Dr. Rachel Levine, the first transgender person to be nominated for a Senate-confirmed position in the federal government, had been seated in her confirmation hearing to become the nation’s assistant secretary of health for a little less than an hour when she was grilled about “genital mutilation” of minor children by a Republican committee member.
“American culture is now normalizing the idea that minors can be given hormones,” Sen. Rand Paul (R-KY) said on Thursday, likening standards of care for transgender minors to castration and female circumcision and blaming increasing rates of trans-identified youth on “the social pressure to conform and do what others do.”
“Do you believe minors are capable of making such a life-changing decision of changing one's sex?” Paul asked Levine.
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In response, Levine thanked Paul for his “interest” in the question of transgender medicine, calling it “a very complex and nuanced field with robust research and standards of care that have been developed” by pediatricians.
“If I’m fortunate enough to be confirmed, I will look forward to working with you and your office and coming to your office to discuss the particulars of the standards of care for transgender medicine,” Levine said. Levine, who currently serves as Pennsylvania’s secretary of health, is a pediatrician and former state physician general whose handling of the coronavirus pandemic in Pennsylvania has drawn widespread praise, did not address the substance of the question, or attempt to correct Paul’s apparent misunderstanding of medical transition for transgender youth.
Paul, a former self-certified ophthalmologist, repeated his question of whether Levine supported access to hormone blockers and “reconstruction of genitalia” for minors, before relaying the story of Keira Bell, a British citizen who was assigned female at birth before taking puberty blockers and supplemental testosterone as a teenager. Bell, who later de-transitioned when she was an adult, led a court case that effectively blocked transgender children under 16 from medical transition in the United Kingdom. It is not standard medical practice to perform gender confirmation surgery on minors in the United States, and Bell’s surgery was not performed until she was 20.
“I’m alarmed that you’re not saying they should be prevented from making decisions to amputate their breasts or genitalia,” Paul said. “We have always said that minors do not have full rights—will you make a more firm decision on whether or not minors should be involved in these decisions?”
Levine reiterated that transgender medicine is “a very complex and nuanced field,” as well as her offer to talk with Paul and his staff about the issue, upon which Paul asked the record to show that she refused to answer his question and likened trans men being given testosterone to hydroxychloroquine being used to treat COVID-19.
“We should be outraged that someone is talking to a three-year-old about changing their sex,” Paul said.
Levine was later defended by other members of the Senate Committee on Health, Education, Labor, and Pensions, who called Paul’s line of questioning inappropriate and uninformed.
“It is really critical to me that our nominees be treated with respect and that our questions focus on their qualifications,” Sen. Patty Murray (D-WA) said, “rather than ideological and harmful misrepresentations.”
The LGBTQ Victory Institute, which works to elevate LGBTQ people in politics and government, called Paul’s remarks deeply offensive.
“His remarks echo the talking points of the same organizations who said gay men deserved AIDS and that LGBTQ people should be criminalized,” Ruben Gonzales, the group’s executive director, said in a statement. “He explicitly attacked vulnerable trans youth for his own perceived political gain and it was a disgrace.”
Levine has been the subject of repeated misgendering by Republican lawmakers and staff since her nomination, particularly as the leadup to the Equality Act—set to be passed by the House of Representatives later on Thursday—has prompted opponents to fixate on trans children in school sports as a reason to defeat the legislation.
Rep. Marjorie Taylor Greene (R-GA), for example, hung an anti-transgender sign in the hallway outside her office on Wednesday in response to another lawmaker’s display of the transgender pride flag. That lawmaker, Rep. Marie Newman (D-IL), has a transgender daughter.
