The confirmation hearings of Dr. James Holsinger to be U.S. Surgeon General the top doctor on U.S. health policy were already going to be tense, given his past controversial writings about homosexuality. But coming only two days after former Surgeon General Dr. Richard Carmona told a House panel how the Bush Administration meddled in his affairs and forced him to avoid such sensitive topics as stem cells and sex education, Holsinger's appearance was even more of a target for critics who believe the administration is allowing politics to intrude on science and medicine.
That much was clear from the noisy start of the hearings Thursday. Protesting President George W. Bush's nominee, ten members of Planned Parenthood chanted "Hey! Hey! Ho! Ho!/Ideology's got to go!" as hearing attendees filed into the building. Holsinger was appearing before the Senate Health, Education, Labor and Pensions Committee. While the committee took no action on his nomination, a vote is expected before Congress recesses for the summer in August.
Holsinger is one in a series of controversial scientists appointed by the Bush administration. Critics have accused Bush of pandering to the right in his choices of doctors that prescribe prayer for female maladies like premenstrual syndrome, scientists that don't believe in global warming and, as in Holsinger's case, physicians who once wrote that homosexuality is unnatural and could lead to illnesses.
The clamorous entrance was by no means the hardest part of Holsinger's day. Within the first half-hour, Committee Chairman Ted Kennedy, a Massachusetts Democrat, brought a red flush to Holsinger's cheeks when he questioned him about a paper Holsinger wrote at the request of the United Methodist Church in 1991, called "Pathophysiology of Male Homosexuality." It asserted male homosexual practices are unnatural and concluded that "when the complementarity of the sexes is breached, injuries and diseases may occur." Holsinger responded, saying his research was based on outdated information and that he no longer holds that opinion.
Over 70 activist groups sent a letter to Kennedy and the Committee's ranking member, Michael Enzi, saying that they had to "oppose the nomination" because great Surgeon Generals have made decisions "in the face of strong political opposition but faithfully adhered to science". Holsigner's "long documented history of prejudice towards lesbians and gay men [would] further marginalize and stigmatize LGBT people."
Maryland Senator Barbara Mikulski then attacked Holsinger for his work for the Veterans Administration, accusing him of doing little to end systemic sexual harassment in VA hospitals and "indifference" to the health of women veterans. "Have you changed?" Mikulski challenged.
Holsinger said her examples were one-sided and not the full story. Instead of attempting to answer each allegation, he simply responded: "I think you really want to know who I am. "I want to know who you are now," Mikulski snapped back. Holsinger then thanked her and said he looked forward to working with her on Maryland's healthcare.
Senator Patty Murray, Washington Democrat, asked whether Holsinger would advocate abstinence-only sex education. Holsinger said he has not studied the issue and felt uncomfortable answering. He said the same thing when asked about embryonic stem cell research.
Such evasive answers are certain to stoke the concerns of Democrats still reeling from Carmona's testimony earlier this week. Carmona, who served between 2002 and 2006, said the administration forced him to suppress important public health reports, insisted he cite Bush by name at least three times a page in every speech and forbade him to speak or issue reports on stem cells, sex education, and other areas of medicine that proved politically inexpedient to the Bush Administration.
Citing that hearing, Senator Bernie Saunders of Vermont repeatedly demanded assurances from Holsinger that, if confirmed, he would not tolerate the misuse of science for politics. Holsinger responded that he would resign if he felt the administration was inappropriately interfering with his job.
To that end, Kennedy Thursday also introduced legislation to prevent future meddling with the Office of the Surgeon General by making the selection of nominee a much more public process and giving the office financial independence.
"The Office of the Surgeon General has become a morass of shameful political manipulation and distortion of science," Kennedy said. "The Surgeon General must be a person who can be an indisputable respected and trusted voice about the health, wellness and safety."
The Republican members of the committee gave Holsinger the opportunity to highlight his achievements - serving 26 years at the Department of Veteran Affairs, nearly a decade as Chancellor of the University of Kentucky's Medical Center, and his appointment as Kentucky's Secretary of the Cabinet for Health and Family Services. Holsinger said his focus, were he to become Surgeon General, would be to prevent childhood obesity, and even Democrats opposing his nomination praised his resume.
Holsinger's confirmation is by no means assured, though. Gay rights groups and women's health activists pledged to lobby against him in the coming weeks before his confirmation vote.