Until 2019, Matthew Kacsmaryk was a lawyer representing a Christian organization aligned with the religious right. Now a US federal judge, he is set to decide the future of abortion pills across the country.
The 45-year-old Kacsmaryk has been in the spotlight ever since a coalition of anti-abortion activists sued the US Food and Drug Administration (FDA), seeking to overturn the federal agency's approval of mifepristone over 20 years ago.
By filing the suit in Amarillo, Texas, plaintiffs were certain to have Kacsmaryk oversee the case, as he is the only sitting federal judge in the city.
That was not a coincidence, said ACLU project director Jennifer Dalven.
The group behind the suit "was able to hand-select their judge," picking one who "has issued a series of radical decisions" on hot-button social issues, Dalven said.
"In any rational universe, this case would be laughed out of court on multiple grounds."
Conservative opponents to abortion rights have closed ranks around Kacsmaryk, who was appointed by former president Donald Trump and confirmed in 2019 by the then-Republican-controlled Senate.
The judge is "the latest target of judicial intimidation" whose "real offense is his background litigating religious liberty cases," said Carrie Severino, who leads the conservative legal group Judicial Crisis Network.
Before assuming his life-long post as a federal judge, Kacsmaryk was a lawyer for the First Liberty Institute, a Texas-based group that focused on cases surrounding religious freedom.
Those included representing bakers who refused to make a wedding cake for same-sex couples because it violated their Christian beliefs, and supporting a public high school coach who was fired after praying on the field with students.
While at First Liberty Institute, Kacsmaryk openly opposed the Supreme Court's landmark decision to legalize same-sex marriage as well as transgender people's choice to use bathrooms of their gender identity.
In a 2015 article, he decried the "sexual revolution" which he said was "spearheaded by secular libertines."
"Even the unborn child must yield to the erotic desires of liberated adults," Kacsmaryk said.
When the Senate was considering his nomination -- confirmation of the president's picks requires a simple majority -- Democrats were strongly opposed, voting en bloc against him.
Democratic leader Chuck Schumer at the time described Kacsmaryk as having "demonstrated a hostility to the LGBTQ bordering on paranoia."
Kacsmaryk nonetheless vowed that once in office, he would judge impartially without letting his beliefs influence his decisions.
While he has mostly dealt with low-level cases since taking office in Amarillo, Kacsmaryk has already ruled once against the Biden administration when it comes to reproduction-related issues.
Late last year, he ruled that a federal program which funds contraception for minors without their parents' consent was illegal -- although he did not order an immediate halt to the program.
His sister, whose child Kacsmaryk helped place up for adoption when she gave birth at 17, now believes he is the right person to decide the mifepristone case.
"I feel like he was made for this," Jennifer Griffith, still an opponent to abortion rights, told The Washington Post.
"He is exactly where he needs to be."