A Republican state representative in South Dakota, who last week wrote a letter warning of the dangers of anal sex, has now compared it to “taking a dump in your bed”.

Steve Hickey, who sits in the South Dakota House of Representatives, said on his Facebook page: “Pardon a crude comparison but regarding men with men, we are talking about a one-way alley meant only for the garbage truck to go down. Frankly, I’d question the judgement of doctor who says it’s all fine.

“Gay sex is not good for the body or mind.”

The lawmaker argued that doctors should declare homosexuality dangerous.

Hickey had written the remarks as an op-ed for the Argus Leader, South Dakota’s biggest newspaper—but the paper declined to publish it.

In a subsequent video interview to the paper, the Republican made even more homophobic remarks in response to criticism from Dr Kevin Weiland, a doctor and Democrat who had branded Hickey “truly sick”.

Hickey said: “Here’s what I’d like to ask Dr Weiland. Do you tell your patients to wash their hands before they eat? Why? Because you touch a doorknob, and you don’t want to get it inside your body. I hesitate to get crude again, but, Dr Weiland, is it OK for, you know, eight of your friends that you’re in love with to take a dump in your bed and then you can sleep in it all year long?

Argus-Leader Managing Editor Patrick Lalley told Hickey: “Don’t be crude”.