I'm not terribly clear on why the federal government has a surgeon general, but it's been one of the highest-ranked public health positions in the land since Ulysses S. Grant filled it with John Maynard Woodworth in 1871. President Bush's nominee for the vacant seat is one Dr. James W. Holsinger, a University of Kentucky professor. Holsinger has come under fire in the media and among some gay groups, mostly for a research paper he wrote for the United Methodist Church in 1991. While he's not criticized for belonging to the United Methodist Church, which officially believes homosexuality is incompatible with Christian teaching, he's been criticized for belonging to a congregation that has a ministry to homosexuals who desire to leave homosexuality. He's also been criticized for upholding church doctrine on approving same-sex unions or permitting ordination of gay clergy.
But the big news has been over the research paper. Major kudos to the Lexington Herald-Leader and ABC News for posting the paper online. In the paper, which is very brief but contains citations from The New England Journal of Medicine and The American Journal of Forensic Medicine and Pathology, he argues that the male and female sex are "indeed complementary." Nothing terribly earth shattering there. He also goes into great detail about the increased incidences of disease and trauma among those whose sexual behavior involves the gastrointestinal tract. The report was given to a committee studying whether to change the church's position that homosexuality is incompatible with Christian teaching. The UMC retained its position.
Comparing the results of male homosexual behavior to those of male heterosexual behavior used to be a topic for discussion. Suffice to say that such comparisons are not frequently seen these days. I'm not sure why -- if it's changing ideas about the morality of homosexuality or political correctness dominating academia or a changed understanding of human sexuality and its ramifications in the medical community. I really don't know why -- but there has definitely been a change in how we discuss these issues.
It's a very interesting story -- not only because the topic is rather salacious but also because it says a lot about newsrooms, modern culture and how our approach to issues changes over time. One of the things that makes the report difficult to cover is that it basically lists studies showing higher incidences of medical problems associated with anal erotic behavior. Some of it is graphic, as medical issues tend to be. So media reports have focused on this section of the paper, which is written rather clearly and without graphic descriptions:
[I]t is clear that even primitive cultures understand the nature of waste elimination, sexual intercourse, and the birth of children. Indeed our own children appear to "intuitively" understand these facts. I think we should note that these simple "scientific" facts are the same in any culture -- patriarchal or matriarchal, modern or primitive, Jewish or gentile, etc. The anatomic and physiologic facts of alimentation and reproduction simply do not change based on any cultural setting. In fact, the logical complementarity of the human sexes has been so recognized in our culture that it has entered our vocabulary in the form of naming various pipe fittings either the male fitting or the female fitting depending upon which one interlocks within the other. When the complementarity of the sexes is breached, injuries and diseases may occur as noted above.
Sarah Vos at the Herald-Leader characterized that section as follows:
Like male and female pipe fittings, certain male and female body parts are designed for each other, Holsinger wrote in a paper prepared for a United Methodist Church committee studying homosexuality.
Here's how Associated Press reporter Jeffrey McMurray conveyed the report:
Sixteen years ago, he wrote a paper for the church in which he likened the reproductive organs to male and female "pipe fittings" and said homosexuality is therefore biologically unnatural.
Uh, not exactly. He said that it was so obvious how male and female genitalia were complementary and it was so well understood by everyone -- even reporters, one could presume -- that the terms male and female are used to describe pipe fittings. Again, he argues, the complementary nature of the sexes is so obvious that we even use the words male and female in other contexts. To say that he compared male and female genitalia to pipe fittings is to miss the point of his argument and make it seem less nuanced.
Either way, I'm not sure why that portion of the paper is so noteworthy. If it is noteworthy, it makes one pause -- is it possible that the plumbing profession is suffering from heteronormativity? Is it a good thing that plumbers developed their vocabulary before political correctness took over? And how, exactly, would people who oppose Holsinger on this point recommend we rename pipes?
Jake Tapper's article for ABC suffered from a horrible headline but his story was much better. First, the headline:
'Homosexuality Isn't Natural or Healthy'
Bush's Choice for Top Doc Compared Human Genitalia to Pipe Fittings and Said Homosexual Practices Can Cause Injury or Death
Only problem with the headline is that Holsinger neither said nor wrote those words. We've already discussed the problem with the subhead.
Anyway, Tapper actually quoted in detail from the paper and showed some substantive responses to it under the heading "What Holsinger's Paper Argues":
Holsinger's paper argued that male and female genitalia are complementary -- so much so "that it has entered our vocabulary in the form of naming pipe fittings either the male fitting or the female fitting depending upon which one interlocks within the other." Body parts used for gay sex are not complementary, he wrote. "When the complementarity of the sexes is breached, injuries and diseases may occur."
Holsinger wrote that "[a]natomically the vagina is designed to receive the penis" while the anus and rectum -- which "contain no natural lubricating function" -- are not. "The rectum is incapable of mechanical protection against abrasion and severe damage ... can result if objects that are large, sharp or pointed are inserted into the rectum," Holsinger wrote.
The explanation goes on for three more paragraphs. Precisely because summation of controversial issues doesn't work well for reporters, Tapper handled this brilliantly. He explained difficult words, quoted directly and somewhat extensively from the paper and put it in context of the question the church was trying to answer. He also went on to quote a number of people, such as the head of the Kinsey Institute, who surprisingly doesn't agree with Holsinger. The head of the Kinsey Institute also accuses Holsinger of being political, which is kind of funny.
It might have been good to get some quotes from neutral observers, less political observers or more religiously oriented observers. To that end, I thought Vos at the Herald-Leader did a good job of putting Holsinger's professional views -- as opposed to his religious views as a Methodist -- into focus:
Holsinger's colleagues at the University of Kentucky were surprised to learn of the views expressed in the 1991 paper. They said his personal objections to homosexuality -- if he had any -- would not affect policy decisions as surgeon general.
They pointed to a 2002 incident in which Holsinger, then chancellor of the UK Medical Center, defended a session on lesbian health issues at a women's health conference over the objection of two state senators. The senators threatened to withhold funding because of the 90-minute session.
Phyllis Nash, who organized the conference, said Holsinger did not have to be persuaded to defend the session. "He basically said we are obligated as individuals to meet the needs of everyone, regardless of orientation."
At the time, Holsinger defended the session in a Herald-Leader article. "It's important to educate health care professionals on the issues that surround lesbians," he said. "It's important professionals have the knowledge base to do care for these patients in a quality manner."
It was this vignette that made the story particularly interesting for me. Not that we really know the extent of Holsinger's personal views or religious views on homosexuality, but let's say Holsinger has the view that his religious beliefs on this topic should have no bearing on his professional vocation. How does that compare with those Roman Catholic politicians such as John Kerry and Rudy Guiliani who support abortion rights despite their personal view that it is horrible? That it literally destroys an innocent human life? Do you see any differences in how the media treat this issue?
And which angles and approaches on this surgeon general story would you recommend?
NOTE: And since homosexuality is a somewhat controversial subject for some of us, please remember to keep your comments on the topic we discuss here -- how the mainstream media treat religious issues. We're not here to discuss the relative merits of homosexual behavior vs. heterosexual behavior or even how churches handle the issue of sexuality. If you want to discuss those things, please feel free to do so elsewhere.