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Last month’s Pa. Senate vote to confirm Rachel Levine as Pennsylvania’s physician general made history — she became the highest-ranking transgender woman in the state government. Now, it’s time for her to get to work.

Levine says the last few months since being nominated by Gov. Tom Wolf to serve on his cabinet have been a whirlwind, but now she wants to refocus on her priorities for the office: Pennsylvania’s prescription drug abuse problem, planning for a future when medical marijuana is legal and advocating for the LGBT community.

Billy Penn talked with Levine about her memories from the last few months, her transition process and how she can personally forward non-discrimination legislation at the state level.

Here’s our conversation, which has been lightly edited for brevity and clarity:

How would you describe the last several months in this new position?

So it’s been a very interesting process. The way this all transpired, is that I had been a physician [at Penn State Milton S. Hershey Medical Center] for many years and my field was adolescent and young adult medicine. I was working with patients with eating disorders. So I was asked in December to be co-chair of Governor Wolf’s transition team.

As that was concluding, I started to have discussions over about a week or so with the chief of staff and Governor Wolf about this position, and then on about January 16, I was called by Governor Wolf and asked to be the physician general. I accepted on that Monday, I saw my patients at Penn State, and the 20th, I was at the inauguration, and on Wednesday the 21st, I walked into the Department of Health. It all happened very quickly.

As the acting physician general, I advised on the severity of issues related to public health, and Governor Wolf on medical issues, public health issues and those types of problems. And I’m part of the cabinet, so during that confirmation process, which lasted five months, I got to meet almost all the 50 senators in PA, and spend half hour to an hour talking about public health issues. And then they voted on June 3. That was the committee meeting, then I was confirmed a week later by the Senate. It was a very interesting process, and I was very gratified to be nominated, of course, and to be confirmed.

You’ve said that you’re a physician first and transgender second. It’s not your job, but do you feel a responsibility to forward non-discrimination legislation or LGBTQ rights?

I like to emphasize that I was not nominated or confirmed to this position because I’m openly transgender. But Governor Wolf is awesome, and he and the administration didn’t shy away from nominating me. And the Senate, to their great credit, didn’t shy away from confirming me.

That being said, I understand that it’s a rather unique position. And I am very pleased to serve as a mentor, as a role model, so to speak, as an advocate to the LGBT population in Philadelphia and throughout the state. I think it’s really important for young people with the progress we’ve made and last week’s [marriage equality] decision, which was incredible, not to despair, not to get hopeless, not to harm themselves.

Things will get better and things are getting better in our culture every day. So it was very exciting to be the co-grand marshal of the Philly Pride Parade a few weeks ago. The governor came to speak and offer his support. The administration is very in favor of non-discrimination legislation. We went to the White House last week for the Pride Day celebration, and I got to meet President Obama. So having a Pride Day celebration at the White House, being with President Obama and Governor Wolf, going to the Philly Pride events, and then the Supreme Court affirms marriage equality.

Things are moving, but there is still work to be done, particularly on non-discrimination legislation in Pennsylvania. So I do accept my role in that, but my first role is as physician general.

As a mentor, what would you tell a transgender child or teen that you wish someone would have told you?

I was a senior in high school in 1975, so there was no cultural context for what I was feeling at that time, and now there is. It’s important for young people who can serve as mentors and role models to try to get help and understand who they are and what they want to do. It’s important for young people to not give up hope and be positive and optimistic. And there are very prominent LGBT individuals and transgender individuals throughout the country, and you can do anything you want. And it takes patience, perseverance and resilience. And I think our society is getting better.

Are Pennsylvania colleges equipped to handle transgender students?

It’s important for colleges and universities, because you want to move the bar from an accepting environment to a welcoming environment. There was a culture where certain schools were intolerant, and then they were tolerant, and then it’s accepting and then it’s a welcoming and a celebratory environment of diversity, and that means many things: cultural, ethnic and it also includes diversity for sexual and gender minorities.

We need to work to create that type of welcoming environment. It’s important for universities to have a fantastic LGBT center with activities and support, as well as medical care, offering advice about transgender medical care, and it’s important for the university health insurance to be able to pay for LGBT health care.

And I think it’s important to have non-discrimination legislation. And I am very confident that will be passed and signed in Pennsylvania, so I think that places of employment as well need to have an accepting and welcoming environment.

What are some of your priorities for the office?

From a public health point of view, the public health crisis in Pennsylvania is that of opioids, which is prescription drug abuse and overdoses. A recent coroner’s report indicated that almost 2,500 individuals died in PA of overdoses, and that’s very likely an underestimate. That would be seven individuals a day die of opioid overdoses. So it has become a severe public health problem. So the Wolf administration is working in an interdepartmental way to address this problem.

I would also highlight the ABC-MAP program which will be getting up and running by 2016, if it’s funded by the legislature. Also the distribution of Naloxone, and we’re working to have that distributed to first responders as well as family members. Other public health issues would be making sure that school children have immunizations. Our immunization rates have not been what they should be. Lyme disease is also a big public health problem. We have the highest number of cases of Lyme disease in the country.

What about priorities specific to Philadelphia?

A little less Lyme disease in the urban parts, but Philadelphia, if you look at the parks you can get it. But opioids and Hep C are all very big health care problems in the city, and we will see what happens with medical marijuana. We’re firmly in favor of legislation that would legalize it, and the Department of Health would have a large role in the distribution of that.

What were you most of proud in terms of your work at Penn State?

We started the Division of Adolescent Medicine and grew that, started the eating disorder program, and that program is thriving. And I was the liaison to the LGBT community and was the facilitator for the student group, as well as the faculty-staff affinity group. The work is to increase education about LGBT issues and increase the visibility of LGBT individuals on campus.

Anna Orso was a reporter/curator at Billy Penn from 2014 to 2017.