Gendered Language in 12-Step Programs

December 20, 2017 Kristance Harlow

Alcoholic Anonymous has a language problem.

Humans are complicated, and 12-step programs do not work for everyone. Substance use disorders do not have a single identifiable cause and there is not a one-size-fits-all treatment. Like most things, treatment options are limited for people who are already marginalized. People of color, especially women and non-cis folks, are at a particular disadvantagewhen trying to access services. Despite opinions on the usefulness of the program, Alcoholics Anonymous (AA) and other 12-step programs are frequently the only options for someone who needs help to stop abusing their substance of choice. They’re free and exist all over the world.

AA is the original 12-step program; all others have been based on its literature. Other programs such as Narcotics Anonymous, Overeaters Anonymous, and Anorexics and Bulimics Anonymous all use the same script with the term “alcoholic” replaced with the relevant description. These other 12-step programs tend to utilize AA’s 12 traditions, a set of suggested guidelines to help groups organize themselves. The traditions state that there is one primary purpose for each group and that is “to carry its message to the alcoholic who still suffers.”

There are some who believe if AA doesn’t work it’s because the person isn’t doing the necessary work and that objections to old-fashioned language and sexist stereotypes are something people have to get over. AA members sometimes say, “The language is archaic, but it works as is. If it ain’t broke, don’t fix it.” Just because something doesn’t harm you, it doesn’t mean it doesn’t harm others.

Linguistics guides us in everything we do. Language provides the primary platform for self-expression and social interactions. Language reflects cultural norms and reinforces social contracts that keep social constructs in place. Addiction has sociocultural roots, and the last thing programs seeking to alleviate addiction should be doing is reinforcing harmful tropes.

There is no denying that AA, as a whole, has not changed its language much since the release of the first edition of the program’s primary text. Alcoholics Anonymous (colloquially known as “The Big Book”) is predicated on outdated sexist stereotypes about men, masculinity, and the role of women in the family. A poignant example is in Chapter 9, which reads, “Liquor incapacitated father for so many years that mother became head of the house…Thus mother, through no fault of her own, became accustomed to wearing the family trousers.”

Tackling this problem necessarily involves considering non-binary identities and trans folks. People of trans experience have few resources at their disposal. At least 30 percent of people who identify as trans report misusing alcohol and drugs “specifically to cope with the discrimination they faced due to their gender identity or expression.” College students who identify as transgender are more likely than peers who are cisgender to drink heavily, have blackouts, and “experience negative consequences from drinking.” Even if they want to get sober, discrimination is rampant within the medical and recovery communities.

The Big Book and other AA publications such as Twelve Steps and Twelve Traditions use “he/him/his” pronouns throughout the text. It is not inclusive to use masculine pronouns as the default when referring to any generic person (such as, “A person is an alcoholic if he cannot stop drinking despite repeated negative consequences”). That causes us to think of alcoholics as men, when the phrase is about all people, regardless of gender. The reliance on generic masculine pronouns is exclusionary. It reinforces early 20th century Western notions of gender roles. The literature’s intent is to help the person with alcoholism or addiction to recover, and generic masculine language makes that mission more challenging. It is not an egalitarian way to disseminate a message of recovery.

If AA is meant to help everyone and anyone who “has a desire to stop drinking” then making the program as inclusive as possible is critical to achieving that goal. Relying more on gender neutral language–by changing “he” to “they,” for example–would be a simple way to be more inclusive but AA has been resistant to modify the language of their primary literature. “They” was voted Word of the Year in 2016 and has been written into dictionaries as a gender neutral pronoun that is plural and singular. (“A person is an alcoholic if they cannot stop drinking despite repeated negative consequences.” That sentence could be about anyone, not just men, and feels less alienating to people who do not identify as a “he.”)

The first edition of the Big Book was edited before publication to cut down on demanding phrases such as “you must.” And the “as you understand Him” was added to qualify “God.” Most of the edits in the subsequent editions of the text were made to the personal stories at the end of the book. Contrary to popular belief, there have been changes to the rest of the book (the first 164 pages) over the years. Numbers have been changed to more accurately reflect membership. No longer does the text say that program members are “ex-alcoholics” and instead says “ex-problem drinkers.” Even some minor edits have been made to gender specific phrases; from “one hundred men” to “thousands of men and women.” In other places, edits added gender where there wasn’t: “That God could and would if [He were] sought” (bracketed words were added).

