This week, President Donald Trump quietly appointed anti-LGBTQ activist Roger Severino to lead the Department of Health and Human Services’ Office of Civil Rights (OCR), an office whose work he has actively opposed.

In his previous role as Director of the DeVos Center for Religion and Civil Society for the Heritage Foundation, Severino spoke out against the civil rights protections he will now be tasked with upholding and supported the wholesale repeal of the Affordable Care Act.

“By appointing Mr. Severino to enforce the life-saving protections that he has made his personal mission to dismantle, the Trump administration has once again put the fox in charge of the hen house,” said Mara Keisling, executive director of the National Center for Transgender Equality (NCTE), in a statement.

While at the Heritage Foundation, he authored a report opposing the OCR’s implementation of a portion of the Affordable Care Act (ACA) known as the 1557 rule, which prohibited discrimination based on race, color, national origin, age, disability, and sex in federally-funded health programs.

“He has made attacking women’s and LGBT people’s access to health care one of the centerpieces of his career,” Keisling added, “while his baseless claims about protections for transgender people—repeated over and over without any regard for the consequences on transgender people’s lives—betray a fundamental misunderstanding of federal civil rights laws, medical science, the reality of what it means to be transgender.

Severino has particularly opposed extending non-discrimination protections to transgender people, calling the efforts of OCR to do so an “abuse of power” that requires people to pledge “allegiance to a radical new gender ideology,” forces doctors to perform “controversial” transition-related surgeries, and gives transgender people “special privileges” that disadvantage people of faith. He celebrated a judge’s nationwide injunction against enforcing parts of the 1557 rule last year.

Several civil rights organizations have signed on to the NCTE statement objecting to Severino’s appointment, expressing deep concern about being tasked to uphold civil rights.

“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,”said Winnie Stachelberg, executive vice president for external affairs at the Center for American Progress, in the statement. “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.”

Access to healthcare has been a major focus of transgender rights organizations and was an area that advocates saw a number of victories under President Barack Obama.

“I could not think of a more dangerous person to head up the Office of Civil Rights at HHS,” said JoDee Winterhof, senior vice president of policy and political affairs at the Human Rights Campaign. “Mr. Severino takes pride in being a stark opponent of the LGBTQ community and has made it clear that his number one priority is to vilify and degrade us.”

Severino’s appointment continues a trend of Trump appointing leaders in agencies and offices whose very existence they have opposed, stoking fears that the placements are intended to destroy the agencies from within.

“Mr. Severino is now in a position to transform his dangerous rhetoric into action that can inflict serious harm on the lives of millions of Americans,” Keisling said. “We cannot let this happen.”