CSPAN Matthew Kacsmaryk thinks being transgender is "a delusion" and that pharmacists shouldn't have to provide birth control to women. He's 42 and about to become a lifetime federal judge.

WASHINGTON ― The Senate voted Tuesday to move forward with confirming Matthew Kacsmaryk to be a lifetime federal judge, despite strong protests from Democrats ― and one Republican ― over his record of opposition to LGBTQ rights and abortion rights.

The Senate voted 52-44 on a procedural step to advance Kacsmaryk’s nomination to the U.S. District Court for the Northern District of Texas. Every Democrat present voted no. Every Republican but one, Susan Collins (Maine), voted yes.

Democratic Sens. Kirsten Gillibrand (N.Y.), Kamala Harris (Calif.), Mazie Hirono (Hawaii) and Ron Wyden (Ore.) did not vote.

Kacsmaryk, 42, is set for his final confirmation vote on Wednesday.

Lots of President Donald Trump’s judicial nominees have records of opposing LGBTQ rights and abortion rights; indeed, it is essentially a requirement at this point. But Kacsmaryk, the deputy general counsel for First Liberty Institute, a right-wing Christian advocacy group, has drawn particular criticism for his extreme views on both fronts.

He has fought against protections for LGBTQ people in employment, housing and health care. He has called including protections for LGBTQ people in the Violence Against Women Act “a grave mistake.” In 2015, when Utah passed nondiscrimination protections, Kacsmaryk called the law ”a bad idea” because it suggests that discrimination based on sexual orientation and gender identity should be taken as seriously as other forms of discrimination. He signed on to a 2016 letter that called being transgender “a delusion.”

Kacsmaryk also ripped the Supreme Court’s decision in Obergefell v. Hodges, the landmark 2015 marriage equality case. He wrote that “five justices of the Supreme Court found an unwritten ‘fundamental right’ to same-sex marriage hiding in the due process clause of the Fourteenth Amendment ― a secret knowledge so cleverly concealed in the nineteenth century amendment that it took almost 150 years to find.”

Senate Democrats held a press call and gave floor speeches ahead of the vote on Kacsmaryk to emphasize their firm opposition.

“It strikes me as unusual, more than coincidental, that in June – the LGBTQ Pride Month – our Republican colleagues would decide to bring to the floor the nomination of a Texas district court nominee, Matthew J. Kacsmaryk,” said Sen. Dick Durbin (D-Ill.). “This is yet another extreme nominee outside the mainstream of American thinking who does not deserve to be rubber-stamped for a lifetime appointment by the United States Senate.”