Kim, an AA attendee, says that her sponsor, sober for 15 years, is a “feminist and doesn’t like the book because of how gendered it is so [they] don’t read [it].” When talking about her own perspective, Kim explains, “It doesn’t bother me too much, I think [it’s] because I’m so used to male-dominated vernacular.” She has bigger qualms with the religious aspects of the book as an atheist.

A commonly invoked argument for keeping the Big Book as it was originally written is that it is important for knowing the history of Alcoholics Anonymous. But AA meetings are not history classes, they’re a place for people to get a “daily reprieve” from their alcoholic thinking. The need for reflection and change is a sentiment that one of AA’s founders and Big Book writers, Bill Wilson, reiterated throughout his life. In 1965 he told attendees of an AA conference, “Our very first concerns should be with those sufferers we are still unable to reach.” Bill W.’s comments recognized “how much and often [AA] failed” “people of nearly every race, culture, and religion” because it couldn’t reach them. This makes AA’s resistance to language changes that much more baffling when viewed in the context of its own history and traditions.

Jenny, sober three years, says she has been able to apply the principles despite some of the problematic wording in the Big Book. She attributes some of that to “alternatives in literature such as the Women’s Way Through the 12 Steps.” She is more concerned about women who don’t know about those resources, and has encountered problems with the primary AA literature when working with other women in recovery.

There are identity-specific meetings to meet the needs of various subgroups of attendees. These are important and helpful, as recovery can be a painful and arduous process and feeling safe is paramount. There are meetings for women, agnostics, young people, LGBT identifying folks, and men (to name a few). Most of these exist in urban centers, but they are barely a blip on the map of AA general meetings around the world. Nearly half of all people on Earth live in rural areas, where there are fewer choices for in-person groups.

Resistance to changing the gendered text of AA literature places an unfair burden on the many people who want to get sober but feel ostracized by the oppressive language. It others people in a program that is specifically meant to be inclusive to all.

Originally published on The Fix.

More Reading
Crisis Intervention / Intervention and Recovery / Research

Shame, Alcoholism, Stigma, and Suicide

April 29, 2022
Domestic Violence / Mental Illness Stigma / Politics

Stop Blaming Mental Illness for Gun-Related Violence

Consent and Assault / Research / Sexual Assault / Victim Blaming

Alcohol and Rape Prosecutions: Consent, Intoxication, and Memory

Addiction / Intervention and Recovery / Prevention / Traumatized Minds

Childhood Trauma, Body Dysmorphic Disorder, and Plastic Surgery Addiction

Addiction / Intervention and Recovery / Science

Long Term Effects of Overdoses on the Brain


  1. j. on December 21, 2017 at 5:01 pm

    Oh, for sure and thank you!

    What is the problem that they would be so self-willed about this blatant oppression?

Leave a Comment

Join the mailing list.

No spam and we will never share your information.

Something went wrong. Please check your entries and try again.

If you or someone you know is in immediate danger, call your local emergency number. The numbers listed here are the commonly used numbers for the stated region, the numbers can vary greatly depending on where you live. If you don't know your country's equivalent to 911, this wiki page and The Lifeline Foundation have comprehensive listings.



The Americas





112 & 999



112, 999, 110



112, 911, 999, 111, & 000


Find help for a crisis by texting, calling, or chatting online with these free crisis organizations. Looking for one outside of the USA? Check out our support listings.

Crisis Text Line
Text: “HOME” to 741741

Suicide Lifeline
Text: “ANSWER” to 839863
Call: 1-800-273-8255

Domestic Violence Hotline
1-800-787-3224 (TTY)

Child Abuse Hotline

The Trevor Project
Text “START” to 678678

These online and international resources may help you anywhere you are located. Looking for local support outside of the USA? Check out our support listings.

DV Support Abroad
Call toll-free worldwide

I'm Alive Virtual Crisis Center
Live chat with trained volunteers

Crisis Connections
24/7 crisis support with interpretation in 155+ languages