According to HuffPo, the so-called “most pro-LGBT Republican president” quietly appointed Roger Severino—a former Heritage staffer who has railed on everything from marriage equality to bathroom access for trans people—to head the Civil Rights Office at HHS, a position charged with making sure that the very people Severino has attacked “have equal access to health care.” What could ever go wrong with this?

Sen. Patty Murray (D-WA), ranking member of the Senate Health, Education, Labor, and Pensions committee, called Trump’s selection—made last week during the failed Trumpcare fiasco in Congress—“appalling”:

Severino has attacked the way the previous Barack Obama administration enforced civil rights protections for the LGBTQ community, particularly in regards to transgender people. He claimed that allowing people to use the bathroom that corresponds with their gender identity will traumatize female sex abuse victims and be taken advantage of by men. (There is no evidence that gender-segregated restrooms are safer for cisgender women than unisex restrooms, according to Lambda Legal.) Severino has also opposed protections for gender identity when it comes to healthcare. This is especially relevant to his new job, because the civil rights office at HHS is tasked with making sure people have equal access to healthcare. The office does this in part by collecting complaints of discrimination, investigating them, and enforcing the rules. And the Affordable Care Act has a nondiscrimination provision that the Obama administration, after seeking , defined as including gender identity and sex stereotyping. (A federal court that the Obama administration, after seeking thousands of public comments , defined as including gender identity and sex stereotyping. (A federal court put the gender identity provision on hold last December.)

Robin Maril, associate legal director for the Human Rights Campaign, said that Trump’s move meant “that someone would be placed in charge of enforcing some of our nation’s most important civil rights laws who doesn’t necessarily believe that discrimination against LGBTQ people is a problem.” While Severino can’t single-handedly undo gains made from the previous administration, he still wields immense power in his position, and that’s enough to worry many LGBT advocates.