James Holsinger University of Kentucky via AP

At his Senate confirmation hearing, Dr. James W. Holsinger sought to offered assurance that he would be a strong voice for public health, unswayed by political ideology, and to answer criticism of his past writings. He said a controversial 1991 paper about homosexuality and health no longer represents his views.

Holsinger's hearing came just two days after the last person to serve in the post told Congress that the Bush administration had manipulated the surgeon general's office for political purposes.

Asked what he would do if pressured to promote ideology over sound science, Holsinger said he could never be persuaded to advocate a position contrary to his conscience.

"I think I have a clear response to that. I would resign," Holsinger told the Senate health committee.

Committee Chairman Edward M. Kennedy, D-Mass., said he was worried that if confirmed, Holsinger would let his own ideological beliefs cloud his scientific judgment. He referred to the paper that Holsinger wrote on homosexuality for a study committee of the United Methodist Church.

"Dr. Holsinger's paper is ideological and decidedly not an accurate analysis of the science then available on homosexuality," Kennedy said. "Dr. Holsinger's paper cherry picks and misuses data to support his thesis that homosexuality is unhealthy and unnatural."

Holsinger said the 1991 writing was not intended to be a scientific paper and relied on the information available to him at the time.

"First of all, the paper does not represent where I am today. It does not represent who I am today," Holsinger said.

Holsinger said he was personally troubled by allegations that he harbors bias against gays.

"I've worked diligently to provide quality health care to everyone regardless of personal characteristics including sexual orientation," he said.

Holsinger said if confirmed, one of his first priorities in office would be to tackle the issue of childhood obesity. He talked about how in Kentucky, where he was secretary of the state's Cabinet for Health and Family Services, he made an effort to put healthier foods in school vending machines and cafeterias.

Before the Senate hearing, gay rights groups, the American Public Health Association and 35 members of the House lined up in opposition to Holsinger's nomination. The Kentucky doctor garnered the support of a prominent former surgeon general, Dr. C. Everett Koop, as well as the American College of Physicians.

Holsinger's paper is interpreted by gay groups and others as saying that homosexuals face a greater risk of disease and that homosexuality runs counter to anatomical truths.

In the paper, which focuses extensively on human anatomy and the reproductive system, Holsinger said the "varied sexual practices of homosexual men have resulted in a diverse and expanded concept of sexually transmitted disease and associated trauma."

Health and Human Services officials said Holsinger wrote the paper when he was asked more than 17 years ago to compile a survey of peer-reviewed scientific data on health issues facing homosexuals.

"Since then, the science has deepened with continued research on these issues. Dr. 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," said Health and Human Services spokeswoman Christina Pearson.

If confirmed, Holsinger would succeed Dr. Richard Carmona, whose term expired last July. Carmona accused the Bush administration on Tuesday of muzzling him on several hot-button health issues, such as abstinence-only education and embryonic stem cell research. He also said the administration quashed or delayed important health reports for political reasons.

Kennedy has said Holsinger's record "appears to guarantee a polarizing and divisive nomination process."

Holsinger is a professor from the University of Kentucky's College of Public Health. He also worked for 26 years in a variety of positions at the Veterans Affairs Department, including stints as chief of staff or director at several VA medical centers.