'Homosexuality Isn't Natural or Healthy'

which "contain no natural lubricating function" -- are not. "The rectum is incapable of mechanical protection against abrasion and severe damage ... can result if objects that are large, sharp or pointed are inserted into the rectum," Holsinger wrote.

The cardiologist details many different diseases gay men can catch, and several sexual practices they may engage in, including "anal eroticism," which can lead to injuries and even death. "From the perspective of pathology and pathophysiology, the varied sexual practices of homosexual men have resulted in a diverse and expanded concept of sexually transmitted disease and associated trauma ?"

In the context of the larger argument in his church as to whether homosexuality should be accepted, Holsinger presented a medical and scientific argument that anal intercourse was not natural.

"It is absolutely clear that anatomically and physiologically the alimentary and reproductive systems in humans are separate organ systems, i.e., the human does not have a cloaca," he said, referring to the posterior orifice that serves as the one opening for genital, urinary and intestinal tracts in amphibians, birds and reptiles. The surgeon general nominee wrote that "even primitive cultures understand the nature of waste elimination, sexual intercourse and the birth of children. Indeed our own children appear to 'intuitively' understand these facts."

A Political Agenda?

Professor Eli Coleman, Director of the Program in Human Sexuality at the University of Minnesota Medical School said that the paper seems to have a pre-1970s view of human sexuality. "I an't imagine that any scientific journal would be able to publish this material because of its very narrow views of homosexuality," he said.

In fact, if one of his students handed the paper in, Coleman would give it a failing grade, he said. "I find it rather outdated in terms of its scientific knowledge and also narrow in its view of homosexuality," Coleman said. "It concerns me because I think our public policy really should be based upon best available science."

"It's a totally faulty paper. The man doesn't know anything about human sexuality," said June M. Reinisch, Ph.D., director emeritus of the Kinsey Institute for Research in Sex, Gender & Reproduction. "There's clearly a political agenda in this paper. This is not a scientific paper."

Paragraph by paragraph, Reinisch said Holsinger presents faulty arguments. Many homosexuals do not engage in the sexual act he criticizes; 40 percent of heterosexuals do. "It seems to me he's arguing the only way reproduction happens is in a loving heterosexual environment which is of course not true," Reinisch said, noting artificial methods, rape and one-night stands.

Reinisch, who was director of the Kinsey Institute when Holsinger wrote this paper, said that if Holsinger "is going to come up with this position in 2007 I think I can clearly say that he is not qualified to be surgeon general."

Holsinger holds a doctorate in anatomy and physiology and an M.D. from Duke University. He spent much of his career working for the Veteran's Health Administration. From 2003 to 2005 he was Kentucky's secretary of the Cabinet for Health and Family Services.