Dr. Rachel Levine, who has helped lead the nation’s coronavirus response as President Biden’s assistant secretary for health and made history as the first openly transgender federal official confirmed by the Senate, has a new title: admiral.

The Department of Health and Human Services announced Tuesday morning that Dr. Levine has been sworn in as a four-star admiral in the U.S. Public Health Service Commissioned Corps, which she already leads in her role as assistant secretary.

Admiral Levine is the first female four-star admiral in the history of the corps, a uniformed service of more than 6,000 health, science and engineering professionals who work in federal agencies and on the front lines of health crises and natural disasters. She is also the first openly transgender person to become a four-star officer in any of the nation’s eight uniformed services.

As assistant health secretary, Admiral Levine has a broad portfolio that also includes addressing racial disparities in health and the effects of climate change on health.

In a brief interview, she said joining the corps and wearing the uniform of a public health service officer was “consistent with my thoughts about service” and her desire to be a role model and advocate for transgender people, especially transgender youth.