Bush makes controversial appointment of new head of family planning office

BMJ 2007; 335 doi: (Published 25 October 2007) Cite this as: BMJ 2007;335:844
  1. Janice Hopkins Tanne
  1. New York

    In a controversial move President George Bush has appointed Susan Orr as acting deputy assistant secretary for population affairs, to head the Office of Population Affairs at the Department of Health and Human Services.

    Dr Orr, who is not a physician but has a PhD, was widely criticised in the US press because in a 2001 interview with the Washington Post she was quoted as saying that she supported a Bush proposal to stop requiring health plans for federal employees to cover contraception. She was quoted as saying, “We're quite pleased, because fertility is not a disease.”

    Dr Orr has served in the US health department for six years. She was working at the conservative Family Research Council—whose slogan is “family, faith, and freedom”—when she made the controversial statement. The council says that she is not a “foe of contraception” but that she made the statement to make it clear that some federal employees might have the option to choose health plans that did not include contraception, because they did not need or want contraception.

    The Office of Population Affairs advises the secretary of health and human services and the assistant secretary for health on reproductive health topics, including adolescent pregnancy, family planning, and sterilisation, as well as other population issues. The office has a budget of $283m (£140m; €200m) to provide family planning services to more than five million Americans with low incomes.

    President Bush made the appointment on 15 October. Within three days eight Democratic members of the House of Representatives and 19 Democratic senators had asked Mike Leavitt, head of the Department of Health and Human Services, to withdraw the appointment. They called President Bush's choice “yet another misguided decision by an administration that is intent on undermining women's health in the United States” (, 19 Oct, “Washington in brief: Democrats protest HHS appointment).

    Mary Jane Gallagher, head of the National Family Planning and Reproductive Health Association, said the group was “appalled” by Dr Orr's appointment to oversee “the only federal funding for family planning services for the poor and uninsured.” The association runs more than 4000 clinics across the country for people on a low income.

    Last year President Bush appointed Eric Keroack to fill the same post. Dr Keroack is a Massachusetts obstetrician and gynaecologist who opposed abortion and contraception, even for married couples (BMJ 2006;333:1191 doi: 10.1136/bmj.39052.474433.DB). Dr Keroack resigned after the Massachusetts Medicaid office took legal action against him (, 30 Mar, “HHS official facing legal action resigns”). Although the controversy over Dr Keroack's appointment and resignation are entirely unrelated to Dr Orr and her appointment, both appointments have been heavily criticised by pro-choice organisations and some of the US media.

    The Planned Parenthood Federation of America denounced President Bush's appointment of Dr Orr and called on him to replace her with someone better qualified. Cecile Richards, head of the federation, said, “The appointment is a nightmare for anyone who believes in birth control and sex education.” She sees it as further evidence that the Bush administration is intent on appointing an anti-choice sympathiser to head the family planning programme for poor and uninsured people provided under Title X of the Public Health Service Act.

    Ms Richards said, “There are plenty of qualified people who could oversee Title X without pushing an ideological agenda, but we don't believe Susan Orr is one of them.”

    The Wall Street Journal's questions about Dr Orr's attitudes were referred to the Office of Public Affairs, which said that Dr Orr was supporting President Bush's policy allowing freedom of choice and that employees should be able to choose the health coverage they wanted (, 16 Oct, “ Contraception foe named to contraception post”).

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