Rachel Levine, former Pennsylvania health secretary, has been approved as Biden assistant secretary of health administration.
Wednesday’s vote went 52-48 in his favor, as two Republican senators, Lisa Murkowski of Alaska and Susan Collins of Maine, joined all Democratic members in supporting his nomination.
As Pennsylvania’s senior health official, a role she had held since 2017, she had become the public face of the state’s response to the coronavirus pandemic.
In her new role, she is expected to oversee health and social service offices and programs nationwide.
President Biden highlighted Ms. Levine’s experience when he appointed her in January.
She will bring “the continued leadership and essential expertise we need to help people navigate this pandemic – regardless of zip code, race, religion, sexual orientation, gender identity or disability”, Mr Biden said.
The appointment was hailed by transgender rights activists, who called it a historic breakthrough.
Few transgender people have held senior positions at the federal or state level.
It comes at a time when legislatures across the United States, primarily those under Republican control, are considering an unprecedented wave of bills targeting trans youth.
One type of bill, introduced in at least 25 states, seeks to prohibit transgender girls and young women from participating in women’s educational sports.
One of these measures has already been promulgated by the governor of Mississippi, Tate Reeves, and similar measures have been sent to the governors of Tennessee, Arkansas and South Dakota.
Another variety of bills, introduced in at least 17 states, seek to ban or restrict certain types of medical care for transgender youth.
None of these measures has yet been finally approved.