Those answers will likely not quell the controversy. Critics say the paper certainly seems to be written from Holsinger's point of view.
Noting that Holsinger also belongs to a church that offers a ministry to "cure" gays of the sexual orientation, gay and lesbian rights advocates immediately protested Holsinger's nomination. "His writings suggest a scientific view rooted in anti-gay beliefs that are incompatible with the job of serving the medical health of all Americans," said the Human Rights Campaign in a statement. "It is essential that America's top doctor value sound science over anti-gay ideology."
Democrats will likely be sympathetic to such arguments. Holsinger's confirmation hearing, which has yet to be scheduled, will be heard by the Senate Health Committee, chaired by longtime gay rights advocate Sen. Ted Kennedy, D-Mass. Members of the committee include three Democratic presidential contenders -- Sens. Hillary Clinton, D-N.Y., Chris Dodd, D-Conn., and Barack Obama, D-Illinois -- eager to prove their bona fides during the primary season to the gay and lesbian community.
Holsinger, a professor of preventive medicine at the University of Kentucky College of Public Health, did not return calls for comment.
When announcing his nomination on May 24, Bush said that as "America's chief health educator, [Dr. Holsinger] will be charged with providing the best scientific information available on how Americans can make smart choices that improve their health and reduce their risk of illness and injury."
Holsinger wrote that "[a]natomically the vagina is designed to receive the penis" while the anus and rectum -- 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.