Adm. Rachel Levine on the fight against medical discrimination

A The day after the Department of Health and Human Services announced plans to strengthen protections against discrimination based on sexual orientation and gender identity, Adm. Rachel L. Levine, assistant secretary of health, said the move represents another important step toward more equitable care.

“We had made progress under the Obama administration, but we had lost ground under the previous administration,” said Levine, the first openly transgender person to be confirmed by the Senate for a federal office, in a conversation of the STATUS List Spotlight series on Tuesday. “And it’s great to see us bounce back.”

Under the Trump administration, a 2020 HHS ruling eliminated a provision that included gender identity and “termination of pregnancy” among protected groups that health care providers cannot discriminate against. Levine called the previous administration’s actions “misinterpretation” and said the Biden administration’s interpretation is that “when they say you can’t discriminate on the basis of gender, that means you can’t discriminate on the basis of gender. cannot discriminate on the basis of sexual orientation and gender identity”. Levine added that the HHS Office for Civil Rights will take cases “from people who believe they are being discriminated against because of their sexual orientation or gender identity.”

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And while she expects states to challenge the rule in court, “it’s really critically important work.”

Levine, a doctor who specializes in adolescent medicine, said the Biden administration has made it a priority to ensure more equitable care and treatment for the LGBTQIA+ community. President Biden has issued several executive orders aimed at addressing discrimination and strengthening health equity.

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“Health equity is fundamental. It’s fundamental to everything we do at the Department of Health and Human Services,” Levine said. “With every grant, with every funding opportunity, health equity is built in and it’s a top priority.

She noted that the HHS proposal follows a Title IX rule change recently proposed by the Department of Education that clarifies harassment based on sex also includes discrimination based on a person’s gender identity. .

Levine said discrimination in schools and communities — and more systemic biases, such as state laws aimed at restricting gender-affirming care or banning trans youth from participating in certain sports — have taken their toll on LGBTQIA+ people, who are also at higher risk for mental health issues. “There have been very difficult politically motivated actions and laws in these states, including, in particular, actions in Texas and Florida, and laws passed in Alabama and other states,” Levine said. . “Gender affirming treatments are medical care. It’s about mental health care. It is literally life-saving care.

“We haven’t made progress unless we’ve all made progress,” said Levine, who pointed out that young people, older adults and immigrants are particularly vulnerable to bullying, harassment and harassment. discrimination. “Transgender women of color,” she said, “are literally at risk of violence and murder.”

Levine also addressed other public health crises, including a shortage of vaccine doses to combat the spread of monkeypox.

“Unfortunately, we use all the stores we have of the Jynneos vaccine,” she said. “We are working with the manufacturer, who is in Europe, to produce more, and then we will buy whatever we can.”

She also referred to the drug overdose crisis, which led to the death of 107,000 people in the United States in 2021, according to estimates by the Centers for Disease Control and Prevention.

“We have frankly lost ground in many states and as a nation during the Covid-19 pandemic,” Levine said. She stressed the need for more harm reduction efforts nationwide, including wider use of new test strips that may show fentanyl contamination, and for “states to legalize service programs.” of syringes, so that we can work on the integration of the distribution of naloxone”.

On climate change, Levine drew attention to HHS’s new Office of Climate Change and Health Equity, named to reflect the reality that the impacts of climate change are exacerbated in already disadvantaged communities, he said. she declared. “Climate change is here now. And the health impacts of climate change are here, right now,” Levine said. “They are not an existential threat, which means maybe a threat in the future. They are here now.

Despite so many existing and emerging issues, Levine said, she remains hopeful in her work. “In the face of the pushback, in the face of the discrimination that I see, what that does is I sublimate it,” she said, “and I’m able to turn that into extra motivation to work for the health equity for everyone in our nation and working for health equity for our LGBTQI+ community.

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