Quick: name the Surgeon General of the United States. Can you do it? I couldn’t. I know all about the guy who is being nominated and nothing about the one who is currently serving. I had to look him up on Wikipedia. He is Rear Admiral Kenneth P. Moritsugu PHSCC, M.D., M.P.H., and he has been acting Surgeon General since his boss, Vice Admiral Richard Henry Carmona, M.D., RN, M.P.H, F.A.C.S., finshed his term in 2006. (For the record, David Satcher is the last surgeon general I have a clear memory of!)
On Thursday, the man selected to replace Moritsugu and take on the full mantle of surgeon general will have his confirmation hearings in the Senate. His name is James Holsinger and it’s a good bet you’ve heard of him. You may have heard that his nomination is a controversial one because he is a conservative Christian or because he has expressed the view that homosexuals are diseased and pathological, and both of those things are true. But he is controversial mostly because he used weak science and faulty reasoning to try to back up his view that homosexuality is pathological. It is that use of unscientific argument disguised as science that makes him an upsetting candidate to take on the job of top public health educator in the US.
This is a link to the paper that is the basis for all this criticism (PDF, hosted on ABCnews.com). Holsinger wrote it in 1991 for the United Methodist Church’s Committee to Study Homosexuality. The main text is only 6 pages long so go ahead and read it. I’ll be here when you get back.
Done? Good. So you probably have some questions, and so do I. Let’s lay some of them out. My first question comes after reading the second paragraph, which begins, “There is absolute concensus in the scientific community concerning the structure and function of the human alimentary and reproductive systems.” Holsinger goes on to explain that they are entirely separate systems in humans (as we do not possess cloacas, something he returns to later), and then explains how the reproductive systems of men and women interact to produce baby humans.
Now, I’d bet that there is no debate in the scientific community that the two systems are separate, nor that only one of them functions in a way that absorbs nutrients into the body while only the other functions in a way that causes reproduction when properly combined with the right other reproductive organs. But, how many scientists would agree that each system has only one function? And how many would deny that both systems can function in ways that create pleasure? Or would contend that pleasure is not an important part of human existence?
So one question I would ask at Dr. Holsinger’s nomination hearing on Thursday is this:
Dr. Holsinger, do you believe that public health policy and health education should ignore the ways that we use our bodies for pleasure, and should omit information about how we can do so safely?
My second question comes after a description of how the anus and rectum do not lubricate in the way that a vagina does, and so can be damaged by penetrative sex. From this observation he argues that “the varied sexual practices of homosexual men have resulted in a diverse and expanded concept of sexually transmitted disease and associated trauma.” He cites a study that I wont attempt to evaluate because I haven’t read it yet. The section he sites notes findings that bisexuals, heterosexuals, and homosexuals had different rates of assorted sexually transmitted diseases. Without commenting on the quality of the research, I can say about this is that his use of the study, whatever its own merits, doesn’t support his argument. He is trying to argue that homosexual sex is pathological and heterosexual sex is not, and he presents evidence that every group gets STDs, but that those STDs are distributed differently across groups. In the study, more homosexuals than heterosexuals get things like amoebiasis and giardiasis while heterosexuals are more likely than homosexual to have urethral gonorrhea and or chlamydia. Unless he’s willing to argue that only some STDs are signs of pathology while others are just fine, I don’t see how this helps his argument.
So, my second question for Dr. Holsinger at his nomination hearings would be this:
Dr. Holsinger, would you say that some diseases are markers of pathology in a person while others are not? If so, which diseases are markers of heathly lifestyles and which are markers of pathological lifestyles?
My third question comes from a strange quote he uses to support the claim that “trauma and tumors are the primary problems related to the anorectum in homosexual men.” He quotes a study that found that women who engaged in “anal-receptive intercourse” did not suffer from anal-sphincter dysfunction and rarely suffered from anorectal problems in general, partly because “consensual penile-anal intercourse can be performed safely provided there is adequate lubrication.” Ignoring that finding even though he cites it, Holsinger then goes on to decry the dangers of fisting and of unlubricated forceful anal sex.
So my third question would be this:
Dr. Holsinger, is it safe to say, based on your writing, that you only think homosexuality is pathological if it does not involves enough lube? In other words, would it be a key part of your public health policy to educate people about the value of proper lubrication? Or, rather, would you suggest that no sex that requires lubrication not supplied by the body itself can ever be healthy sex?
Last, I am puzzled by Holsinger’s claim that squamous-cell anal cancer, which is associated with HPV virus strains that cause genital warts is further evidence of the pathology of homosexuality. After all, those same strains cause genital warts in women, and lead in some cases to cervical cancers (for which we are all supposed to be screened annually or every two years, and which are often contracted through heterosexual contact).
So my fourth question would be:
Dr. Holsinger, how can a disease that occurs frequently in women who have heterosexual sex be used as evidence that homosexual sex is pathological, but not used as evidence that heterosexual sex is pathological?”
He ends his paper with an analogy to pipe fittings in order to illustrate just how taken-for-granted the sense of male-fitting-into-female is in our culture, and notes that injuries and diseases result “when the complimentarity of the sexes is breached.”
I do not want a man who reasons this way to be my Surgeon General. It is not his private views on homosexuality that are the problem, though I strenuously disagree with them. It is certainly not his privately held religious convictions, so long as could keep them separate from his scientific evaluation of evidence.
No, it is his inability to weigh scientific evidence to come to logical conclusions that is the problem. Perhaps Holsinger has gotten smarter in the 16 years since he wrote that article. I hope that difficult questions are asked during his confirmation hearings so we can discover whether he can now reason more logically than he could in 1991.
For updates during the confirmation hearings on Thursday, check the HRC web site’s blog.
To let your Senator that you oppose Holsinger’s nomination, you can use this HRC Action Form.