President Donald Trump’s pick for head of the U.S. Department of Health and Human Services’ Office for Civil Rights will lead a division that is supposed to crack down on discrimination—and has a lengthy anti-LGBT record.

Roger Severino, a former lawyer with the Becket Fund, a law firm that advocates for religious liberty, was one of the leading attorneys in the 2006 Conaway v. Deane case, banning same-sex couples from marriage in Maryland. In August 2006, Severino penned an op-ed for the Philadelphia Inquirer saying that the concept “live and let live” doesn’t apply to gay rights and religious beliefs.

That was about a month before Severino and Anthony R. Picarello, a former colleague and now vice president and general counsel of the Becket Fund, filed a brief with the Maryland Court of Appeals that used religion as a basis to reject health benefits to same-sex partners (PDF).

The case involved an effort by nine Maryland couples to win marriage rights in the state. According to the brief, Severino and his partner filed, “If legalized same­-sex marriage becomes more common, employees will likely ask their religious employers to extend spousal health and retirement benefits to those partners, just as they would to different­ sex spouses. Some religious employers may be willing to overlook or ignore an employee’s same­-sex marriage, but may also refuse to subsidize it, or otherwise treat it as the equivalent of traditional marriage on religious grounds.”

The brief continued: “Legalized same-sex marriage will create an unprecedented level of legal confusion and consequent litigation in public accommodation and employment law, and over government funding with the only certainty being that they will challenge the workings of religious institutions like never before.” And it asked: “Will state governments force religious institutions to place orphan children under their care within same­-sex ‘families’?”

Severino has just assumed leadership of the Office for Civil Rights at HHS, he will oversee and enforce patient privacy protections and defend the public against discrimination in health care, according to the Office for Civil Rights website.

During the Obama era, the Office for Civil Rights implemented section 1557 in the Affordable Care Act (ACA), which protected transgender individuals based on gender identity and prohibited religious exemption. Given Servino’s anti-LGBT record, he might reverse these protections. He has written scathing critiques about the ACA’s new gender mandates, while also safe-guarding doctors that use religion as a defense to neglect transgender patients.

Before his current post, Severino worked as the director of the DeVos Center for Religion and Civil Society at the Heritage Foundation, a research tank that analyzes the impact of religion on civic life and public policy in the United States.

“Roger Severino has a distinguished record of fighting for the civil rights and freedoms of all Americans. We have no doubt that Roger in his role at HHS will protect the civil rights of all Americans,” said Marguerite Bowling, a spokeswoman for Heritage.

Neither the Becket Fund nor HHS responded to direct requests for comment. A spokesperson for Becket said he couldn’t find an attorney to comment before press time for The Daily Beast’s emailed questions. However, in a statement sent to The Daily Beast, Eric Rassbach, deputy general counsel at Becket, said Severino worked “tirelessly to defend civil rights for all Americans in accordance with Becket’s mission of defending religious liberty for people of all faiths. He will be an outstanding director of the Office of Civil Rights.”

For nearly seven years, Severino worked as a trial attorney for the Department of Justice’s Civil Rights Division where he enforced the Fair Housing Act, the Religious Land Use and Institutionalized Persons Act, and Title II and Title VI of the Civil Rights Act of 1964, according to his HHS bio.

Advocacy groups with knowledge of Servino’s past have mixed views on his appointment.

More than 10 years ago, Lambda Legal, a legal group defending LGBT communities, was a plaintiff on the Conaway case. In 2006, Lambda defended nine same-sex couples, including one gay widower, who sued the state of Maryland after being denied marriage licenses. Lambda lost the case.

Sharon McGowan, the director of strategy at Lambda, said she isn’t “optimistic” about Servino’s new role at HHS. “The arguments put forth by Severino and others at the Becket Fund during the marriage struggle were indicative of the scare tactics folks were trying to use to somehow pit equality for LGBT people against religion,” McGowan said. “The attempt of Roger Severino to suggest that religious liberty will come to an end if LGBT people are given equal rights under law… certainly, gives insight on where he would strike a balance if he were given the opportunity, that he has now been given to make civil rights laws.”

The National Center for Lesbian Rights (NCLR), a non-profit law firm advocating for LGBT constituents, said that Severino’s designation to the HHS is “deeply concerning” to the LGBT community.

“It’s a continuation of President Trump’s pattern of appointing people to lead important federal agencies who fundamentally disagree with the agencies’ mission,” said NCLR’s director of policy, Julianna Gonen. “Severino was a very vocal critic of the most important rules that he’s supposed to enforce which is prohibiting sex discrimination in health care under the affordable care act.”

In a blog post Severino co-wrote for Heritage, he complained that the Affordable Care Act’s gender identity mandate will interfere with the religious beliefs of doctors. “These regulations propose to penalize medical professionals and healthcare organizations that, as a matter of faith, moral conviction, or professional medical judgment, believe that maleness and femaleness are biological realities to be respected and affirmed, not altered or treated as diseases,” the post said.

Severino has even used the anti-LGBT vision of a local Boy Scouts chapter to object to gay rights, writing a 2006 op-ed for the Philadelphia Inquirer in support of a local branch that lost access to government-affiliated campsites and buildings after excluding LGBT students.

“If the gay-rights movement is willing to trample on the moral beliefs of the Boy Scouts for the sake of `tolerance,’ will religious institutions that also provide social services and oppose gay rights on religious grounds fare any better?” he wrote.

In January, the Boy Scouts of America reversed rules that banned transgender members.

Tatyana Bellamy-Walker covers LGBT politics. Her work has appeared in the New York Daily News, New York Amsterdam News and Women’s eNews. She tweets at @bell_tati.