During the recent Senate confirmation hearing for Dr. Rachel Levine, a Pennsylvania pediatrician nominated to become President Joe Biden‘s assistant health secretary, Sen. Rand Paul (R-Kentucky) compared health care for transgender individuals to genital mutilation.

“Most genital mutilation is not typically performed by force but, as WHO notes, that by social convention, social norm, the social pressure to conform, to do what others do and have been doing as well as the need to be accepted socially and the fear of being rejected by the community,” Paul said. “American culture is now normalizing the idea that minors could be given hormones to prevent their biological development of their secondary sexual characteristics. Dr. Levine, do you believe that minors are capable of making such a life-changing decision as changing one’s sex?”

Levine, who, if confirmed, would be the first openly trans person to be confirmed by the Senate, responded by stating: “Transgender medicine is a very complex and nuanced field with robust research and standards of care that have been developed.”

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