The Senate has confirmed yet another of Donald Trump’s anti-LGBT federal judicial nominees, one who was rated “not qualified” by the American Bar Association.

By a vote of 50-48, the Senate confirmed Leonard Steven Grasz to a lifetime appointment to the U.S. Court of Appeals for the Eighth Circuit, the Associated Press reports. All Republicans voted for Grasz, all Democrats and Independents against him. Two Republicans, John McCain of Arizona and Thad Cochran of Mississippi, did not vote. The Eighth Circuit covers Arkansas, Missouri, Iowa, Minnesota, North and South Dakota, and Nebraska.

Grasz, who goes by his middle name, is a board member at the Nebraska Family Alliance, an anti-LGBT group affiliated with Focus on the Family, an equally anti-LGBT national organization, notes Lambda Legal, one of numerous civil rights groups that opposed his confirmation.

“Mr. Grasz’s connections to the NFA run deep,” reads a letter signed by Lambda Legal and 29 other LGBT organizations. “In fact, Mr. Grasz’s son, Nate Grasz, currently serves as Director of Policy for the organization and has opposed marriage equality, bans on conversion therapy, and anti-discrimination protections for LGBT people.” The NFA filed a friend-of-the-court brief opposing marriage equality in the Obergefell v. Hodges case before the U.S. Supreme Court, and condemned the court’s eventual ruling for equal marriage rights.

As chief deputy attorney general of Nebraska in the 1990s, Steven Grasz opposed recognition of same-sex marriages from other states (at the time it looked as if Hawaii would be the first state to legalized same-sex marriage). He also argued before the Nebraska Supreme Court that state law did not allow a lesbian couple to adopt.

In 2013 he proposed an amendment to the Omaha city charter that would exempt business owners from the city’s human rights ordinance if their anti-LGBT discrimination was rooted in religious beliefs.

During the confirmation process, Lambda’s letter reads, “Grasz was unwilling to say whether he supported prohibiting discrimination in employment based on sexual orientation and gender identity; refused to commit to recuse himself in cases involving questions of marriages, families and LGBT rights, and in cases involving whether religious liberty trumps anti-discrimination laws; and declined to say whether he shared the NFA’s view that same-sex couples and their families are ‘less optimal’ than different-sex couples and their families.” He was one of just four nominees since 1989 to receive a unanimous “not qualified” rating from the ABA, which cited his opposition to transgender rights as one of the reasons for the rating, according to the letter.

“It is exasperating, and yet unsurprising, that Senate Republicans could not even bring themselves to oppose a Trump nominee that received a unanimous ‘not qualified’ rating from the non-partisan American Bar Association,” Lambda Legal director of strategy Sharon McGowan said in a press release. “The total disregard for those most vulnerable in this country — those who depend on a fair and impartial judicial system to protect their basic rights — was on full display today by each Senator who voted to hand a lifetime appointment to Steven Grasz to the Eighth Circuit, where he will wreak lasting damage on civil rights for generations to come.”

Senate Judiciary Committee chairman Chuck Grassley, McGowan added, “today rightfully and finally urged Donald Trump to reconsider the nomination of Jeff Mateer,” who has called transgender children part of “Satan’s plan,” supported so-called conversion therapy, and said marriage equality will lead to polygamy, bestiality, and people marrying inanimate objects. He is nominated for a judgeship on the U.S. District Court for the Eastern District of Texas. But Grassley “must also take accountability for all the Jeff Mateer-quality nominees he’s been jamming through the confirmation process, including Steven Grasz today,” she said. The Senate has already confirmed other anti-LGBT judicial nominees such as John Bush and Joan Larsen.

Three other problematic nominees are scheduled to go before either the Judiciary Committee or the full Senate this week, according to Lambda. The committee is set to hold a hearing Wednesday morning on Matthew Kacsmaryk, who McGowan calls “essentially a carbon copy” of Mateer. A vote by the full Senate is expected Wednesday on the nomination of Don Willett, who like Kacsmaryk is opposed by Lambda and other LGBT groups. A vote is expected Thursday on James Ho, about whom these groups have raised concerns.