June 7, 2007 — -- President Bush's nominee for surgeon general, Dr. James W. Holsinger Jr., wrote a paper in 1991 that purported to make the medical argument that homosexuality is unnatural and unhealthy. Doctors who reviewed the paper derided it as prioritizing political ideology over science, and Democratic aides on Capitol Hill say the paper will make his confirmation hearings problematic, if not downright bruising.
Holsinger, 68, presented "The Pathophysiology of Male Homosexuality" in January 1991 to a United Methodist Church's committee to study homosexuality. (Read the paper here.) The church was then considering changing its view that homosexuality violates Christian teaching, though it ultimately did not do so. Relying on footnotes from mainstream medical publications, Holsinger argued that homosexuality isn't natural or healthy.
"A confirmation fight is exactly what the administration does not need," said David Gergen, a former adviser to Presidents Nixon, Ford, Reagan and Clinton, who predicted the paper would cause a "minor storm" among Democrats on Capitol Hill.
"You have to wonder given the quality of some of the nominations that have gone forward recently, whether the selection group in the White House has gone on vacation," Gergen said. "There has been a growing criticism the administration favoring ideology over competence, and this nomination smacks of that."
In its response to the controversy Thursday, the White House avoided directly discussing the controversial paper.
"Dr. Holsinger has dedicated his life to the care of others and public service and his respect for all is evidenced by his actions and his career ," said White House spokesman Emily Lawrimore. "On numerous occasions, he has taken up the banner for under represented populations and he will continue to be a strong advocate for these groups and all Americans. Dr. Holsinger is a highly respected, well-qualified physician and educator. His impressive medical background, which includes leading one of the Nation's largest healthcare systems, decades of service in the armed forces, along with his commitment to combating childhood obesity, will serve him well as Surgeon General. We urge the Senate for a swift confirmation."
But 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.
"That paper was a survey of scientific peer-reviewed studies that he was asked to compile by the United Methodist Church, it's not that he was saying 'this is what I believe,'" Babin said. "It's a reflection of the available scientific data from the 1980s. It should be noted that in 1991, homosexuals were banned from the military and several years before that, homosexuality and Haitian nationality were considered risk factors for HIV/AIDS. Over the last 20 years, a clearer understanding of these issues has been achieved.
Asked about medical experts who disputed that Holsinger's paper expressed opinions timely in 1991 and pressed to explain what Holsinger's views on homosexuality are currently , Babin said, "we look forward to the confirmation process, where we can share Dr. Holsinger's qualifications and views."
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's paper argued that male and female genitalia are complementary -- so much so "that it has entered our vocabulary in the form of naming pipe fittings either the male fitting or the female fitting depending upon which one interlocks within the other." Body parts used for gay sex are not complementary, he wrote. "When the complementarity of the sexes is breached, injuries and diseases may occur."
Holsinger wrote that "[a]natomically the vagina is designed to receive the penis" while the anus and rectum --