‘This Is Politics’: Dr. Rachel Levine’s Rise as Transgender Issues Gain Prominence.

At the time, she said, there were “some attacks” on her, but “they were not that brutal.” But after she was elevated to health secretary and took a front-and-center position responding to the pandemic, the hate escalated.

“She told me she was at a gas station early on in the Covid lockdown and some guy in a pickup truck started driving around her screaming about medical tyranny,” said Mara Keisling, the executive director of the National Center for Transgender Equality.

At first, she tried to ignored it. But she drew the line at the dunk tank episode, and used her daily news conference to push back.

“While these individuals may think that they are only expressing their displeasure with me,” she said, they were hurting “thousands of L.G.B.T.Q. Pennsylvanians.”

As assistant secretary for health, Dr. Levine has a wide portfolio; the job is what you make it, and can be either the “most influential public health voice” in the nation, or “window dressing,” depending on the aspirations of its occupant, said Dr. Levine’s predecessor, Adm. Brett P. Giroir.

Dr. Levine said she intended to prioritize mental health, health equity and the opioid epidemic, a problem she also tackled while in Pennsylvania. Her “most urgent” priority, she said, is fighting the coronavirus, and especially addressing vaccine hesitancy.

But she also intends to advocate on behalf of transgender youth, and work to raise awareness, as she did during her visit to Belmont Hill. Her former math teacher, Michael Sherman, who has taught there for 48 years, said Dr. Levine was invited because the school wanted to emphasize diversity, and she is the only known female graduate.