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Policy & Politics

HIV Medicine Association, Other Groups Oppose Bush Surgeon General Nominee

July 12, 2007

The HIV Medicine Association and other groups -- including the American Public Health Association and some gay and lesbian organizations -- have announced their opposition to President Bush's surgeon general nominee, James Holsinger, ahead of his Senate confirmation hearing on Thursday, Reuters/Scientific American reports (Dunham, Reuters/Scientific American, 7/11). Thirty-five House members also have expressed their opposition to Holsinger's nomination, according to the AP/International Herald Tribune (AP/International Herald Tribune, 7/12). Bush nominated Holsinger on May 24 to succeed former Surgeon General Richard Carmona, who ended his term last year with no replacement.

HIVMA, APHA, the Human Rights Campaign, the National Gay and Lesbian Task Force and other groups in their opposition to Holsinger cite in part a document he wrote in 1991 called the "Pathophysiology of Male Homosexuality," according to Reuters/Scientific American. The document was written to a United Methodist Church panel studying homosexuality (Reuters/Scientific American, 7/11). In the document, which focuses on anatomy and the reproductive system, Holsinger wrote that the "varied sexual practices of homosexual men have resulted in a diverse and expanded concept of sexually transmitted disease and associated trauma" (AP/International Herald Tribune, 7/12). Holsinger also called anal sex unnatural and gave an anatomical explanation.

HIVMA, which has 3,600 members, announced its opposition to Holsinger on Monday (Reuters/Scientific American, 7/11). Holsinger's "perspective on homosexuality places him well outside the medical mainstream and raises questions about his ability to provide national leadership on behalf of all of our nation's people and to address one of our country's most critical public health problems," HIVMA Chair Daniel Kuritzkes wrote in a letter to Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.). He added, "These views are of particular concern because of the disproportionate impact of HIV/AIDS on men who have sex with men, especially gay men of color, as we try to reduce the 40,000 new HIV infections in the nation each year" (HIVMA release, 7/9).

APHA, which has 50,000 members, announced its opposition to Holsinger on Wednesday on similar grounds. "At a time when one of our association's top priorities is to eliminate disparities in health, including disparities in the gay and lesbian community, we cannot support a nominee with discredited and nonevidence-based views on sexuality," APHA Executive Director Georges Benjamin wrote in a letter to the Senate HELP committee (Reuters/Scientific American, 7/11).

Former Surgeon General C. Everett Koop and the American College of Physicians have expressed their support for Holsinger. HHS officials have said that Holsinger more than 17 years ago was asked to compile data on health issues facing MSM. "Since then, the science has deepened with continued research on these issues," HHS spokesperson Christina Pearson said, adding that Holsinger "remains focused on addressing the health of all in need, including gay and lesbian populations, consistent with sound science and the best medical practices" (AP/International Herald Tribune, 7/12).

Online The New York Times on Thursday published an opinion piece by five experts suggesting 15 questions senators should ask Holsinger, including ones dealing with HIV/AIDS and needle-exchange programs.

Kennedy, Rep. Waxman Write HHS Secretary Leavitt Asking for Documents Related to Surgeon General Carmona's Tenure
In related news, Kennedy and Rep. Henry Waxman (D-Calif.) on Wednesday wrote to HHS Secretary Mike Leavitt and asked for documents relating to Carmona's tenure as surgeon general (Reuters/Scientific American, 7/11). Carmona on Tuesday in a hearing with the House Committee on Oversight and Government Reform said the Bush administration routinely blocked him from speaking about or issuing reports on certain issues -- including human embryonic stem cell research, abstinence-only sex education, emergency contraception and other sensitive public health topics -- while he was serving in the position. Carmona, a former professor of surgery and public health at the University of Arizona, was nominated by Bush to serve as surgeon general from 2002 to 2006 (Kaiser Daily HIV/AIDS Report, 7/11). Waxman asked for the documents by July 25 and Kennedy by July 27 (Reuters/Scientific American, 7/11).

Online Kennedy's letter and Waxman's letter are available online. Note: You will need Adobe Acrobat to view Waxman's letter.

NPR's "Morning Edition" on Thursday reported on issues related to Holsinger's nomination, including objections from HRC and other groups. The segment includes comments from Stephen Wyatt, dean of the University of Kentucky College of Public Health; Joe Solmonese, HRC president; and Maria Kemplin, who was a project manager in Holsinger's office when he was chancellor of University of Kentucky (Silberner, "Morning Edition," NPR, 7/12). Audio and a partial transcript of the segment are available online.

Several newspapers published editorials in reaction to Carmona's comments. Summaries appear below.

New York Times: Carmona's testimony "sounds so ham-handedly partisan that it would be laughable if it weren't so damaging to the public's understanding of important public health issues," a Times editorial says. House and Senate oversight committees "must look for ways to protect" the surgeon general from "future political interference," the Times writes, adding that Congress could give the surgeon general's office its own staff and budget and could "ban any effort to censor or delay the surgeon general's reports and speeches" (New York Times, 7/12).

  • Philadelphia Inquirer: "What happened to Carmona was a sickening politicization of an appointed post that should be a source of unassailable credibility on public health issues," and it "fits a pattern in the Bush White House of willfully ignoring science when the research clashes with political goals," an Inquirer editorial says. The editorial concludes that Congress should take actions to ensure the surgeon general is "on call for the public, not for a political party" (Philadelphia Inquirer, 7/12).

  • USA Today: Although it does not "speak well of Carmona that he accepted the muzzling" of the Bush administration, his "forthrightness" is "at least timely" because of confirmation hearings scheduled for his nominated successor, Holsinger. The editorial concludes that despite difficulties in "bucking" a president's policy, "independent leaders" are needed to protect the public's health (USA Today, 7/12).

  • Wall Street Journal: Officials of any administration are "expected" to "support the policies of an elected president," and if Carmona "really thinks that the surgeon general should be above politics, 'naive' is not the first adjective that comes to mind," a Journal editorial says. If Carmona "disagreed so profoundly" with Bush's policies, he could have resigned or spoke "up anyway and face[d] the consequences," the editorial says, concluding that either option would have been "more honorable" than his "late hit on the president who appointed him" (Wall Street Journal, 7/12).
  • Back to other news for July 2007

    Reprinted with permission from You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at The Kaiser Daily HIV/AIDS Report is published for, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2007 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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    This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
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