Rachel Levine sought studies favoring gender transitions for minors, email shows


Florida Transgender Roundtable
Department of Health and Human Services Assistant Secretary for Health, Admiral Rachel Levine speaks after having attended a roundtable on gender-affirming care and transgender health, Wednesday, June 29, 2022, in Miami. (AP Photo/Wilfredo Lee) Wilfredo Lee/AP

Rachel Levine sought studies favoring gender transitions for minors, email shows

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A top Biden health official sought justification for gender transition surgeries for minors as Pennsylvania’s physician general and did not receive it at the time, according to newly released emails.

Dr. Rachel Levine, the assistant secretary for health at the Department of Health and Human Services, requested research favoring allowing minors to undergo gender transition surgeries, such as double mastectomies, in 2017 from a doctor at the Children’s Hospital of Philadelphia. The doctor said they were unaware of any such data, despite confirming that minors were receiving the surgeries at their hospital, according to emails obtained by Megan Brock through a Right-to-Know request and shared with the Washington Examiner.


“I know that we had discussed at US PATH the possibility of gender confirmation surgery for young people under 18 years of age,” Levine wrote in an email on May 4, 2017, to Dr. Nadia Dowshen, co-founder of the Gender and Sexuality Development Clinic at the Children’s Hospital of Philadelphia. “This could include top surgery for trans young men and top and bottom surgery for trans young women. Is there any literature to support this protocol?”

Levine, the first openly transgender federal official to be confirmed by the Senate, has been a staunch advocate for “gender-affirming care,” such as gender transition surgeries or puberty blockers, and has argued that states should not limit minors’ access to such treatments. Levine was Pennsylvania’s physician general beginning in 2015 and later was named as secretary for Pennsylvania’s Department of Health in 2018.

Emails between Rachel Levine and Nadia Dowshen

In her response, Dowshen, who helps run the hospital’s clinic that “offers psychosocial and medical support for gender variant, gender expansive, and transgender children and youth up to age 21,” acknowledged that the surgeries were happening at the hospital but did not know of any research available in 2017.

“Hi Rachel, I’m not aware of existing literature but it is certainly happening. I think we’ve had more than 10 patients who have had chest surgery under 18 (as young as 15) and 1 bottom surgery (17),” Dowshen replied in an email to Levine on May 5, 2017.

That same year, Levine and Dowshen were both involved in efforts opposing a Pennsylvania state bill that would have prohibited Medicaid and the Children’s Health Insurance Program from covering transition-related services, including gender transition surgery, in the state. The bill was later rejected by the state legislature.

Levine has continued to be outspoken on transgender issues, including while going through Senate confirmation for assistant secretary of health. Last year, during a confirmation hearing, Sen. Rand Paul (R-KY), a member of the Health, Education, Labor, and Pensions Committee, grilled Levine over whether minors should have access to gender transition surgeries or puberty blockers, among other treatments.

“Transgender medicine is a very complex and nuanced field with robust research and standards of care that have been developed,” Levine told Paul, without directly answering the question of whether minors are able to make decisions regarding such procedures.


Earlier this year, President Joe Biden signed an executive order directing HHS to take steps to increase access to “gender-affirming care,” including for minors amid several states taking legislative action to limit children’s access to the treatments.

The Washington Examiner asked HHS for comment on behalf of Levine.

© 2022 Washington Examiner

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