This post is part of Outward, Slate’s home for coverage of LGBTQ life, thought, and culture. Read more here.

Mike Pompeo, one of the most rabidly anti-LGBTQ politicians in America, is President Donald Trump’s pick to replace Secretary of State Rex Tillerson, bringing extreme Christian conservatism to the State Department. At the CIA, Pompeo’s views made members of the intelligence community deeply uncomfortable. If confirmed to State, he’ll be able to influence U.S. policy abroad in ways that negatively affects international efforts to address human rights abuses of LGBTQ people. He’ll also have the power to reverse hard-won improvements to the policy on gender changes for transgender individuals.

Before 2010, the government required sex reassignment surgery to change the gender marker on a U.S. passport. SRS procedures are expensive and complex, and many transgender people do not feel they need it. So in 2010, Secretary of State Hillary Clinton modernized the process to let people update the gender marker on a passport by providing either a doctor’s note certifying the applicant is undergoing treatment for gender transition or a birth certificate that has been updated to show the correct gender.

Even under the updated rules, changing one’s gender on legal documents isn’t easy.

It’s not something that can be undertaken on a whim, and it’s only available to trans people who are undergoing some form of medical transition. Allowing for a broader range of medical transition beyond SRS was a sane, measured step, one that especially benefited lower-income trans people who are financially unable to access surgery, as well as transgender men, most of whom choose not to pursue surgery.

In the transgender community, people who are eligible to change their gender under the current rules are exhorting one another not to wait to make the necessary applications for an updated passport. This includes me, as a transgender man who has updated my name and driver’s license, but not my birth certificate or passport. I don’t travel outside the U.S. often, but changing my passport has become far more urgent with the news of Pompeo’s appointment. Although it’s likely I’ll be able to make the change before the policy is updated, I worry for my young trans siblings who have yet to begin medical transition.

It may seem to some people that genital surgery is not too terribly high a bar for transgender men like me to clear, but even leaving financial barriers aside, phalloplasty is not an appealing option for many of us. Multiple surgeries are required to create a phallus, and these surgeries have a high rate of complications. Although I experience some genital dysphoria and would, ideally, prefer to have a penis, the specifics of phalloplasty and its high complication rate have led me to decide that it is probably not right for me. It would be a huge additional burden to have to undergo such a dangerous, painful, and unnecessary procedure—simply to have my passport match my driver’s license and the everyday appearance that I present to the world.

Which brings me back to Pompeo. This is a man who canceled a speech at the CIA by the parents of hate-crime victim Matthew Shepard, co-sponsored acts attempting to slow the spread of marriage equality and protect religious discrimination against LGBTQ people, and opposed gay and lesbian military service in a speech at the 2011 Values Voter Summit—after the repeal of “don’t ask, don’t tell.” As secretary of state, Pompeo would have the authority to reverse the Obama-era change, once again requiring surgery to change a passport, or even prohibiting trans people from updating their passports at all.

When transgender people travel abroad, a passport with the wrong gender can out us in hostile, sometimes violently anti-LGBTQ environments. It can also create confusion with border officials, and delays if a passport gender doesn’t match the gender on other documents. If we could trust that common sense and humanity would inform Pompeo’s decisions in his new role, there’d be no reason for worry. But for extremists like him, creating unnecessary hardship for transgender people is the goal, not an unintended consequence. His appointment as secretary of state imperils LGBTQ people at home and abroad.