The Biden administration’s US assistant health secretary Rachel Levine was sworn in on Tuesday as an admiral of the Public Health Service Commissioned Corps. The 6,000-officer force responds to health crises on behalf of the federal government, including administering coronavirus vaccines and providing care to communities after hurricanes, the Washington Post reported.

The former Pennsylvania health secretary is the sixth four-star admiral in the history of the health corps. After becoming the nation’s highest-ranking openly transgender official as a senior Biden health appointee, Levine is now the public health service organization’s “first-ever female” four-star admiral as well as the first openly transgender four-star officer across any of the eight uniformed services, which include the Army, the Navy, and the Air Force.