His controversial 1991 paper argues 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.
Doctors who reviewed the paper -- written for a United Methodist Church's committee to study homosexuality -- derided it as prioritizing political ideology over science.
Kennedy previously said in a statement, "I am disappointed that the administration looked past the many talented physicians who have a record of bringing people together and instead chose an individual whose record appears to guarantee a polarizing and divisive nomination process. Our committee has the responsibility to assess whether Dr. Holsinger can serve effectively as surgeon general for all Americans."
House Democrats set the stage for the hearing, which is expected to be contentious, by publicly interviewing Dr. Richard Carmona, the surgeon general from 2002 to 2006, who claimed that the Bush administration suppressed public health information because of the administration's conservative ideology.
"The vetting was done by political appointees who were specifically there to be able to spin, if you will, my words that would be preferable to a political or ideological preconceived notion that had nothing to do with science," Carmona testified.
White House spokesman Tony Snow Wednesday told reporters that "nobody, as far as I could tell, was 'muzzling' him. But on the other hand, there is certainly nothing scandalous about saying to somebody who was a presidential appointee, you should advocate the President's policies."
Other surgeons general -- Dr. David Satcher, who served in that role under President Clinton, and C. Everett Koop, who served under President Reagan, also told stories about political interference.
"Mr. Reagan was pressed to fire me every day, largely because of my work on AIDS, but he would not interfere," Koop testified. "Over the years since I left office I've observed a worrisome trend of less than ideal treatment of the surgeon general, including undermining his authority at times when his role and function seemed abundantly clear. Clearly, the surgeon general must be free to serve the American people without political interference."
What Democrats seem to fear is that Holsinger is precisely the kind of doctor who wouldn't need any political interference since he already is guided more by political considerations and theology than science. Some conservative groups, however, are also opposed to Holsinger's nomination, because in 2002 he spoke in favor of embryonic stem cell research. A White House spokeswoman said that Holsinger no longer feels the same way because of advances in stem cell research that does not involve human embryos.
Beyond that, the White House has generally not addressed the controversy.
Holly Babin, a spokeswoman for the Department of Heath and Human Services -- the agency that will take the lead on trying to achieve Holsinger's confirmation -- insisted that the paper was by no means reflective of Holsinger's thinking.