TRANSCRIPT: TransLash Podcast Episode 26, ‘A Conversation With Dr. Rachel Levine’

Imara Jones: Hi fam, it’s Imara Jones. Welcome to the TransLash Podcast, a show where we tell trans stories to save trans lives, discussing news, politics, and culture, in a way that is deeply relevant for our community, or at least we hope so, and those who care about us. I have to tell you all that I am thrilled to be back with you for our regular podcast conversation. You can clearly hear it in my voice. You know, those are the types of conversations we like to have here. They spotlight the incredible insights that trans people have and how we are reimagining and remaking the world around us.

Now, we at TransLash Podcast departed from this normal format over the summer because we thought it was so important to reveal the fact that the forces which managed to introduce nearly 130 anti-trans bills in almost 40 States didn’t come out of nowhere. We laid that all out in our special series – The Anti-trans Hate Machine: A Plot Against Equality, and we’re so grateful that you embraced it. Your comments and positive feedback kept us going through what were some really difficult moments in talking about some really tough things.

So, I know I speak for everyone at TransLash, however, when I say that leaving behind the strange world of dark money, secret organizations, and extreme religious ideology, to come back into the light of our regular podcast, is truly making our fall. 

This week and our first week back since June, we’re diving into a topic that’s been on everyone’s minds for more than a year. We’re talking about COVID-19, that seemingly never-ending story. I know things haven’t been looking great as the Delta variant surges across the country. It leaves many of us looking for ways to protect ourselves. But the good news is that, there is someone from our very own community who is now responsible for helping us get out of this mess. It’s the person joining us this week, the incredible Dr. Rachel Levine. She’s the assistant Secretary of Health at the US Department of Health and Human Services. 

Dr. Rachel Levine: That is what we’re trying to work against, is this complacency that the pandemic is in the past.

Imara: But let’s start out as we always do, with a little bit of trans joy.

One thing that brings me joy is trans people supporting each other in a time when we need it most. A wonderful organization which does just that, is Trans Lifeline. They run an anonymous confidential hotline where you can always call and speak with a transperson. This is especially important to remember during this Suicide Prevention Awareness Month. Trans Lifeline also helps support our well-being in other ways. Trans Lifeline raises money to help trans people with hormone replacement therapy, name changes, and other essential services. And most of it goes to the most marginalized in our community, like those who are incarcerated. Since 2015, Trans Lifeline has answered over 100,000 calls and raised over a million dollars. Here’s Yana Calou, the director of public relations at Trans Lifeline.

Yana Calou: You know, we believe that having affirming trans community and contact with other trans people is what makes our lives feel possible and what prevents crises in the first place, so we always say like, you know, we don’t define what a crisis is and isn’t, and we want people to call whether they’re in crisis or they just need a resource or need someone to talk to or just like took their first shot of estrogen and like want to celebrate that with another trans person. So, we’re essentially here to talk to any trans or questioning person who wants to talk to a trans peer for any reason.

Imara: Yana, you and everyone else at Trans Lifeline, are trans joy. With that, let’s get to it. Dr. Rachel Levine, assistant secretary of health at the Department of Health and Human Services, made history earlier this year as the first trans person to be confirmed to a public office by the United States senate. In this role, she is at the center of coordinating the nation’s response to the coronavirus epidemic. But Dr. Levine is not new to this. Prior to joining the Biden administration, she was the first secretary of health for the state of Pennsylvania and the first trans person to hold that position.

There, she led that state through the first year of the COVID crisis. Before her time as a public servant, Dr. Levine was a professor of Pediatrics and Psychiatry at the Penn State College of Medicine. And if that wasn’t enough, she’s held posts which include the vice chair for clinical affairs for the Department of Pediatrics and chief of the division of adolescent medicine and eating disorders at the Penn State Hershey Medical Center. So, it’s no surprise that I am beyond excited to talk with Dr. Levine and to get everything that she has to tell us about where we are in the epidemic and how it impacts trans people, specifically, and the state of our health care system more broadly. Dr. Levine, thank you so much for joining me today. 

Dr. Levine: Thank you. I appreciate that. 

Imara: All of us over the last year have gone through a historic time with COVID, regardless of, if you are a health professional leading a state health department or at the national level or individually. And I’m wondering, as a person who’s had a unique role at this moment in leading us through the COVID crisis, where you think, from all of your experiences and your position right now in Washington, are we in the epidemic? Where are we in COVID right now? 

