The Trump administration has quietly appointed a Heritage Foundation staffer who has railed against civil rights protections for transgender patients as director of the federal agency charged with protecting the civil rights of all patients.

Though the administration did not issue a formal announcement, Roger Severino is now listed on the website of the U.S. Department of Health and Human Services as director of the Office for Civil Rights. His prior position was as director of the DeVos Center for Religion and Civil Society at the Heritage Foundation, where he focused on “religious liberty, marriage and life issues.” (The DeVos Center is named for the in-laws of Education Secretary Betsy DeVos.)

The civil rights office is in charge of enforcing patient privacy protections and ensuring that patients’ civil rights are protected, that they are free from discrimination and that they have access to services such as interpreters.

Asked for comment, HHS forwarded a link to Severino’s title and biography. In a statement, Heritage spokeswoman Marguerite Bowling said, “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 new role at HHS will protect the civil rights of all Americans.”

Severino’s position does not require Senate confirmation.

Based on his prior writings, Severino will likely take the agency in a different direction than it had under the Obama administration. Last year, the agency issued rules banning discrimination against transgender patients, carrying out provisions of the Affordable Care Act. (A federal judge put those rules on hold on Dec. 31, siding with a Catholic hospital system, other religious health providers and five states that challenged them. The Trump administration has not sought to overturn the injunction.)

When those rules were proposed, Severino and a Heritage colleague wrote a scathing critique, saying they jeopardized the religious liberty and freedom of conscience of health care providers.

“By prohibiting differential treatment on the basis of ‘gender identity’ in health services, these regulations propose to penalize medical professionals and health care 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,” Severino wrote with colleague Ryan Anderson.

In a column for the conservative website Daily Signal, Severino and Anderson wrote that the HHS rule would force doctors to perform sex reassignment surgeries. “They would effectively require controversial procedures, such as ‘sex-reassignment’ surgery, that respected medical professionals argue have not been proven effective in treating serious mental health conditions.”

Despite the column’s assertions, federal rules cannot force doctors to perform procedures for which they are not trained or competent. Moreover, professional societies support coverage for gender transition treatments.

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In another column for the Daily Signal, from September 2016, Severino argued that Congress should not give money to Planned Parenthood. “Instead of allowing Planned Parenthood access to new federal funding streams, Congress should be closing the spigot entirely,” he wrote. “Such a move would reflect the simple fact [that] Planned Parenthood has long since disqualified itself from taxpayer money because of its callous disregard for innocent human life.”

A coalition of progressive groups criticized Severino’s appointment.

“I could not think of a more dangerous person to head up the Office of Civil Rights at HHS,” JoDee Winterhof, senior vice president of policy and political affairs of the Human Rights Campaign, said in a statement. “Once again, Donald Trump is declaring war against our community by appointing anti-LGBTQ people at all levels of his administration.”

The Leadership Conference on Civil and Human Rights also expressed its dismay. “This appointment, made without fanfare, is part of disturbing trend by the Trump administration of naming people who disagree or outright oppose the mission or role of an agency or office to leadership positions within those entities,” the group said in a statement.

Before Heritage, Severino worked from 2008 to 2015 as a trial attorney in the Department of Justice’s Civil Rights Division, where he handled cases involving the Fair Housing Act, the Religious Land Use and Institutionalized Persons Act, and the Civil Rights Act of 1964, according to his HHS biography. Before that, he worked as legal counsel for the Becket Fund for Religious Liberty.

Severino is the latest Heritage employee to join the Trump administration. Earlier this month, ProPublica reported that Heritage staffers were among 400 employees the administration has quietly installed across the government, including at HHS. Separately, a recent piece by In These Times chronicled the far-reaching influence Heritage has achieved in the new administration.