In his questions, Paul tried to draw a connection between genital mutilation — a practice condemned by public health experts as a human rights violation — and transition-related surgery and medication for children. Paul also complained about Levine’s support for children who make the decision to take hormone-blocking medications despite the concerns of their parents, asserting she supported surgeries for minors, too.
“For most of our history, we have believed that minors don’t have full rights and that parents need to be involved,” Paul said at the Senate Health, Education, Labor and Pensions committee hearing. “We should be outraged that someone’s talking to a 3-year-old about changing their sex.”
Levine — whose confirmation hearing was held in tandem with that for Vivek H. Murthy, Biden’s choice for surgeon general — sidestepped Paul’s specific points and responded in general terms.
“Transgender medicine is a very complex and nuanced field with robust research and standards of care that have been developed,” Levine said, promising to discuss the issue further with Paul if confirmed.
Levine’s nomination has sparked misinformation-laden posts on social media and has been attacked by some evangelical groups and religious-liberty advocates, contending that Biden’s nomination of Levine is an effort to “normalize” being transgender. But Levine — who would oversee an array of public health efforts as the Department of Health and Human Services’ assistant secretary of health — has been backed by LGBTQ and health advocates, who have pointed to her record and rallied to her as a breakthrough figure.
“Any senator who votes against Dr. Levine is motivated not by an honest review of her qualifications or concern for the nation’s health, but instead by cynical partisan politics or outright bigotry,” Annise Parker, president of the LGBTQ Victory Institute and a former mayor of Houston, said in a statement. The Victory Institute provides leadership training and coaching for LGBTQ people seeking elected office. Health-care experts said Paul had wrongly portrayed aspects of transition care, such as whether hormone-blocking drugs were readily available to young children.
Sen. Patty Murray (D-Wash.), chairwoman of the Senate health committee, later praised Levine’s answers and rebuked Paul for his questions.
“It is really critical to me that our nominees be treated with respect and that our questions focus on their qualifications and the work ahead of us, rather than on ideological and harmful misrepresentations like those we heard from Senator Paul earlier,” Murray said.
Several other Democrats, including Sen. Tammy Baldwin (D-Wis.), the first openly gay candidate elected to the Senate, also hailed Levine’s handling of Paul’s questions while criticizing their Republican colleague.
Contrary to Paul’s arguments, and those presented in a recent wave of GOP-led bills targeting transgender children, current medical guidelines in the United States do not recommend transition-related surgeries for minors.
Before puberty, most transgender children simply begin with a social transition, changing their names, pronouns and clothes to match their gender identities. Medical interventions for older transgender youths can include puberty blockers and hormone treatments, but surgeries are generally recommended only after a person turns 18.
The clash between Paul and his fellow senators over his questions to Levine eclipsed the candidacy of Murthy, who served as surgeon general during the Obama administration and is bidding for a second stint. Murthy, who narrowly won confirmation in 2014 after a 13-month battle, is expected to need the support of all 50 Senate Democrats to win the job again, although Sam Runyon, spokeswoman for Sen. Joe Manchin III (D-W.Va.), last week said the senator was undecided on Murthy. Manchin voted against Murthy in 2014.
Republicans have been critical of Murthy’s long-held stance that gun violence is a public health problem — an issue that Sen. Mike Braun (R-Ind.) probed again at Thursday’s hearing — and his role as a close Biden adviser.
“I worry about your ability to separate political influence from your ability to communicate health-care decisions,” said Sen. Richard Burr (R-N.C.), the committee’s top Republican, faulting Murthy for speaking at the Democratic National Convention and coordinating with Biden’s messages on vaccines.
“The surgeon general has to be trusted for the facts,” Burr said.
Republicans did not address Murthy’s work as a highly paid coronavirus consultant for the cruise line industry, Airbnb and other companies last year, which began while he was also advising Biden — at the time, the presumptive Democratic nominee — in daily calls on coronavirus strategy. The Washington Post reported last week that Murthy was paid more than $2 million to offer expert advice on the pandemic.
Good-government watchdogs have raised questions about Murthy’s potential conflicts of interest, a concern echoed by some members of the medical community.
“Taking hundreds of thousands of dollars from these companies on the eve of shaping federal policy around these issues is absolutely unacceptable in my mind,” Vinay Prasad, a physician who has studied conflicts of interest and has written critically about Murthy’s candidacy, told The Post. Prasad said he was disappointed that Democrats repeatedly criticized Trump’s health nominees, who were scrutinized for their corporate ties, but did not raise the issue at Murthy’s confirmation hearing.
Murthy has pledged to recuse himself from issues related to his former clients, and his supporters have rallied to his defense.
“There are people who would sell their integrity for $,” tweeted Sachin H. Jain, CEO of the SCAN Group and a former HHS official. “I know personally Surgeon General nominee @vivek_murthy isn’t one of them.”
In the hearing, Republicans quizzed both Biden nominees on their coronavirus strategies, criticizing Levine for poor outcomes at Pennsylvania nursing homes during the pandemic.
“The tragic high mortality rate in your state’s nursing homes shows more was needed but wasn’t provided,” Burr told Levine.
Democrats called for swift confirmation of both nominees, citing the mounting toll from the coronavirus.
“I hope we can come together to confirm them in quick bipartisan fashion, and work with them the way families across the country so desperately need us to,” Murray said.