Dr. Levine: Well, thank you for that question. It’s – it’s really a pleasure to be here. Uh, COVID-19 has certainly been the-the biggest public health crisis that the nation and the world has seen in over a hundred years. And it has impacted every country and everyone in our way of life. I think that there are a couple of lessons in COVID-19. One is that we are truly all interconnected at a national level and at a global level. And the other is the importance of public health, uh, local state, national and international public health, in terms of keeping us all healthy.

You know, under President Biden’s leadership, we have made so much progress in our battle against COVID-19 over the last, uh, five months or more. You can see the light at the end of the tunnel for our nation in terms of COVID-19, but we are not there yet. And it is very important that people not be complacent, that they don’t take this for granted. And our ticket out is through our safe and effective and very important vaccine. So, my most important message of the day is that everyone, 12 and above, should be getting their COVID-19 vaccinations. That is our ticket out.

Imara: A part of, it seems where we are in the epidemic right now are reaching hard-hit communities and communities where the lack of access to a whole host of things makes vaccinations hard to get. And among those are, as you know, trans communities, communities of color, those communities that are the most marginalized of the marginalized. And I’m wondering what, um, the plan is, from where you sit, to begin to reach those communities.

Dr. Levine: There are two challenges, um, as you’ve been discussing. I mean, one is working past, um, vaccine hesitancy, making sure that everyone has the information they need, uh, to make a decision about these safe and effective vaccines, and-and we are working on through media, we’re working through social media, uh, to do that. And we’re also working through our COVID-19 community core where we have local trusted community members and stakeholders giving the message about the safety and the effectiveness of the vaccine, and that includes, um, members of our LGBTQ+ and trans community.

In addition, access is an issue. And we are doing everything we possibly can to increase access to vulnerable and marginalized communities, including the communities of color, uh, and LGBTQ+ and trans communities. So, you know, we are making sure that, that the vaccines are available, uh, at doctor’s offices, at pharmacies, at community health centers, other community venues, whether it’s a barbershop or a baseball game, making sure that there are still small, medium, and large venues where people can get the vaccine. There are community programs. Uh, for example, uh, I-I was just actually talking with Dr. Stanford in Philadelphia, and I actually went and visited her program. And she-she runs the COVID-19 Black consortium in Philadelphia, and they are going door-to-door to try to get, uh, individuals vaccinated who otherwise would not know about vaccines or have access. And I think in some ways, some communities, that’s what we need to do. 

Imara: You mentioned the push to expand access, to try to reach communities where access is difficult, to deal with vaccine hesitancy, to do things like meet people in barbershops and other places in their communities that when- we’re- make it easier, but I’m wondering how you’re also feeling about what you might be seeing from where you sit, which is perhaps our growing complacency around the need to get a vaccine at all. Many people, as I’m coming across, are talking about pandemic in the United States, even in the past tense. And meaning, as a public health official, as you’re dealing with this push that still needed to get essentially half the population vaccinated, at the same time when there is this “been there, done that” kind of attitude that might be increasing in the public.

Dr. Levine: Well, that is what we’re, that is what we’re talking about, and that is what we’re trying to work against, is this complacency that the pandemic is in the past. And so, it is critically important that people not take this for granted and-and think of the – of the pandemic as something that happened last year. Especially, with what is now known as the Delta variant. And so, the variants, uh, that have been seen throughout the world and throughout the country now have Greek names to avoid stigmatizing the country where they may have developed. Uh, there is evidence that the Delta variant is more transmissible, it’s more infectious, so that more people could get it, and that it is, uh, more virulent which means that the case of COVID could be more severe, leading to more hospitalizations and possibly more deaths.

Now, the good news is that our vaccines, such as the Pfizer vaccine and the Moderna vaccine, are protected against the Delta variant. The challenging news is that communities and states that are, uh, that are behind in terms of their vaccination rates are vulnerable to this Delta variant. And that would include, of course, members of our LGBTQ+ and trans community who have not been vaccinated. And so, we should not be complacent because this– we can, again, we can see our-our recovery ahead of us, but we are not there yet and we have to continue this push against both vaccine hesitancy and then also make sure that we make the vaccines accessible to our community. 

