Admiral Rachel L. Levine, the United States assistant secretary of health, made history when she became a four-star admiral in the United States Public Health Service Commissioned Corps on October 19, 2021. She is the first openly transgender four-star officer in the United States.

At her swearing-in ceremony, Dr. Rachel Levine said:

“This is a momentous occasion, and I am honored to take this role for the impact I can make and for the historic nature of what it symbolizes. I stand on the shoulders of those LGBTQ+ individuals who came before me, both those known and unknown. May this appointment today be the first of many more to come, as we create a diverse and more inclusive future.”

NBC News

On October 19, 2021, Admiral Rachel Levine posted on Twitter a video of her swearing-in. She tweeted: “I am deeply honored & grateful to join the ranks of men & women across this great nation who have committed to defend the United States against small & large threats, known and unknown. I promise to uphold that trust to the fullest extent of my abilities.”

NBC News reported: In heading the health corps, Levine will be in charge of deploying the country’s public health workers to respond to crises ranging from the coronavirus pandemic, which has killed more than 725,000 Americans, to natural disasters such as flooding.

It is worth noting that the number reported by NBC News has gone up since October 19, 2021.

Some people appear to be confused after hearing that Dr. Rachel Levine had become a four-star admiral. On Twitter, some people posted photos of women who had become four-star generals before Admiral Rachel Levine did. Those who posted those tweets were not incorrect that other women had become four-star generals. Their confusion appeared to be that they had not heard of the United States Public Health Services Commissioned Corps.

What is the U.S. Public Health Services Commissioned Corps?

The United States Public Health Services Commissioned Corps (USPHS) is described this way:

The USPHS Commissioned Corps is one of the nation’s uniformed services – a branch committed to the service of health. Officers advance our nation’s public health, serving in agencies across the government, as physicians, nurses, dentists, veterinarians, scientists, engineers, and other professionals.


The mission of the USPHS is “Protect, promote, and advance the heath and safety of the nation.”

Their four core values are:

Leadership: We provide vision and purpose in public health through inspiration, dedication, and loyalty.

Integrity: We exemplify uncompromising ethical conduct and maintain the highest standards of responsibility and accountability.

Service: We are committed to public health through compassionate actions and stewardship of time, resources, and talents.

Excellence: We exhibit superior performance and continuous improvement in knowledge and expertise.

The USPHS works in the Center for Disease Control and Prevention, the Federal Drug Administration, Indian Health Services, National Institutes of Health, Department of Justice Federal Bureau of Prisons, and the Department of Defense of the United States of America. The USPHS works in specific departments under each of those areas.

In other words, there were women who became four-star admirals under various branches of the U.S. military, and who did that before Dr. Rachel Levine became a four-star general. It is worth pointing out that she is not only the first woman to become a four star officer in the USPHS, but also the first openly transgender officer across any of the country’s eight uniformed services, and is the first transgender four-star officer.

Why does this matter?

It matters because it shows that our nation accepts transgender people for who they are – not only in words, but also in actions.

You may recall that the Biden-Harris administration, via the Pentagon, overturned a Trump-era ban on transgender people in the military. The New York Times reported the change followed the executive order from President Biden asking the Secretary of Defense to immediately prohibit involuntary separations, discharges, and denials of reenlistment or continuation of service on the basis of gender identity or under circumstances related to their gender identity.

In March of 2021, the Department of Defense posted an issuance titled: “In-Service Transition for Transgender Service Members”. A section of that issuance provided information that provided a pathway for transgender troops to transition. This included the ability for a transgender person to receive medical care and treatment for gender transition, and for the transgender person to live in their self-defined gender.

On September 20, 2021, the Department of Veterans’ Affairs announced:

Today, we are also taking steps to clarify VA policy for Veterans who were given other than honorable discharges based on homosexual conduct, gender identity or HIV status. Under this newly-issued guidance, VA adjudicators shall find that all discharged service members whose separation was due to sexual orientation, gender identity or HIV status are considered “Veterans” who may be eligible for benefits like VR&E, home loan guaranty, compensation & pension, health care, homeless program and/or burial benefits, so long as the record does not implicate a statutory or regulatory bar to benefits.

Department of Veterans’ Affairs

A young person, who has figured out that they are transgender, now has at least one transgender person to look up to. Representation is very important. Everyone wants to feel seen, and accepted, and to be treated like human beings. Admiral Rachel Levine is the first openly transgender woman to become a four-star uniformed officer. A young person, who is transgender and still figuring out what to do as a job, has at least one example of a transgender person obtaining a very high honor.

In addition, selecting a transgender person to do a job that they have already shown that they are very good at helps to normalize seeing people who are not cis-gender in positions of power and authority.

What did Admiral Rachel Levine do before becoming Assistant Secretary of Health?

NPR reported on March 24, 2021:

The Senate voted Wednesday to confirm Dr. Rachel Levine as assistant secretary for health in the Department of Health and Human Services. The vote is a history-making one: Levine is the first openly transgender federal official to be confirmed by the Senate.

The vote was 52-48 in favor of her confirmation.


On June 9, 2015, PhillyMag reported that Dr. Rachel Levine was confirmed as Physician General of Pennsylvania. She was the first transgender person appointed to a Pennsylvania Governor’s cabinet.

PhillyMag reported, on April 14, 2020, that Dr. Rachel Levine oversaw the Pennsylvania Department of Health and its battle against the coronavirus in Pennsylvania. She oversaw the 13,000 employees in that department. She was also a professor of pediatrics and psychiatry at Penn State College of Medicine. Previous to the coronavirus, she was focused on the opioid crisis.

Admiral Rachel Levine Made History is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites.

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