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Rand Paul tried to derail Rachel Levine’s historic confirmation hearing with transphobic misinformation

Levine, if confirmed, would be the highest-ranking openly trans official in the federal government.

Sen. Rand Paul speaks at the confirmation hearing for Vivek Murthy and Rachel Levine.
Tom Brenner/Getty Images

In her opening statement, Dr. Rachel Levine — the Biden administration’s nominee for assistant secretary of health and who would be the highest-ranking openly trans government official in American history — emphasized her long résumé, leadership during the Covid-19 pandemic, and history working in pediatric and adolescent health.

“My career has been helping people live healthy lives,” Levine said. “As the assistant secretary for health, I would be committed each day to helping the people of our nation and improving our public health. I am both humbled by the opportunity and ready for the job.”

Sen. Rand Paul (R-KY), meanwhile, used his time to promote transphobic misinformation.

In a moment in which the pandemic is exposing severe health challenges, especially for America’s most marginalized, Paul’s line of questioning was particularly egregious.

Paul opened with an extended statement about “genital mutilation” — a frequent misnomer Republicans have used in the past to pursue anti-trans policy. He promoted the myth that social pressures are contributing to American children pursuing trans-affirming health care, criticizing Levine for supporting minors “being given hormone blockers and surgical reconstruction of a child’s genitalia.” He asked if she believed children were capable of making decisions regarding their gender identity.

When Levine responded by saying transgender medicine is a “complex and nuanced field with robust research and standards of care” and offering to work with Paul’s office more on the issue, he refused to drop the question. He shared the story of Kira Bell, a 23-year-old British woman who is suing an NHS gender clinic over allowing her to transition to being a male as a teenager.

As Paul told it, Bell “read something about transsexuals” online as a teenager and was persuaded to transition before ultimately regretting it. “Transsexual” is a term the advocacy group GLAAD defines as outdated; it’s often weaponized by conservatives when referring to people who identify as transgender. In addition, transition regret or de-transitioning occurs at low rates — a 2015 survey found only 8 percent of transgender people in the US de-transitioned, most commonly because of pressure from a parent, with 62 percent of de-transition cases proving temporary.

When Levine gave the same reply she used to Paul’s prior question, he became agitated, using incorrect pronouns and painting a disturbing picture of trans health care in a time when violence against the transgender community is at high levels.

“For most of the history of medicine, we wouldn’t let you have a cut sewn up in the ER (without parental consent),” Paul said. “But you’re willing to let a minor take things that prevent their puberty, and you think they get that back? You give a woman testosterone enough that she grows a beard. Do you think she’s going to go back looking like a woman when you stop the testosterone? You have permanently changed them.”

Despite Rand’s claims that puberty blockers and gender-affirming hormones are distributed with little thought, as Katelyn Burns wrote for Vox, “Nowadays, doctors recommend taking a humane and affirming approach when a child expresses that their gender may not match their assigned sex at birth. This affirmation includes allowing trans kids to socially transition (i.e., use whichever name, pronouns, and clothing make them comfortable); medical interventions — like puberty suppression or gender-affirming hormones like estrogen or testosterone — are only recommended for adolescents who have been insistent, persistent, and consistent in their gender identity over long periods.”

The affirming model has been recommended by nearly every major American medical association, including the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, the Endocrine Society, the World Professional Association for Transgender Health, the American College of Obstetricians and Gynecologists, and many others.

Still, Paul went on. “Infertility is another problem,” he continued, making his view of the value of biological women, and therefore his concerns about trans men, plain.

Paul was eventually cut off by health, education, and labor committee Chair Patty Murray (D-WA). She and other Democrats praised Levine for her professionalism in handling Paul’s transphobic remarks, and spoke to the greater problem Paul’s rhetoric presented.

“It is really critical to me that our nominees be treated with respect and that our questions focus on their qualifications and the work ahead of us, rather than on ideological and harmful misrepresentations like those we heard from Sen. Paul earlier,” Murray said.

Levine’s confirmation would be historic — and it would come at time when conservatives continue to attack trans rights

Levine’s nomination is historic. If confirmed, she would not only be the highest-ranking trans official in government but the first trans person to be confirmed by the Senate. It would be a watershed moment for LGBTQ representation and perspective in the federal government. But Levine, as a deeply qualified doctor who has held numerous statewide positions in Pennsylvania, would also be a critical appointment as the country faces enormous health challenges. As Burns explains:

Because of the historic nature of Levine’s appointment, there has been much talk about her trans identity. Meanwhile, her qualifications, which should not be overshadowed, have taken a back seat. For the last three years, she’s been the secretary of health for Pennsylvania, where she has taken the lead on the state’s handling of the Covid-19 pandemic. Her clear-eyed press conferences instructing Pennsylvanians on how to survive the pandemic have earned praise from Democrats inside the state. Before she became the secretary of health, she was the state’s physician general.

Sen. Tina Smith (D-MN) made sure to call out that point, condemning Paul’s questions.

“I appreciate the dignity and the professionalism in your response to Senator Paul,” Smith said. “This is a moment when we should focus on the grave challenges before us — and one of these challenges is that LGBTQ+ people long faced discrimination and barriers to health care, and they’re much more likely to lack access to insurance and affordable medical care. We need advocates at all levels to make sure that we address that inequity and that we fight discrimination and ensure that everybody, all patients, have access to care.”

Paul’s line of questioning comes on the heels of another public GOP attack on trans youth from Rep. Marjorie Taylor Greene (R-GA). As the House works to pass the Equality Act, which would ban discrimination against LGBTQ people, Greene hung a transphobic sign outside of her office that read, “There are two genders: MALE & FEMALE ... Trust the Science!”.

Greene’s sign was particularly hateful considering her office is directly across from that of Rep. Marie Newman (D-IL), who hung a transgender flag outside of her office in support of her transgender daughter. Greene has also attacked Newman on Twitter and misgendered her daughter on the House floor.

Levine, who was unanimously confirmed twice by the Republican-controlled Pennsylvania state Senate, would be confirmed if she maintains the support of all 50 Senate Democrats. Multiple Republicans during the hearing expressed an eagerness to work with her, suggesting a bipartisan confirmation may be likely.

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