Imara: Yeah, and I think the bottom line is that it’s not over. One of the things that I think was a really pivotal moment in your hearing was the questioning from Senator Rand Paul about trans health care, specifically trans health care for youth. I think that most people found that line of questioning extremely aggressive and I think that we were all, and I know I personally was all blown away by your stoicism. I think that I probably would have turned over the table which is not, is probably the best, um, reaction. And one of the things that you kept saying to Rand Paul was, you know, if- let’s- “Why don’t we talk about this in a, in a different setting? I’m happy to take you through this because it’s intricate.” And as you mentioned, and as many other people that I’ve spoken to have mentioned, it is a complicated area of healthcare. And there’s actually 40 or 50 years of research behind it, and there are now medical bodies, including the American Medical Association, that have standards around it. And so, I’m wondering, if you did have that conversation with Senator Rand Paul, what would you say? And in general, what’s your thinking, as a health care professional, when you see these bills?

Dr. Levine: Sure. Um, so, that offer stands, and I am still very pleased to, uh, to-to go to Senator Paul’s office and discuss with him and his staff transgender medical, um, standards of care, including the standards of care for transgender youth. Um, as you mentioned, they- they are very well established through WPATH, the World Professional Association for Transgender Health, there’s the US Arm called USPATH, um, and then other medical bodies, um, uh, such as the Endocrine Society which has published articles and standards for-for medical care for our community. And those standards continue to evolve according to, uh, to medical research because they are, they are evidence-based.

That’s the type of thing that I would emphasize, is that, is that this is a well-accepted medical field that the-the people practicing this type of medicine for-for youth, include pediatricians and adolescent medicine specialists such as myself as well as pediatric endocrinologist, as well as, you know, of course, nurses and nurse practitioners and psychologists and therapists, that, you know, the care for children is often lead at our-our nation’s fantastic children’s hospitals. I know in Pennsylvania, I know where I was previously that there are excellent clinics at the Children’s Hospital of Philadelphia, Children’s Hospital of Pittsburgh, as well as Penn State. These are not people who are winging it, these are experienced medical professionals providing this care.

Often also, I would highlight, uh, the role of-of LGBTQ medical centers and health centers that often provide this care for often children and adults, Whitman Walker in Washington, D.C., the Mazzoni Center in Philadelphia. These bills that you’re talking about are-are-are very concerning and very challenging. Transgender youth are vulnerable and-and they’re at risk of bullying and harassment, um, and significant challenges. And-and we should be advocating for them, we should be nurturing these vulnerable youth as opposed to passing bills that prevent their participation in activities and sports and the most egregious bills limiting their access to this potentially life-saving medical treatment and gender affirmation care.

President Biden is firmly in favor of-of our community. He has spoken about this publicly, including, um, at an address to Congress. We have activities throughout the administration in all the departments and-and-and robust activities at the Department of Health and Human Services to work on advocacy and on LGBTQ policy changes that impact, um, transgender medicine and the care of trans youth and adults. 

Imara: Yeah. I think that that’s absolutely right in terms of the fact that this is life-saving care and I– that’s well established. You know, we’ve done a limited series called The Anti-trans Hate Machine: A Plot Against Equality, a four-part series that looks into this. And when we spoke to doctors who treat trans adolescents in states like Oklahoma, and when we have spoken to the parents across the country, mostly in the south as well, south and southwest and midwest, everyone talks about how complicated these decisions are, how intricate they are, how many adults are involved in them, and they are all totally shaken by the idea that the government would then come in and be yet another factor in making these decisions. And it’s a powerful thing I’ve learned by-by doing this, this process.

One of the things that I’m curious about, being in-in this moment as a trailblazing doctor, because you are that, um, in your own, right? As you mentioned, starting in Pediatrics and doing a lot of groundbreaking work there in New York and in Pennsylvania, then being a groundbreaking trans person as a groundbreaking physician, I’m wondering how you experience this moment of being this person who has had an amazing opportunity by the moment that we’re living in, which is emblematic of great hope, and then, at the same time, being in the middle of the storm in the trans backlash, specifically around medical care. And I’m wondering how that, how you experience that as, as a person. 

Dr. Levine: Sure. Well, you know, I-I am, I’m just so excited and-and proud, uh, to be, uh, nominated by President Biden and to be confirmed by the Senate with a bipartisan vote, and also humbled, um, by the opportunity to-to serve in, in the, in-in President Biden and Vice President Harris’s administration. I also was very proud to serve in-in Governor Wolf’s Administration, um, in Pennsylvania. Um, and I hope that, um, that, uh, you know, I can be a – a figure that helps people understand our community better, um, you know, trans individuals, the trans community. W-we’re human. We’re people like everybody else. And, you know, and-and, uh, I’m proud to serve, um, and I have always been proud to serve in medicine, helping, you know, teens and families, children, do education and clinical research, and, uh, now, in public health, in public service, um, you know, just hope to, hope to contribute.

