The man sitting in a Pennsylvania carnival’s dunk tank at a fundraiser last weekend was going for a Marilyn Monroe look, he said, styling himself in a floral print dress and a long blond wig.

But on social media, the organizers of the Bloomsburg, Pa., event said he resembled a more local public figure: Pennsylvania Health Secretary Rachel Levine, an openly transgender woman who has risen to prominence in recent months leading the state’s response to the coronavirus pandemic.

“Dr. Levine? Thank you. You were a hit and raised a lot of money for the local fire companies. Wonder why so many were trying to dunk you?” the Bloomsburg Fair Association wrote on Facebook, adding a smiling emoji.

The fair has since deleted the post, but it is the latest incident in an ugly trend of vitriol against Levine, a 62-year-old pediatrician who first came out publicly about nine years ago.

State leaders and health officials across the United States have been villainized by opponents of shutdown orders, mask requirements and other pandemic restrictions — some of whom have even shown up armed outside their homes. As one of just a handful of openly trans public officials nationwide, the criticism against Levine has also devolved into a barrage of attacks on her gender identity.

“The COVID-19 pandemic has brought hate and transphobia into the spotlight through relentless comments and slurs directed at Secretary of Health Dr. Rachel Levine, who is a highly skilled, valued, and capable member of my administration,” Pennsylvania Gov. Tom Wolf (D) wrote in a statement Wednesday.

He slammed the “derogatory incident” in Bloomsburg, a town in the state’s northeast, as one of several “vile acts” this year that have unfairly targeted Levine, who has worked in his administration since the start of his first term.

In 2015, Wolf first appointed her as Pennsylvania’s physician general, the state’s top doctor. Impressed with her background in behavioral and mental health, the state Senate voted unanimously to approve her, paying little attention to her gender identity during the confirmation process.

“With very few exceptions my being transgender is not an issue,” she told The Washington Post’s Katie Zezima in 2016, declining to comment on an attack by a former Florida congressman.

But three years later, after Levine received a promotion to become Pennsylvania’s health secretary, the coronavirus has turned her into a household name across the state. And as she has sought to contain the pandemic with aggressive social distancing rules, it’s also made her the target of more frequent abuse.

In May, a radio personality repeatedly misgendered Levine, calling the health secretary “sir” at least three times while questioning her on the state’s coronavirus response. A commissioner at a township near Pittsburgh said he was “tired of listening to a guy dressed up like a woman.” After Pennsylvania ordered its residents to wear masks at all times in public, a Facebook page run by one town shared a meme referring to her as “a guy who wears a bra.”

Then, the crowds at a college town’s carnival sent her likeness — a cisgender man in a wig and a dress — flying into a container of cold water, over and over again.

Was already thinking it probably wouldn’t be a good idea to go to the fair this year. Now I’m definitely out. How...

Posted by Mackenzie Brouse on Monday, July 20, 2020

The Bloomsburg Fair Association said the dunk tank had nothing to do with Levine’s gender identity. Rather, the organization said, it was meant to help volunteer fire departments in the area recover funds they had lost to the pandemic and statewide shutdowns.

“A fellow dressed up in a dress to get people to throw balls at the dunk tank to raise money,” Randy Karschner, president of the Bloomsburg Fair, said in an apology on Tuesday. “It turned into where people thought we were offending Dr. Rachel Levine, and that was no intention at all.”

David Broadt, who sat in the tank and serves as the fire chief at a nearby township, said he was not intending to impersonate Levine. But when he got on the platform and crowds started mentioning the resemblance, he played along. Some people shouted, “Where’s your mask?”

“It was just in fun,” Broadt told the Press Enterprise. “It wasn’t done to disrespect her.”

Still, Rafael Álvarez Febo, who leads the Pennsylvania Commission on LGBTQ Affairs, said it was clear the fair had intended to attack Levine for more than her position in state government.

“The leadership of the Bloomsburg Fair knew they were catering to Transphobic sentiments when they chose to impersonate Dr. Levine,” he said in a statement. “Marginalized communities know when we are being targeted.”

As for Levine? She said she remains “laser-focused” on the virus, no matter what else happens or what people say about her.

“I am going to do absolutely everything I can to achieve that whether people agree with me or if they don’t agree with me,” she said at a news conference Tuesday. “Their health is still important to me.”