WASHINGTON — At a confirmation hearing on his qualifications to be surgeon general, Dr. James W. Holsinger today disavowed a controversial 1991 church paper on homosexuality that had sparked charges that he was anti-gay and unscientific. He also said he'd quit rather than bow to political pressure such as his predecessor said he had endured.
The Methodist church paper Holsinger wrote that came to light after his nomination by President Bush in May sparked a backlash from gay-rights advocates and others. It was one of many points of contention between Holsinger, the former University of Kentucky Medical School chancellor, and members of the Senate Health, Education, Labor and Pensions Committee.
Holsinger worked to get his priorities across - that he would use the "bully pulpit" of the surgeon general's office to fight childhood obesity, eliminate tobacco use in America, and prepare the public health service to meet the next disaster. He got glowing introductions from Kentucky Senators Mitch McConnell and Jim Bunning.
Then the committee grilled Holsinger for two hours about the homosexuality paper, his history with female veterans, and his position on condom use, among other things. Two senators said later they were not impressed with his answers.
Sen. Edward Kennedy, D-Mass., committee chairman, returned repeatedly to the paper, titled Pathophysiology of Male Homosexuality, pointing out research flaws that Kennedy said called into question Holsinger's credibility.
Holsinger denied any suggestion that he had padded the bibliography, and said the paper was written for a Methodist church council, not other scientists. "I think the issue is very different today. We're now 20 years later; I don't think we'd be asking the same questions."
Finally, Kennedy put it to him point-blank: "I've got to know where you stand on that document."
"That paper doesn't represent where I am today, who I am today," Holsinger replied. "It is not a published paper. It was not meant to be a scientific paper, not meant to be published."
Holsinger also was asked pointedly how he would deal with political pressure to place ideology over science. Bush's first surgeon general, Dr. Richard Carmona, on Tuesday testified that the administration had repeatedly muzzled him, censored his speeches and buried science that didn't match party ideology.
"What happened to Dr. Carmona sounds more like what happened in Stalinist Russia," said Sen. Bernard Sanders, I-Vt. He asked Holsinger what he would do.
"If I were faced with a situation which I could not in good conscience do, I would resign," Holsinger said. Earlier in the questioning, he had said, "I am committed to using science as the method under which I deal with issues that might come before the surgeon general."
He said he has taken politically unpopular stands before, citing an incident in 2002 when the University of Kentucky Hospital's Women's Health Center came under fire for addressing the health needs of the lesbian community. "I fought fiercely for that, even when our budget was threatened," Holsinger said.
Sen. Patty Murray, D-Wash., pressed him further. "Would you be troubled if the White House or Health and Human Services were to edit your speeches?"
Holsinger said he would try to talk to them first, and reach a consensus. "If I couldn't, I would quit," he said.
Murray pointed to Carmona's statement that the White House had ordered him not to talk about sex education, but to "preach abstinence-only" despite scientific studies that show the approach does not work. She asked Holsinger what he would do.
Holsinger said he wouldn't be able to "sign off" on that. Murray asked whether he had a problem advocating condom use. "I would encourage condom use" as one appropriate method of preventing unplanned pregnancies and the spread of sexually transmitted diseases, he said.
Evidently his answer did not seem straightforward enough. Alex Glass, spokeswoman for Murray, said later, "I don't think she was satisfied with his responses. She definitely still has concerns."
The harshest questioning came from Sen. Barbara Mikulski, D-Md., who clashed often with Holsinger when she chaired a subcommittee that handled Veterans Affairs appropriations while Holsinger was the VA's chief medical director.
She accused Holsinger of indifference to the needs of female veterans and ignoring sexual harassment complaints at a VA hospital in Atlanta. "Instead of rigorously investigating numerous sexual harassment complaints within the VA, you were dismissive and adopted a culture of silence," Mikulski said. "What has changed?"
Holsinger said that as the father of four daughters he is deeply concerned about women's health. "I hope you will give me the opportunity to work with you," Holsinger said.
After the hearing, Mikulski's office said her opposition to Holsinger had not changed. "She was not moved by his answers," said spokeswoman Melissa Schwartz.
Three Democratic senators on the panel who are presidential candidates and who had publicly expressed reservations about Holsinger - Sen. Hillary Rodham Clinton, Sen. Barack Obama, and Sen. Christopher Dodd - did not attend the hearing.