Much to the consternation of LGBT rights supporters, the Trump administration has appointed to head the civil rights division of the Department of Health & Human Services a former staffer with the anti-LGBT Heritage Foundation who wrote extensively against the civil rights of transgender people.

A series of statements from LGBT advocates came out Thursday over the appointment of Roger Severino, who until this week was director of the DeVos Center for Religion & Civil Society for the Heritage Foundation.

Winnie Stachelberg, executive vice president for external affairs at the Center for American Progress, gave no quarter in a statement over the Severino’s appointment and its implications for transgender health.

“Frankly, it is sick that President Trump would appoint Roger Severino to lead OCR – putting a man who made his career opposing healthcare non-discrimination laws in charge of enforcing those very same protections,” Stachelberg said. “Before the Affordable Care Act, insurance companies routinely denied equal treatment to same-sex couples and more than half of private insurance plans explicitly discriminated against transgender patients, with more than a quarter of transgender people reported being denied medical care by a provider. Severino’s writing makes it clear that he wants to take us back to the days when 1 in 4 transgender people was refused medical care outright.”

Among the posts Severino wrote for The Daily Signal, the blog for the Heritage Foundation, were in opposition to LGBT people, especially transgender rights. After the White House came out against a provision in a congressional defense spending package that would have allowed anti-LGBT discrimination among federal contractors, Severino wrote a post called “Obama Threatens to Veto Military Bill Because It Protects Religious Groups.” After the Pentagon lifted its ban on openly transgender service, Severino wrote a post called “Pentagon’s Transgender Policy Defies Common Sense.”

Severino also defended North Carolina’s anti-LGBT House Bill 2, which prohibits transgender people from using the restroom in schools and government buildings consistent with their gender identity. Decrying the “unrelenting and coordinated attacks” against the state for enacting the law, Severino criticized former U.S. Attorney General Loretta Lynch for filing a federal lawsuit against the measure, which he said amounted to progressives “using government power to coerce everyone, including children, into pledging allegiance to a radical new gender ideology.”

Marguerite Bowling, a spokesperson for the Heritage Foundation, defended Severino in response to concerns he’d seek to undermine transgender health in his role at HHS.

“Roger Severino has a distinguished record of fighting for the civil rights and freedoms of all Americans,” Severino said. “We have no doubt that Roger in his new role at HHS will protect the civil rights of all Americans.”

As head of the HHS civil rights division, Severino would be charged with enforcing Section 1557 of Obamacare, which prohibits discrimination on the basis of race, sex, disability and age in health programs. The Obama administration interpreted the prohibiting on sex discrimination to bar discrimination against transgender people in health care, including the refusal of gender reassignment surgery.

Wade Henderson, outgoing CEO of the Leadership Conference on Civil & Human Rights, said in a statement the office of civil rights at HHS requires “strong and experienced leadership” to enforce Section 1557, and Severino is “not that leader.”

“Since enactment of the ACA seven years ago today, members of The Leadership Conference have strongly advocated for the full and complete implementation of Section 1557,” Henderson said. “In his previous position at the Heritage Foundation, Mr. Severino repeatedly denounced and actively worked to oppose OCR’s implementation of Section 1557. These actions call into question his ability to fully enforce the ACA and protect communities of color and other underserved populations, who are most at risk for unequal access to health and health care.”

It should be noted U.S. District Judge Reed O’Connor has enjoined the enforcement of the Obamacare regulation interpreting Section 1557 to apply to transgender people. The Trump administration missed a deadline to appeal the decision to the U.S. Fifth Circuit Court of Appeals, but the American Civil Liberties Union is seeking to intervene to defend the regulation.

Harper Jean Tobin, policy director for the National Center for Transgender Equality, said Severino could still do “a number of things” to impact transgender protections under Section 1557 as litigation proceeds.

“The government will now have to make a decision, and OCR is ostensibly the client DOJ in this decision, as to whether to ensure, as the government normally would in a case like this, that federal law and the federal regulation interpreting it and applying the federal law is defended, that a rule overturning it is reviewed by a higher court,” Tobin said. “I think the fear is that OCR and DOJ could sort of work together to have this injunction made permanent without any review by a higher court, which would be highly unusual and really inappropriate.”

After a rule-making process consisting of many years and with two separate comment periods, Tobin said letting the injunction against the regulation stand would be “tantamount to repealing the regulation without going the required rule-making process and instead just acceding to a fringe legal position by one district court judge.”

Tobin added OCR has other responsibilities related to transgender health, such as the federal health care privacy law, or HIPAA, which assures privacy for transgender people in health care settings.

“Up until now, OCR has in cases involving transgender people, just as it does for everybody else, acted to enforce the laws to protect their privacy, but given Mr. Severino’s aggressively hostile work to dismantle any kind of legal protections for transgender people, we’re worried about what kind of direction the agencies would take on those bedrock protections,” Tobin said.

Caitlyn Oakley, an HHS spokesperson, had no comment in response to concerns from LGBT advocacy groups that Severino wouldn’t protect transgender health in his new role.

“We aren’t commenting on personnel at this time,” Oakley said.

Matt McTighe, executive director of Freedom for All Americans, said in a statement Severino appointment to HHS and his anti-trans history spells trouble for transgender health.

“Roger Severino has a proven track record of opposing fair and equal treatment for the transgender community,” McTighe said. “He is a dangerous pick for a position that is meant to enforce critical civil rights protections. This is yet another example of the Trump administration’s failure to live up to the president’s campaign promise of protecting LGBT people and it will have devastating consequences for transgender people across the country.”