Surgeon General Nominee Dismisses Homosexuality Paper

President Bush's nominee for surgeon general sought to distance himself yesterday from his controversial 1991 paper on homosexuality and health, saying that it was not a scientific study and that many issues it raised are outdated.

Democrats on the Senate health committee cited the paper in grilling Kentucky cardiologist James W. Holsinger Jr. about whether he could separate ideology from science if he were confirmed.

Much of the hearing was devoted to questions about whether Holsinger would reject the kind of political interference from Bush administration officials that former surgeon general Richard H. Carmona complained of Tuesday in testimony before a House committee.

Holsinger said that he would step down if pressured to put politics above science -- but only as a last resort after trying to educate policymakers on the science and forge a consensus.

"Candidly, if I were unable to do that and I was being overridden, if necessary I would resign," he said.

Carmona, who served from 2002 to 2006, told the Committee on Oversight and Government Reform that Bush appointees routinely vetted his speeches for political red flags, told him to mention the president's name at least three times on every page of his public remarks, and approved or denied his travel appearances with an eye to their political impact. Carmona accused the administration of silencing him on hot-button issues such as embryonic stem cell research and abstinence-only sex education.

Holsinger said he has a track record of bucking political opposition, including his efforts to raise taxes on tobacco in Kentucky, a tobacco-growing state. Yesterday he said he would take on the pharmaceutical industry by calling for a ban on the advertising of drugs directly to consumers.

Gay and lesbian groups and the American Public Health Association have opposed Holsinger's nomination. Among his supporters is former surgeon general C. Everett Koop.

No committee vote has been scheduled on the nomination, and a spokeswoman for the chairman, Sen. Edward M. Kennedy (D-Mass.), said he has not decided how he will vote.

Kennedy said Holsinger's paper was poorly researched and did not reflect the science on sexuality available at the time.

"Dr. Holsinger's paper cherry-picks and misuses data to support his thesis that homosexuality is unhealthy and unnatural," Kennedy said, adding that as surgeon general Holsinger would have to provide medical information "free of interference from his personal views."

Holsinger said he prepared the paper for a study committee of the United Methodist Church. In it, he argued that the sexes are anatomically complementary and that "when the complementarity of the sexes is breached, injuries and diseases may occur."

Holsinger said yesterday that his views had evolved and that the issues he raised in the paper would not be relevant in public health discussions today. "I have a deep appreciation for the essential humanity of everyone, regardless of their personal circumstances or sexual orientation," he said.

Holsinger, 68, a former Kentucky health secretary and onetime chief medical director of the U.S. Department of Veterans Affairs, said that his highest priorities as surgeon general would be fighting childhood obesity, eliminating tobacco use and helping public-health first responders prepare for terrorist attacks and natural disasters.