Dr. Rachel Levine isn’t one to mince words — and she’s done staying quiet. After four years of quietly building inclusive health policy from the inside, the highest-ranking openly trans official in U.S. government history is sounding the alarm on what she calls the “erasure” of life-saving progress under the Trump administration’s second term.
Levine, a pediatrician and former Assistant Secretary for Health, has spent years fighting health disparities — from HIV prevention to blood safety, long COVID, and nutrition. Her efforts were instrumental in weaving LGBTQIA+ health equity into the fabric of federal health policy. “It wasn’t something we worked on only on Friday afternoons,” she said. “It was baked into everything we did.” But now, that very foundation is being bulldozed by a far-right wrecking ball.
RFK Jr., now heading the Department of Health and Human Services, has slashed key programs, axed 20,000 workers, and installed Brian Christine — a urologist with a rap sheet of anti-trans rhetoric — in Levine’s former role. HHS websites now include disclaimers disavowing “gender ideology,” and federal guidelines have turned back the clock on years of LGBTQIA+ research.
From Equity to Erasure
Levine’s mission was clear: connect siloed agencies like the CDC and FDA, prioritize vulnerable communities, and push data-driven solutions. Under her, the Office of Infectious Disease and HIV Policy blossomed into a crucial pillar of the national Ending the HIV Epidemic initiative. She even embraced the title “syphilis czarina” — because yes, even that mattered.
But those gains are now vanishing. “A generation’s worth of LGBTQI+ health research has been canceled,” warned Scout, of the National LGBT Cancer Network. Trans health data is disappearing. Projects are scrapped. Researchers have been ghosted. Even scientific work like transgenic mice studies — essential to understanding hormone interactions — has become the butt of conservative jokes.
The Trump administration’s rollback is more than administrative cruelty. It’s personal — and it’s political. “This is a result of a specific strategy by conservative think tanks,” Levine noted. “They pivoted from marriage equality to trans athletes to targeting all trans and nonbinary people.” Her point? This is no accident. It’s a calculated takedown.
Fighting Back with Facts — and Hope
Despite the carnage, Levine isn’t retreating. She’s writing, speaking out, and reminding queer America to stay in the fight. “I am a positive and optimistic person because I choose to be,” she said. “That fuels my work — and it fuels everyone’s work.” She believes the pendulum will swing back. “Justice will win out. But we have to work for it.”
The LGBTQIA+ community, she stressed, must not fracture. “They are trying to pit us against each other. We cannot let that happen.” Her message to queer youth, health professionals, and those lost in the fog of policy changes is direct: we are stronger together — and we don’t get to sit this one out.
From PrEP access to HIV prevention, trans youth protections to gender data inclusion — Levine’s blueprint was a lifeline for many. Its dismantling is not just a policy shift. It’s an attack on identity, on facts, and on lives. As Dr. Carlton Thomas, a prominent queer health influencer, put it: “She set everything in motion. Now we owe it to her — and to each other — to show up.”
Because when they come for one part of the rainbow, they’re coming for the whole flag.