“Each patient must be told upfront how much they will pay for an office visit.” The pronoun they refers back to patient. But patient is singular and they is plural. According to the “rules,” pronouns and their antecedents must agree in number—so what gives?
Not that long ago, this sentence would have been written: “Each patient must be told upfront how much he will pay for an office visit.” But we don’t know if the gender of the patient is a he or a she. Those in charge of the English language have never created a gender-neutral pronoun to refer to a gender-neutral noun, so over the centuries, writers relied on their writer’s intuition to do what they felt was correct in a given situation.
In the last few years, however, several of the powers that be in the world of the English language chose the word they as the gender-neutral pronoun.
The American Dialect Society’s website states that 200 of its linguists “voted for they used as a gender-neutral singular pronoun as the Word of the Year for 2015. They was recognized by the society for its emerging use as a pronoun to refer to a known person, often as a conscious choice by a person rejecting the traditional gender binary of he and she…. The use of singular they builds on centuries of usage, appearing in the work of writers such as Chaucer, Shakespeare, and Jane Austen.”
The editors of Time magazine noted that “they is now a recognized and grammatically correct singular pronoun.”
The Washington Post style guide, The Merriam-Webster Dictionary, and the Oxford Dictionary all recognize the singular they as a gender-neutral pronoun. Merriam-Webster points out that “the word they (with its counterparts them, their, and themselves) as a singular pronoun to refer to a person of unspecified gender has been used since at least the 16th century.”
Several gender-neutral pronouns have been invented (ne, ve, ey, ze, and xe), but they have not caught on and never will because they sound like a foreign language and look odd in an English sentence: When the student finished reading the book, ne took a long walk. (with ne taking the place of he or she)