By Martha Doyle
BBC's Religious Affairs reporter
Conservatives say the American church has broken the rules
Now that the first openly-gay cleric Anglican bishop has been confirmed, the question in church-watchers' minds is whether Gene Robinson's appointment will really lead to the break-up of the 500-year-old Anglican Communion.
The answer is far from straightforward. Since the vote, both liberals and conservatives have repeatedly stressed that they do not want the historic communion to split.
At the same time, they reiterate their differences on whether or not they can accept practising-gay clergy in a way that looks increasingly incompatible and irreconcilable.
To liberals, it is a matter of progress and tolerance, while to conservatives, who take a more literal interpretation of scripture, homosexuality remains sinful.
The position that the church finds itself in can partly be attributed to a decision taken in 1998 at the last Lambeth Conference of Anglican bishops.
A resolution was passed which, roughly speaking, accepted gay worshippers as full members of the church, but ruled that homosexual practice was incompatible with scripture and said gay people should remain celibate.
It was not backed by a number of American bishops.
Consequently, conservative evangelicals, like the UK-based Church Society, insist that by confirming Gene Robinson as Bishop of New Hampshire, America's Episcopalian Church has broken this rule and put itself outside the communion.
Some evangelicals are urging the Archbishop of Canterbury to formally cut ties with the American church.
However, the real battle lines in this dispute were drawn in June, during a similar debate in the UK over the appointment of the openly-gay, but celibate, Canon Jeffrey John as Suffragan Bishop of Reading.
Conservative evangelicals - determined not to be consigned to a minority anti-gay protest group within the Church of England - began to rally like-minded Anglican leaders worldwide.
Key among them were bishops from the developing world.
The row could have far-reaching consequences for the church
More than half of all Anglicans live in Africa. Many belong to staunchly conservative societies where homosexuality is not accepted.
Together, they set up a growing network called the Anglican Mainstream, claiming to represent the moral consensus of the church.
The world's media increasingly talks of a "church split", but what the conservatives are really saying is that they are not going anywhere.
Rather, they are accusing the pro-gay liberals of already having left the church, by diverging from current church teaching in approving practising gay clergy.
This is a far more complicated scenario than an actual schism.
Its outcome is far less predictable and it could ultimately involve a battle for both the soul of the church and its property.