The Senate voted to confirm a Trump-appointed federal judge with a long history of anti-LGBTQ statements to a lifetime appointment Wednesday.

The Senate voted to confirm Matthew Kacsmaryk as the new U.S. district judge for the Northern District of Texas by a 52-46 vote. Sen. Susan Collins of Maine was the only Republican to vote against his confirmation.

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Collins, who has voted to approve 90 percent of Trump’s judicial nominees, nearly one-third of whom “have records that demonstrate hostility towards the rights of LGBT people,” according to Lambda Legal, said she opposed Kacsmaryk’s nomination because of his “alarming bias against LGBTQ Americans and disregard for Supreme Court precedents.”

Kacsmaryk is a former assistant U.S. attorney for the Northern District of Texas and a member of the far-right Federalist Society. He currently serves as the deputy general counsel at First Liberty Institute, a religious nonprofit, NBC News reported.

Kacsmaryk worked at the First Liberty Institute under Jeff Mateer, who was forced to withdraw his nomination for a federal judgeship after LGBTQ groups cited hostile comments that included calling transgender children part of “Satan’s plan.”

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Kacsmaryk’s own views appear to be in the same terrain.

In 2015, Kacsmaryk said the LGBTQ movement “has been typified by lawlessness and just a complete refusal to obey basic rule of law principles,” according to the Alliance for Justice.

Kacsmaryk rejected the Supreme Court’s ruling in Obergefell v. Hodges, which legalized same-sex marriage nationwide, claiming that “traditionally and legally, we define sex according to chromosomes.”

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“That’s how we ordered our marriage laws and made certain presumptions of paternity in the family code,” Kacsmaryk said in an interview with a Christian blog. “All of that is cast into disarray if you declare sex irrelevant to marriage.”

In 2016, he signed on to a letter from multiple religious groups that described transgender identity as a “delusion.”

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Kacsmaryk also represented an Oregon bakery, Sweet Cakes by Melissa, that refused to bake a wedding cake for a gay couple, the Dallas Morning News reported. First Liberty, where he is an attorney, also filed a brief in support of the Colorado bakery involved in a prominent Supreme Court case last year after its owner refused to make a wedding cake for a gay couple.

Kacsmaryk has also called being transgender a “mental disorder” and called homosexuality “disordered,” the Washington Post reported. He fought against protections for LGBTQ people in employment, housing, and health care, HuffPost reported.

Ahead of the vote, 75 pro-LGBTQ organizations signed a letter to the Senate Judiciary Committee urging them not to confirm this “anti-LGBT activist” over his “history of targeting those who do not live according to his particular social and religious beliefs.” Hundreds of parents of transgender children previously issued a similar letter, calling his anti-transgender rhetoric “appalling and unacceptable.”

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Sharon McGowan, the legal director at Lambda Legal, told NBC News that Kacsmaryk was a “dangerous ideologue.”

“Both the substance and the tenor of Kacsmaryk’s writings and speeches give you a sense of just how virulently he opposes equality for LGBT people,” she said.

Kacsmaryk’s record on reproductive rights is not much better.

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He opposed the employer contraceptive mandate in the Affordable Care Act and helped lead an effort opposing a Washington state law that required pharmacists to fill birth control prescriptions, according to the Alliance for Justice.

He criticized the Supreme Court’s Roe v. Wade decision in a 2015 article, writing that “seven justices of the Supreme Court found an unwritten ‘fundamental right’ to abortion hiding in the due process clause of the Fourteenth Amendment and the shadowy ‘penumbras’ of the Bill of Rights, a celestial phenomenon invisible to the non-lawyer eye.”

Senate Minority Leader Chuck Schumer noted on the Senate floor Wednesday that Kacsmaryk also opposed the Equality Act, an LGBTQ anti-discrimination bill that was passed in the House last month.

“He labeled the Equality Act a ‘public affirmation of the lie that the human person is an autonomous blob of Silly Putty, unconstrained by nature or biology, and that marriage, sexuality, gender identity, and even the unborn child must yield to the erotic desires of liberated adults,’” Schumer said. “Why on earth is this man a nominee for a lifetime appointment? Why would my colleagues want to drape black robes over these bigoted views? Our judicial system is designed to protect liberties, not denigrate them.”