President Biden has created a new Office for Climate Change and Health Equity, and that is part of my office. As our climate changes and we look at the public health impacts, we want to make sure that we’re looking at vulnerable communities—African American communities, Latino communities, and American Indian and Native Alaskan communities. We know that there are significant health disparities, and we’re concerned that these communities are bearing the brunt of the impacts of climate change. We want to study these disparities and develop policies to address them.
What does the historic nature of your appointment mean to you?
I like to say that I may be the first transgender federal official to be confirmed by the Senate, but I won’t be the last. And here I’m building on a quote from Vice President Harris, who said that as a Black and South Asian woman, “I may be the first to hold this office, but I won’t be the last.” We’ve come a long way in the LGBTQ community, but we certainly have a long road ahead. We need to raise awareness, and we need to work in terms of health equity for LGBTQ individuals, particularly LGBTQ youth.
You were confirmed by a bipartisan vote of 52-48, but in your hearing you faced some opposition and adverse reactions. How do you handle this kind of situation?
I really think that any hostility comes from a place of fear—that people fear what they don’t understand, and so I want to educate people. Even my being the Assistant Secretary for Health shows people that transgender individuals and LGBTQ individuals are like everyone else. We’re physicians; we’re teachers; we’re lawyers; we are everywhere in society and in our government as well. And I want to show LGBTQ youth that with hard work and perseverance you can be anyone, and you can be anything.
Colleagues Salute Rachel Levine, MD:
“Dr. Levine’s appointment is both historic and emblematic of how far we have come in recognizing the accomplishments and the contributions of LGBTQI people to making our health care and our society more equitable, inclusive, and compassionate for all. Mount Sinai gave Dr. Levine a powerful foundation to build on, and today it is meaningful that during Pride Month 2021, we celebrate one of our alumni and acknowledge our ongoing commitment to enhancing and expanding service, education, and advocacy for the diverse LGBTQI communities we serve.” -Barbara Warren, PsyD, CPXP, Senior Director, LGBT Programs and Policies, Mount Sinai Office for Diversity and Inclusion
“I could not be more thrilled for Dr. Levine, or more proud of her. She is enormously accomplished and a fierce proponent of health equity, adolescent medicine, and transgender health—all critical issues that are close to my heart. We worked together when she did her pediatric training and Adolescent Medicine fellowship at Mount Sinai. I could see even then just how talented, dedicated, and compassionate she was. Dr. Levine’s confirmation is a truly historic moment, and I cannot think of anyone more deserving.” – Angela Diaz, MD, PhD, MPH, Director of the Mount Sinai Adolescent Health Center
“During her confirmation hearing, Dr. Levine never lost protocol. She remained very strong and confident in where she was coming from, and that resonated with what I remember about her back at the Adolescent Health Clinic. I never ever saw her get upset about anything; she was always so competent, calm, and confident, and the patients really liked her as their physician. I’ve enjoyed following her career, and she is a perfect fit for the position.” – Leslie Jaffe, MD, Director of Mount Sinai Adolescent Health Center, 1982-1989
”Dr. Levine is a great communicator with a passion for public health, and she will do a great amount of good in her areas of focus, which include opioid addiction and the COVID-19 response. That she has also been willing as a trans woman to stand up and be so visible is very important for other trans people to see for reassurance and for cisgender people to see as we break down barriers. It is an honor for us at Mount Sinai to be associated with a pioneer in an area where we now take a leadership role.” – Joshua D. Safer, MD, Executive Director of the Mount Sinai Center for Transgender Medicine and Surgery