Exclusive: Biden HHS Instructing Employees to Watch Their Pronouns, Leaked Documents Show

L ast June, when Health and Human Services (HHS) secretary Xavier Becerra appeared before the Senate Finance Committee to testify on the Biden administration’s fiscal 2022 budget, one brief interchange stood out: Toward the end of the hearing, Oklahoma GOP senator James Lankford confronted Becerra on an odd shift in the White House budget proposal’s language. “I noticed you changed a term in your budget work,” Lankford said. “You shifted, in places, from using the term ‘mother’ to ‘birthing people.’ Can you help me get a good definition of ‘birthing people’?”

Becerra demurred. “Well, I’ll check on the language there, but I think if we’re talking about those who give birth, I think we’re talking about, uh . . . I don’t know how else to explain it to you.” The removal of the term “mother,” the HHS secretary maintained, “simply reflects the work that’s being done.”

Becerra neglected to discuss the specific nature of that work. But internal documents obtained by National Review confirm that the administration’s gender-neutral language coincides with a coordinated effort at HHS to implement a new set of rules and standards regarding “equity” and “gender-inclusive correspondence.” The guidance, issued last year, does not specifically cover “birthing people” but does prescribe the use of a number of other gender-neutral terms, often valuing pronoun sensitivity over clarity in official correspondence.

This project, ironically, was hinted at as part of the HHS Plain Writing Act Compliance Report, which is released every April and details the agency’s efforts to train employees in “clear Government communication that the public can understand and use” in its “letters, publications, forms, notices and instructions,” as outlined by the Plain Writing Act of 2010. In 2021, the HHS report introduced “a New Focus section on Promoting Equity,” which “focuses on Executive Order (EO) 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government” — via “the use of plainly written and culturally sensitive, unbiased information.” EO 13985, which was the first executive order that President Biden signed, specifically promised to “embed equity principles, policies, and approaches across the Federal Government.”

The compliance report’s discussion of the implementation of “equity principles” was vague. But another document — the 2021 HHS Guide to Preparing Documents for the Secretary, a 51-page internal rulebook that “offers guidance on drafting and clearing documents” for agency heads — provided details and was leaked by an anonymous HHS employee to the American Accountability Foundation (AAF), a right-leaning watchdog group. The guide, which AAF provided exclusively to National Review, lists a number of updates and new sections, including a “new equity section in memos” and a “new standard on gender-inclusive correspondence.”

The new standard on gender-inclusive correspondence instructs HHS employees to “use gender-neutral salutations and forms of address only.” That includes omitting “gendered courtesy titles (Mr., Mrs., Ms.)” in address blocks and in salutations. (“Instead, write ‘Dear,’ followed by the individual’s name, followed by a colon,” the document suggests.) It goes further, advising against gendered pronouns and other terms when in doubt — and even suggesting using the so-called “singular ‘they’” instead:

When writing to an individual whose name is unknown, avoid using gendered salutations (e.g., Dear Sir/Madam). Refer to the context of the communication to identify a suitable, gender-neutral alternative (e.g., Dear colleague, Dear recipient). Similarly, when addressing a group, avoid gendered language (e.g., Dear Sirs/Madams), opting instead for collective salutations that are gender neutral.

In the body of the letter, avoid using masculine or feminine pronouns (he, she) to refer to individuals whose gender or preferred pronouns are unknown. Instead, consider using the individual’s preferred name; using the singular “they,” “them,” and “theirs” pronouns; or using sentence constructions that avoid the use of pronouns.

The new equity section, meanwhile, mandates that department memos, such as those on a rule, “include noteworthy elements about equity and describe how the action will promote equity for individuals belonging to groups that have been historically underserved, marginalized, or subject to discrimination or systemic disadvantage, including those referenced in EO 13985.” (As an example, the guide’s template for a regulation decision memo to the secretary includes a new section titled “Noteworthy Elements about Equity.” The sample section prompts the author to explain how the discussed regulation will affect “individuals belonging to groups that have been historically underserved, marginalized, or subject to discrimination or systemic disadvantage.”)

All this reflects the “whole-of-government equity agenda” that Biden promised in his first executive order. But it’s a departure from the internal HHS guide’s traditional focus on relatively sterile issues regarding grammar, style, and syntax. The 2021 HHS Guide to Preparing Documents for the Secretary mentions “equity” 16 times, including in its directive that all agency documents be reviewed with an eye for “consistency with Administration statements and policy (e.g., equity).” But the 2018 version of the guide, which was also provided to National Review, does not mention “equity” once. It also does not mention “gender” — in contrast with the 2021 update’s mention of the word 14 times — and instructs staffers to use traditional gendered honorifics.

“This is an agency that’s at the frontlines of public health in America,” Tom Jones, the co-founder of AAF, told National Review. “And instead of concerning themselves with looking at sound science . . . they’re getting themselves all wound up about policing pronouns in documents within the building.” HHS, Jones said, “should be spending their time . . . trying to make the country healthier, not fighting over which selected pronoun is used for somebody in a letter from the Secretary.”

The HHS Office of the Secretary has not yet responded to a request for comment.