I stand on the shoulders of those who came before, you know, we all do, and some of those people we know and some of the people we don’t know because they had to work in the shadows. I’m humbled by that, by– Again, by this opportunity. I hope that we can get past people’s fear of what they have not experienced. I think people sometimes fear what-what they don’t know, and hopefully, we can show that trans people, you know, we serve in-in the government, we serve in public health, and we’re just trying to really, uh, achieve the mission of the Department of Health and Human Services which does really help, uh, the health and health care of everyone. I am very, very pleased to serve in-in that visible role, um, and hope that my visibility helps our community. 

Imara: What is your advice to people who face being in unique roles like you? Being trans, being trailblazers, but then also having an opportunity and being the focal point of, sometimes, hostility, and– I mean, I’ve watched press conferences where you’ve had to correct people and demand that they stop misgendering you. And so, I’m wondering what advice you have to people who may end up in positions like you, w-what were you say to them? 

Dr. Levine: Well, you know, I think that people will end up in positions, you know, Vice President Harris said that, you know, uh, that she may be the first, but she won’t be the last, and I think that that’s true of myself as well. I think that there will be many more trans individuals which will have this opportunity to serve, um, in the, in the federal government. I-I think, one is it’s important to be humble and grateful. Uh, and I am very grateful for the support of our community and the support of– that I have received by the-the administration and by my, my colleagues here at Health and Human Services, and you can see that, you know, in pride month.

I think it’s important, uh, to keep a sense of self and not sort of judge yourself by what others say. Because, um, you know, I’ve received a fair amount of pushback and I understand that, and I am able to compartmentalize that and not let it bother me. I think it’s important, uh, for-for people to do that because, you know, we’re bound to get, we’re bound to get pushed back, um, and to keep going. You know, for those of us fortunate enough to be able to – to be in these visible positions, um, I think it’s important to, to keep going and I’m just so proud to represent our community. 

Imara: Well, I know that we’re proud to have you as a member of our community and I think that we hope that you take your own advice and to keep going. I know that so many of our listeners will and appreciate the example that you have and wish you all the best in leading the country through some very difficult times, politically, and both health-wise, and know that your voice and leadership is needed. 

Dr. Levine: Well, thank- thank you so much. It’s a pleasure to speak with you, and I hope to do it again sometime.

Imara: Absolutely. Absolutely. That was Dr. Rachel Levine, the assistant secretary of Health and Human Services, the first trans person to be nominated and then to be voted upon positively in a Senate-confirmed position.

If you like what you heard, please go to Apple Podcast to rate and review us. It really helps us to go do it. You can listen to TransLash wherever you get your podcast. Please check us out on the web at translash.org to sign up for our weekly newsletter. It’s awesome and you get a video for me each week, so go do that. Follow us on Twitter and Instagram at TransLash media. Like us on Facebook, and tell your friends.

The TransLash podcast is produced by TransLash media. And TransLash team includes Oliver Ash Kleine, Montana Thomas, Jay McAuliffe, and Jana Aicke Mirko. Our intern is Marana Mundson Burke. Alexander Charles Adams does sound editing for our show. Our digital strategy is handled by Daniela Capistrano. The music you heard was composed by Vin Draghi and is also courtesy of CZK Records.

So, what am I looking forward to? Um, there are so many things to look forward to in the fall, right? But the thing that I’m looking forward to is the fact that, um, I am developing a four-part course called Beyond a Hashtag, which looks at ways that we can actually operation– looks for ways that we can actually operationalize a lot of the values that people have, um, kind of uncovered within themselves in society that they want to manifest, around all forms of justice, including racial, gender, disability – the list goes on, and it should go on because we’ve got a lot of stuff to fix. It’s going to be on a platform called Guideness, which has a series of courses for people, um, on a variety of things. So, make sure that you sign up for it. You can find out how to sign up for it by going to my IG page, um, and there will be a link there, and also on my website. But I think that, like, you are just done a lot of thinking about what did it all mean and how when we eventually go back to, um, some sort of more communal interactions, how are we going to carry these values with us? And that’s, essentially, what I’m going to talk about.

So, um, make sure that you, um, sign up for it. And you can sign up right now just to get more information on it and we’ll tell you when we’re actually going to release it, which will be, you know, over the next couple of months, but make sure that you go do that. So, I’m excited about this course, More Than a Hashtag. I’ve been working really hard on it over the summer in addition to everything else, um, not to mention, um, our world, it can be broken, but the change starts with us, and that’s what we’re going to talk about, is how, like, in our daily lives, we can make things better.

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