But Can He Talk About Sex?

Where does future Surgeon General Dr. Sanjay Gupta stand on reproductive health? He has spoken out for emergency contraception, but reproductive health issues haven't gotten a starring role on "House Call."

Since the Obama administration
announced that CNN’s Sanjay Gupta, one of People magazine’s
"sexiest
men alive
" in 2003, might be the next surgeon general, reactions have ranged from
indifferent to outraged. Although Gupta is a neurosurgeon and has been
in the public eye for years – he started his "House Call" show on
CNN in 2004 – many have been scrambling to figure out what this man stands for. 

Two separate controversies
have already arisen since Gupta’s name has publicly been floated as
the next surgeon general. First, New York Times columnist
Paul Krugman lambasted Gupta’s critique of Michael Moore’s
2007 film Sicko, saying that Gupta’s accusation that Moore "fudged
the facts" was, well, just plain wrong. Then Rep.
John Conyers (D-MI) wrote a letter to his fellow Democrats urging them
to oppose Gupta as surgeon general. Conyers claimed that
Gupta would face a "credibility problem," given his lack of experience
in the National Health Service Corp and that "it is not in the best interests
of the nation to have someone … who lacks the requisite experience
needed to oversee the federal agency that provides crucial health care
assistance to some of the poorest and most underserved communities in
America." 

Many bloggers have already
written about Gupta’s lack
of administrative experience
,
his opposition
to marijuana reforms
,
and some of his biggest
medical reporting mistakes
.
But little is known about where Gupta stands on reproductive health.
(Rewire attempted to contact Gupta for an interview, but was
told he isn’t available for interviews at this time.) 

The biggest source on Gupta’s public
record, the transcript archives from "House Call," reveals little;
Gupta’s show has largely avoided the issue. In a 2004 special on the worldwide HIV/AIDS epidemic, Gupta discussed "prevention" abstractly without ever mentioning condoms
or even sex. In another
episode
on the
spread of HIV a few months later, he quotes an HIV-positive man, Peter
Staley, saying, "You can’t stop the spread of HIV unless you talk
about sex." But Gupta’s show doesn’t talk about sex. Instead, it
cuts to an interview with former basketball star Magic Johnson. But the show’s ability to deal with HIV/AIDS improves over the years, and in 2007 "House Call" addressed the problems of transactional sex
in African countries that presents challenges to stopping the spread
of HIV. 

Still, reproductive issues
specifically rarely grace the screen. An entire episode devoted
to "women’s health issues"

covered only the topics of breast cancer, smoking, and heart disease. In
a 2004
special on multiple births
,
he headed up the top of the news program with the news that pregnancies
among girls ages 10-14 were on the decline, which he attributed to "abstinence
programs and birth control," a fairly ambiguous and tentative statement.
Some have suggested that his ties to pharmaceutical companies are too
tight, and that he supported Gardasil while the jury was out on
its safety. 

But when Gupta
was consulted about emergency contraception’s then potential over-the-counter
sale, he confirmed that Plan B was a "high dose birth control pill"
and said that there wasn’t much controversy from the mainstream anti-choice
community because "they think it actually acts before – actually prevents
the insemination part of this and the creation of life," thus quashing
any claims that emergency contraception causes abortion. 

What a Bold Surgeon General Can Do

The public most commonly
knows the surgeon general as the person responsible for putting warnings
on cigarette packages. Yet the surgeon general really serves as
a public health advocate in a broad sense; his or her job is to relate
accurate scientific and medical information to the public to improve
public health. Sticking to that job description, however, might land
a surgeon general in trouble. President Ronald Reagan’s surgeon general,
C. Everett Koop, learned that lesson the hard way.  

Koop discovered that much of the information put forth
by anti-choice groups claiming abortion had negative psychological implications for women wasn’t backed up by science. He then released a statement
that "the available scientific evidence about the psychological
sequelae of abortion simply cannot support either the preconceived notions
of those pro-life or those pro-choice." His position, viewed by
many as an open rebuke to the religious right, cost him the position
of Secretary of Health and Human Services under President George H.W.
Bush. 

Dr. Jocelyn Elders, the surgeon
general under President Bill Clinton and only the second women to ever
hold the position, only served for 18 months. She resigned after a statement
she made before the United Nations about masturbation; she said it is
"part of human sexuality, and perhaps it should be taught." Today
Elders realizes that many of the challenges she faced have remained
the same. (The full transcript is available here.) 

Part of the job of surgeon
general for her, as it would be for Gupta, was  to sell health care
reform to the public. "You have to remember that we were trying to
get through the Clinton health plan at the same time," she said. And in this respect, she thinks Gupta would excel: "I
think Dr. Gupta has been out there working very hard trying to communicate
with the American people. I think he would be an excellent communicator." 

Elders had a very different
public perception when she was appointed than Gupta does. "Everybody
knew when I came to Washington that I was interested in reducing teenage
pregnancy, that I was very into reproductive health," she said. She
doesn’t know where Gupta stands on reproductive health, but "he
has 6,000 public health people who will be working for him who are the
best in the world."  

Still, Elders expects that
many of the reproductive battles ahead will be on the list of battles
she faced: combating thfe spread of HIV/AIDS, advocating for fully funding
Title X to ensure comprehensive family planning, and calling for public funding of abortion for women on Medicaid. "I think we need to get over our ideas
about how condoms will break. We know condoms will break, but the vows
of abstinence break far more frequently than latex condoms," Elders
said. Gupta, if confirmed, might do well to remember that.