Apart from the words that came out of his mouth, there was no reason to suspect that Ben Carson might have been unaware of the rolling cameras yesterday when he explained in a CNN interview that homosexuality is "absolutely" a choice.

The neurosurgeon turned presidential hopeful, Americans' sixth most admired man, engaged in the following exchange with journalist Chris Cuomo:

Cuomo: You think [people] have control over their sexuality?

Carson: Absolutely

Cuomo: You think being gay is a choice?

Carson: Absolutely

Cuomo: Why do you say that?

Carson: Because a lot of people go into prison straight, and when they come out, they're gay. So, did something happen while they're in there? Ask yourself that question.

Cuomo: Most gay people never go to prison—

Carson: Hold on. I said a lot of people who go in, come out [gay]. Are you denying that that's true?

Cuomo: I am not denying that's true, I'm denying that's the basis of homosexuality.

Where to begin. I am denying that's true. Ben Carson—or, Dr. Ben Carson, as he's usually referred to, in full—often tells people to ask themselves questions. It's a clever move. Make an anecdotal observation and then leap to some expansive question that does the work of implying a case without the burden of making one. Then let it linger rhetorically. Smile if you can.

I do deny that incarceration inclines people to some voluntary sexual reorientation. Set aside the conflation of prison rape and its psychological trappings, or this country's deeply disturbing history of attempting to "convert" non-heterosexual people to heterosexuality. If there were evidence out there to the contrary, showing that people identify as gay subsequent to imprisonment, it would be specious. It wouldn't mean that said people were not gay beforehand, openly or otherwise. That's part of why sexuality is extraordinarily difficult to study and impervious to classifying in tidy columns; identifying is different from practicing, not to mention the ever-unknown number of people repressing, denying, or lying to themselves and others—all of which happen because of the intolerant culture that Carson perpetuated yesterday.

Carson himself, on reflection, seemed to understand the problem to some degree. "I do not pretend to know how every individual came to their sexual orientation," he wrote in a statement posted to the Dr. Ben Carson Facebook page after the interview. "I regret that my words to express that concept were hurtful and divisive. For that I apologize unreservedly to all that were offended."

Carson went on to reiterate his prior support for civil rights, civil unions, and state-level decision making on gay marriage. "We are all deserving of respect and dignity," he wrote. It is the sort of apology rarely tendered by public figures, and a reminder of Carson at his empathetic best.

But as a summary of science, it was as deficient as his original remarks. "I'm a doctor trained in multiple fields of medicine, who was blessed to work at perhaps the finest institution of medical knowledge in the world," Carson wrote. "Some of our brightest minds have looked at this debate, and up until this point there have been no definitive studies that people are born into a specific sexuality." At best, this is misdirection. At worst, it is deliberate duplicity.

To say that there are no "definitive studies" is to ignore what is known; to focus on whether people "are born into a specific sexuality" imposes a false simplicity on a complex subject. In many parts of the world, homosexuality is illegal, even punishable by death. Acknowledging biological roots for variation in sexual orientation within populations—that such variation is not a simple choice or a malady—has been important to combating those archaic mindsets and practices. In more progressive places, the idea of a biological element has helped combat notions that people can and should attempt to change themselves, which have only led to deeply disproportionate rates of suicide, self harm, and depression among people who do not identify with heterosexual standards.

Ben Carson has been traveling the country for three years peddling books and sanctimony on the coat tails of his once-prestigious medical career because, as he explained it to me when we met last spring, God is telling him to. He consistently highlights his impoverished childhood and love of the Constitution. He poses as a concerned citizen and humble servant. But the man who has never held political office yet believes that he may have been called to the highest office in the land spreads oppression. And gaffes are gaffes; but Ben Carson is not a man of gaffes.

He has said that the U.S. is "much like Nazi Germany," and then stuck by it. He has repeatedly described universal healthcare as a neomarxist plot to control society, endorsed creationism, and argued for voter ID. And on the point of the nature of human sexual orientation, yesterday was no gaffe. He has before likened homosexuality to bestiality and pedophilia. In his ignorance and willingness to speak it, Ben Carson does disservice not only to people of marginalized sexual orientations, but to all doctors and scientists.

The politicization of matters of science is detrimental to scientific progress in multiple dimensions. But politicians like Rand Paul, who is among many others who also hold an M.D., do not use the title "Dr." as some blanket claim to authority on all matters. Carson brandishes his degree like so many Ozes, Phils, and Nicks. He presents his ill-founded opinions on national television not as opinions, but as facts, the word of a doctor that he might occasionally deign to explain. When he begins speaking on matters of human behavior and sexuality, one could easily be misled into thinking that he does in fact represent the consensus of a scientific community, or at least one side of a legitimate debate. He does not.

A while back, I spoke with Michael Weiss, M.D., Ph.D., M.B.A. (take that, Ben Carson, M.D.) who is chair of biochemistry at Case Western Reserve University. He has done extensive research on sex determination and infertility. Specifically the question at the center of so many of the misconceptions that fuel debate around gay marriage: If homosexuality is genetically based, then as a matter of natural selection, how and why would those genes persist?

As with any complex human behavior, reasonable people do disagree on the relative influence of psychosocial factors in shaping a person. The search for a "gay gene" has far from panned out, and the notion of a solely and entirely biological mechanism for sexual orientation is simplistic. The search for explanations among the scientific community has shifted from nature-versus-nurture to nature and nurture. But that does not make sexual orientation a simple "choice."

Weiss's understanding is that homosexuality and bisexuality persist in populations as consequence of genes that favor diversity in populations. He cites a term for this concept in genetics, coined by Stephen Jay Gould: spandrel. The word is reappropriated from architecture. There are some beautiful artistic features of the arches in Saint Mark's Cathedral in Venice that a person could point to and say, what was the architect thinking? What was the function of this triangular space? It must serve an important weight-bearing role or some other function in the architecture. But actually, the structures, spandrels, were just consequences other design features. In this metaphor, there’s no spandrel gene.

"It’s possible that gay and bisexual behaviors, though they reduce the likelihood of an animal to reproduce, are the consequence of having diversity in a population—to make our groups and societies work in a way that people are playing different roles in the culture, and the tribe or group is more successful; more productive," Weiss said. "And I think there’s a tremendous humane value, and ethical implication of having this viewpoint."

Carson's eminence within the field of pediatric neurosurgery is not disputed, but the procedures he did so well for so many years lend no credence to his intellectual prowess or ethical standards outside of the surgical theater. Whatever testament to character his medical career offers might be mitigated by things like plagiarism in his book and years spent endorsing supplements that claimed to fight cancer with "glyconutrients"—which sound healthy, but are actually just another name for simple sugars.

The multidimensional, multifactorial nature of sexuality only adds to its elegance as a central tenet of the human experience. Ben Carson tied Ted Cruz in the most recent straw poll, with 11 percent of the Republican vote. The odds of him winning the party's presidential nomination, though, are small. The odds of him continuing to speak widely and authoritatively on matters well outside of his purview are not.