Social media users have been sharing posts online which claim that Dr Rachel Levine, former Secretary of Health for the Commonwealth of Pennsylvania and now President Joe Biden’s new assistant health secretary, believes children should be allowed to have gender reassignment surgery without parental consent. There is no evidence to support this claim.
Examples of posts making the claim can be seen here and here. The posts read: “Dr. Rachel Levine, US Assistant Secretary for Health, believes that all children should be allowed to select their gender and have access to government-funded sex reassignment surgery without parental notification or authorization.”
The posts likely refer to an exchange between Senator Rand Paul and Levine during her Senate confirmation hearing on Feb. 25, 2021. A video of the exchange can be seen on C-SPAN here.
Paul starts the C-SPAN clip saying “genital mutilation has been condemned by the World Health Organization, the United Nations Children’s Fund, the United Nations Population Fund.” Reuters was unable to find WHO or U.N. statements condemning gender reassignment surgery for transgender people, and searches for “genital mutilation” and these agencies result in papers on female genital mutilation, an entirely different practice indeed that has been condemned by both agencies (here, here, here, www.unfpa.org/born-complete).
In the exchange, Paul asks Levine whether she supports minors being able to transition, calling the procedure “genital mutilation.”
At 1:33, Paul asks: “Dr. Levine, do you believe that minors are capable of making such a life-changing decision as changing one’s sex?”
Levine responds: “Well, Senator, thank you for your interest in this question. Transgender medicine is a very complex and nuanced field with robust research and standards of care that have been developed and, if I am fortunate enough to be confirmed as the assistant secretary of health, I will look forward to working with you and your office and coming to your office and discussing the particulars of the standards of care for transgender medicine.”
Paul then says: “The specific question was about minors. Let’s be a little more specific, since you evaded the question. Do you support the government intervening to override the parent’s consent to give a child puberty blockers, cross-sex hormones, and/or amputation surgery of the breasts and genitalia?”
Paul then describes a story of a young girl who later regretted transitioning. At 3:50, Paul asks again: “Will you make a more firm decision on whether or not minors should be involved in these decisions?”
Levine responds with almost the exact same answer, explaining that transgender medicine is complex and that she will discuss it with Paul if she is confirmed.
Levine did not directly answer the question, neither confirming or denying the statement presented in these posts, that minors should be able to have access to government-funded sex reassignment surgery without parental consent.
Levine has written and spoken about supporting transgender children in the past (here, here). On Jan. 24, 2020, she tweeted here a CNN article discussing a study that found puberty blockers to be life-saving drugs for trans teens with mental health problems. Reuters did not find evidence, however, of Levine saying she supports giving these treatments without parental consent.
As reported by the Thomson Reuters Foundation in Feb. 2020, a global rise in the number of teenagers seeking to go through gender reassignment has spurred a series of court cases around the age at which young people are able to choose to transition – and who has the final word. Gender reassignment surgery is widely restricted to adults over the age of 18 (here).
The World Professional Association for Transgender Health’s (WPATH) standards of care here, explain the three categories of physical interventions for adolescents. These consist of fully reversible interventions such as hormone suppression to delay puberty, partially reversible interventions such as hormone therapy, and irreversible interventions such as surgical procedures.
The association advises that “moving from one stage to another should not occur until there has been adequate time for adolescents and their parents to assimilate fully the effects of earlier interventions.” Genital surgery should not happen until the individual reaches the age of majority to give consent in a given country and have lived continuously for at least 12 months in their gender identity, according to the association.
Puberty-suppressing medications are reversible, as explained in a 2016 report by the Human Rights Campaign Foundation, American College of Osteopathic Pediatricians and the American Academy of Pediatrics here. The report categorizes hormone therapy and gender-affirming surgeries for “older adolescents” and “adults”, not children.
Missing context. Dr. Rachel Levine did not confirm or deny a question by Rand Paul asking her if she would support overriding parental consent for gender reassignment surgery for minors.
This article was produced by the Reuters Fact Check team. Read more about our fact-checking work here.