By David DeKok

HARRISBURG, Pa. (Reuters) - Dr. Rachel Levine, a transgender woman confirmed on Tuesday as Pennsylvania's physician-general, says she wants to be defined by her public health priorities, not her breakthrough appointment as an influential gubernatorial adviser.

With the state Senate endorsing her appointment in a 49-0 vote, Levine became the first transgender person to serve as a high-level official in Pennsylvania history. But even though she is pleased to be a mentor to the transgender community, Levine says her role as a physician comes first.

Levine, who will advise Democratic Governor Tom Wolf on medical and public health issues, sees addiction to prescription drugs as one of Pennsylvania's most pressing problems.

"I am very grateful to Governor Wolf for nominating me to this position and to the Senate for their consideration of my nomination," Levine said following the vote.

The new physician-general specializes in adolescent medicine and has run a clinic for young people with eating disorders. In keeping with her own personal history, Levine also counsels teenagers struggling with their gender identity.

"One of the most common misconceptions is that it's a choice, or a whim, or a lifestyle thing," Levine said in an interview, referring to gender identity. "It's a deeply personal issue."

Levine, 57, formerly a married father of two, said accurate information about gender identity was unavailable to her growing up in Wakefield, Massachusetts, a mill town about 15 miles (25 km) north of Boston.

From the age of 5 or 6, Levine said, she wondered if she was a girl living in a boy's body.

Levine completed her transition in 2013. She has undergone sex reassignment surgery and hormonal treatment.

GROWING ACCEPTANCE

Jonathan Adams, a spokesman for New York-based advocacy group Lambda Legal, said he did not know of any other transgender people in high-ranking state government positions in the United States.

Levine's appointment is fresh evidence of a growing acceptance of transgender people in the United States, even as discrimination against them remains legal in many jurisdictions, including Pennsylvania.

"Governor Wolf has repeatedly called on the legislature to take action now and pass a non-discrimination law so he can sign it," said spokesman Jeffrey Sheridan.

Healthcare is an area of particular concern for advocates. In most states, it is legal to deny insurance coverage for transgender-related health services, like hormonal therapy or gender reassignment surgery.

Even so, media attention afforded celebrities, such as Caitlyn Jenner, the U.S. Olympian and TV reality star formerly named Bruce, has given the community increased visibility, and that has fueled a national discussion over gender identity.

Levine says her goals as physician-general are broad and inclusive, embracing public health problems that affect all ages, sexes, races, sexual orientations and gender identities.

One of her highest priorities is to help break the addiction of many Pennsylvanians to Oxycontin and other prescription pain drugs without driving them to something worse.

Drug overdose deaths, many from heroin, have risen in Pennsylvania from one per 100,000 population in 1990 to 13 per 100,000 in 2011, according to a study released last year by the Center for Rural Pennsylvania.

"If you simply cut them off, then that is a road to heroin," Levine said. "Because heroin, unfortunately, is extremely accessible."

(Reporting by David DeKok; Editing by Frank McGurty and Eric Beech)