UPDATE: Nov. 29 ― President-Elect Donald Trump’s transition team confirmed on Tuesday that Rep. Tom Price (R-Ga.) is his pick for secretary of Health and Human Services. PREVIOUSLY: WASHINGTON ― Rep. Tom Price (R-Ga.), a potential pick for secretary of Health and Human Services, has a long history of opposing LGBTQ rights. If President-elect Donald Trump nominates him, or someone like him, advocates fear the new administration will undermine important protections for sexual orientation and gender identity.

“Price’s hateful record on LGBTQ issues shows that he lacks an understanding of basic human rights and dignity,” said Sarah Kate Ellis, president and CEO of GLAAD, an LGBTQ advocacy organization. That record renders him “completely unfit for secretary of Health and Human Services,” she added.

The Trump transition team and Price’s office did not respond to requests for comment.

Over the years, Price co-sponsored a constitutional amendment banning same-sex marriage. He voted against a bill that banned employers from discriminating against gay people and a bill that fought anti-gay hate crimes. He called the Obama administration’s guidelines allowing transgender students to use the bathrooms that correspond with their gender identity “absurd.”

Price went out of his way to back Kelvin Cochran, an Atlanta fire chief who was terminated in January 2015 after employees received copies of his self-published book, which equated homosexuality with pedophilia and bestiality. The city’s mayor claimed Cochran was fired for his “judgment and management.” But Price, along with five other Georgia lawmakers, signed onto a letter asking the mayor to reinstate him. (Cochran filed a lawsuit claiming that he was discriminated against because of his faith.)

Al Drago/CQ Roll Call via Getty Images Rep. Tom Price has a dismal record when it comes to LGBTQ rights.

Price also appeared on a conference call in 2013 with Rabbi Noson Leiter, who once suggested that Hurricane Sandy was divine punishment for gay marriage. Leiter asked the congressman whether he thought it prudent to consider the medical and economic impacts of legislation that promotes a “homosexual agenda.”

Price said he agreed. “The consequences of activity that has been seen as outside the norm are real and must be explored completely,” he added.

Lesbian, gay, bisexual, transgender and queer individuals have long dealt with particular health challenges, including discrimination ― which can contribute to mental health issues, poverty and substance abuse ― physical and sexual violence, HIV and AIDS. They also routinely face stigma from health care providers, such as denial of care and being blamed for their health status. Carriers have also denied coverage based on “pre-existing conditions,” such as having a transgender medical history.

Democrats and the Obama administration took unprecedented steps to address these problems, including carving out nondiscrimination protections through the Affordable Care Act. If the health care law is repealed ― an action Price has supported ― many of these protections would likely go away. But even if the law stays on the books, the Trump administration could choose not to prioritize enforcement of LGBTQ protections, or to go further and try to change the rules.

The Affordable Care Act has a nondiscrimination provision, for example, that the Obama administration has defined to include gender identity and sex stereotyping. But the language does not explicitly state whether discrimination based on sexual orientation alone is included in that provision. The Trump administration will have leeway in deciding how to interpret this.

Robin Maril, associate legal director for the Human Rights Campaign, said people are concerned the new administration could chip away at protections “by not enforcing them, or undermining them with exemptions.”

Enforcement is key to making the Obama administration’s rules meaningful. Last year, for example, HHS’s Office for Civil Rights entered into an agreement with the Brooklyn Hospital Center to ensure that transgender patients received equal care. Among the provisions were items making sure staff didn’t make derogatory comments and ensuring appropriate room assignments.

More broadly, the Obama administration has prioritized LGBTQ care in numerous other ways, including awarding grant funding to organizations that help minority men living with HIV and AIDS, taking a stand against so-called conversion therapy for gay kids, and removing the gender marker from Medicare cards to minimize privacy violations.

“It is still too early to know what a Trump administration will do,” said Jennifer Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation. But, “any cutback in coverage would affect those in the LGBT community, and the stakes are particularly high.”

Do you work at HHS or another federal agency? Email us at scoops@huffingtonpost.com and let us know what you’re seeing and hearing, and if you’re thinking of staying in government for the next administration.