WASHINGTON, June 8  President Bush’s nomination of Dr. James W. Holsinger Jr., a Kentucky cardiologist, to be surgeon general is drawing criticism from gay rights groups, physicians and lawmakers who say they are troubled by opinions critical of homosexuality that Dr. Holsinger has voiced in nearly 20 years as a high-ranking layman in the United Methodist Church.

Dr. Holsinger’s friends within the United Methodist Church and the medical community, however, are defending him as a professional who does not discriminate against people in his congregation or in his care.

The critics said they were worried that Dr. Holsinger might not serve gay men and lesbians fairly as surgeon general, the nation’s chief health educator, largely because of a report he wrote in 1991 for a United Methodist committee that essentially described male homosexuality as unnatural.

They also point to his service on the board of a Methodist group that in 1998 criticized the “radical homosexual/lesbian lobby” for trying to force the church “to grant approval to the practice of homosexuality.”