[3] Levine is one of only a few openly transgender government officials in the United States,[4] and is the first to hold an office that requires Senate confirmation.

In one of her most lauded actions as physician general, Levine signed an order allowing law enforcement officers to carry naloxone.

[16] Responding to the audit and allegations that her department had failed to remedy the shortcomings, Levine said "new regulations were imminent and would fix the problems.

"[16] However, more than a year later, reporters with the investigative partnership Spotlight PA found: "Not only do problems remain, but the coronavirus has likely exploited the shortcomings, fueling deadly outbreaks across the state.

"[16] In July 2017, Governor Wolf appointed Levine as Secretary of Health, and she was unanimously confirmed by the Pennsylvania State Senate.

[22] Spotlight PA, also noted that, under Levine, Pennsylvania had a "robust and aggressive" plan to protect nursing home residents but it "was never fully implemented".

[33] In July 2021 the US Department of Justice (DoJ) announced it would not be investigating "whether Pennsylvania violated federal law by ordering nursing homes to accept residents who had been treated for COVID-19 in a hospital.

[38] Shortly after her confirmation, Levine told NBC News that LGBTQ youth are topmost in her mind when it comes to addressing health disparities in the United States.

[39] She cited bullying, suicide, discriminatory policies, and isolation during the COVID-19 pandemic as pressing issues among LGBTQ youth.

[40] During an April 2022 speech at Texas Christian University, Levine criticized "disturbing - and frankly discriminatory - laws and actions" that many states have implemented that affect the lives of LGBTQ youth.

[41] In an interview with NPR, she cited a range of policies, including Florida's "Don't Say Gay" bill and Texas' push to investigate parents who provide gender-affirming care to their transgender children.