A UMNS Report
By Linda Bloom*
July 13, 2007

Testifying on July 12 in Washington before the U.S. Senate Committee on Health, Education, Labor and Pensions, Dr. James W. Holsinger Jr. said the paper - which focused on physical and medical aspects of homosexual practice - "does not represent where I am today. It does not represent who I am today."

The two-hour hearing was available live over the Internet. A committee vote on his nomination will come at a later date.

Holsinger, 68, a professor of preventative medicine at the University of Kentucky and a former leader of that state's health care system, has been active at all levels of The United Methodist Church, including serving as president of the Judicial Council, the church's supreme court. Gay and lesbian groups and others have criticized the council's homosexuality-related decisions as well as his 1991 paper.

Sen. Edward Kennedy, D-Mass., the committee chairman, expressed concern about whether the paper, titled "Pathophysiology of Male Homosexuality," avoided using all the available science on homosexuality in order to conform to an ideological viewpoint. The paper described gay sex as unnatural.

Holsinger responded that the paper was never published and was not intended to serve as a medical treatise. It was created in response to specific questions from the denomination's committee, he explained, characterizing the paper more as a review of health issues related to homosexuality.

He stressed his commitment "to provide quality health care to everyone" and recalled that in 2002 he came under intense political fire in Kentucky for supporting a women's health conference that included a session on health care for lesbians.

At the United Methodist-related Africa University in Zimbabwe, Holsinger said he led an international team "to put together a plan to deal with the AIDS crisis in sub-Saharan Africa," which resulted in the establishment of a school of health sciences at the university. The university has outreach programs for HIV/AIDS education and prevention.

“I have tried to live out my life in the practice of medicine caring for people regardless of their personal circumstances.”

Sen. Michael Enzi, R-Wyo., the committee’s ranking member, said he had talked with Holsinger and found him to be open, forthcoming, knowledgeable and compassionate — "all of the qualities you would expect from a doctor." 

While Enzi acknowledged criticism from gay rights groups regarding Holsinger, he said the doctor’s peers, co-workers and former colleagues have written the committee in support of the nomination, along with C. Everett Koop, a former surgeon general.

Noting his "deep love" for public service and passion for education, Holsinger told the committee he believes he can meet the challenge of the office. "I think I can proudly serve all Americans as the surgeon general," he said.

The criticism directed against him has been troubling, he added, because it doesn't represent who he is, what he believes or how he has operated as a physician.

"I have tried to live out my life in the practice of medicine caring for people regardless of their personal circumstances," he told the Senate committee members. If confirmed, Holsinger said he will continue to do so "regardless of sexual orientation or any other personal characteristics."

Science vs. politics

Several senators referred to comments made by Richard Carmona, the previous surgeon general, during July 10 testimony before the House Oversight and Government Reform Committee.

Carmona said the Bush administration would not allow him to address such issues as sex education, emergency contraception and stem cell research; required him to mention President Bush numerous times during a speech; and wanted him to take other actions of a political nature. Koop, who was surgeon general under President Ronald Reagan, and David Satcher, who served under Presidents Bill Clinton and George W. Bush, also complained to the committee about political interference with their duties.

Holsinger told Sen. Sherrod Brown, D-Ohio, that if the Bush administration or a future administration tried to force him to modify a position based on strong scientific evidence, "I would use the science to attempt to educate the policymakers involved," adding that if necessary, "I would resign."

At another point in the hearing, he said he would take the same action if he was ordered to do something he considered morally wrong. "I think we cannot have unfettered science without moral and ethnical implications. … It's clear there are balances."

He reiterated his position to Sen. Bernard Saunders, an independent from Vermont, who expressed outrage over Carmona's experiences, likening the situation to "what would have happened in Stalinist Russia."

Saunders told Holsinger that his challenge will be "to convince me and this committee" that he can stand up to such political pressure. Holsinger responded that he has taken "tremendous heat" over decisions in the past, citing his experience as chief medical director of the Veterans Health Administration in 1991 when he issued a directive that all returning Gulf War veterans would be treated at VA facilities.

Philosophy and goals

Sen. Barbara Mikulski, D-Md., was critical of some of Holsinger's decisions during his tenure with the VHA, and both she and Patty Murray, D-Wash., expressed concern about women's health needs and access to care.

Under questioning by Murray, Holsinger said he would "encourage condom use" as a means of preventing pregnancy and sexually transmitted diseases but would discuss with young people all available options, including abstinence.

Holsinger's own goals as the nation's top doctor would include fighting obesity, especially in children, continuing the efforts of his predecessors at "making America a tobacco-free nation" and upgrading the U.S. Public Health Service Commissioned Corps so it is "second to none" in its ability to respond to natural and manmade disasters.

Kennedy noted that Holsinger had voiced opposition in 2002 to a Kentucky bill that would have invoked criminal penalties for embryonic stem cell research and pressed him about whether he would support extending that research beyond the Bush administration's current guidelines. Holsinger declined to give a specific answer, saying he was not well informed about the issue.

*Bloom is a United Methodist News Service news writer based in New York.

News media contact: Linda Bloom, New York, (646) 369-3759 or newsdesk@umcom.org.

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