The first openly transgender person to hold a senior US government position has been confirmed by the US Senate.
Rachel Levine has been confirmed as the Assistant Secretary of Health by a narrow 52-48 margin.
Dr Levine is the only transgender person to ever be confirmed by the Senate.
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Before being nominated, Dr Levine served as the head of the Pennsylvania Department of Health.
She is a trained paediatrician, specialising in adolescent medicine and eating disorders.
"When I assume this position, I will stand on the shoulders of those who came before — people we know throughout history and those whose names we will never know because they were forced to live and work in the shadows," Dr Levine said in a statement.
"In particular, I want to address transgender youth. I know that each and every day you confront many difficult challenges.
"Sadly, some of the challenges you face are from people who would seek to use your identity and circumstance as a weapon. It hurts. I know.
"I cannot promise you that these attacks will immediately cease, but I will do everything I can to support you and advocate for you."
Senate Majority Leader Chuck Schumer called Dr Levine's confirmation an " important milestone for the American LGBTQ community".
"As transgender Americans suffer higher rates of abuse, homelessness and depression than almost every other group, it's important to have national figures like Dr Levine who by virtue of being in the public spotlight will help break down barriers of ignorance and fear," Senator Schumer said.
Her nomination was opposed by all but two Republicans, with Kentucky senator Rand Paul taking umbrage at Dr Levine's advocacy for minors undergoing gender transition procedures.
"For most of our history, we have believed that minors don't have full rights and that parents need to be involved," Senator Paul said.
"We should be outraged that someone's talking to a three-year-old about changing their sex."
Senator Paul referred to gender reassignment surgery as "genital mutilation".
Dr Levine also drew questions over Pennsylvania's handling of the coronavirus pandemic, with specific questions about nursing homes being asked.
The Assistant Secretary of Health is one of the most senior non-cabinet roles in the US government, serving as the chief advisor to the Secretary of Health and Human Services.
When a president enters office, they are tasked with filling thousands of jobs within the federal government, many of which require Senate confirmation.
Most of those Biden Administration positions are currently unfilled.
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