SAN FRANCISCO—U.S. Surgeon General nominee James Holsinger, who has been criticized by gay rights groups, bowed out of a meeting of the United Methodist top court whose agenda includes dealing with the issue of a transgender pastor.

Holsinger, president of the United Methodist Judicial Council and a Kentucky cardiologist, said he was concerned his nomination could become a distraction.

The council’s docket contains several GLBT-related issues and some church members are holding a vigil and other events to highlight those issues.

Holsinger was nominated for surgeon general by President Bush in May. He has faced criticism for voting to expel a lesbian pastor from the United Methodist Church and writing in 1991 that gay sex is unnatural and unhealthy.

At Senate confirmation hearings in July, Holsinger distanced himself from the 1991 paper, saying that was based on data available at the time and asserting he has “a deep, deep appreciation for the essential humanity of everyone, regardless of their personal circumstances or their sexual orientation.”

The Senate has not yet taken a vote on the appointment.