People-first language

People-first language (PFL),^[1] also called person-first language (PFL), is a type of linguistic prescription to avoid marginalization or dehumanization (either conscious or subconscious) when discussing people with a health issue or disability. It can be a type of disability etiquette but more often is applied to any group that would otherwise be defined or mentally categorized by a condition or trait (for example, disease, age, disability, or appearance) rather than as a group of people who have that condition or trait. Rather than using a label or an adjective to define someone, person-first language puts the person before the diagnosis and describes what the person has (for example, "a person with diabetes" or "a person with alcoholism"), not an assertion of what the person is (for example, "a diabetic" or "an alcoholic"). Thus a person is foremost a person and secondly a person with some trait. Advocates of person-first language point out that failing to mentally separate the person from the trait tends to reinforce a sense (even if only subconsciously) that both the trait and the person are inherently bad or inferior and thus tends to marginalize or even dehumanize the person. It also tends to implicitly reinforce a sense of permanency even regarding issues that are temporary; for example, a person with a substance use disorder has a fair chance of achieving long-term remission—many years in which he is healthy and productive—but calling him a "substance abuser" reinforces an unspoken sense that he is inherently and permanently tainted and casts too much doubt on maintenance of remission.

Definition

People-first language is a type of linguistic prescription in English. It aims to avoid perceived and subconscious dehumanization when discussing people with disabilities and is sometimes referred to as a type of disability etiquette. People-first language can also be applied to any group that is defined by a condition rather than as a people: for example, "those that are homeless" rather than "the homeless".

Rather than using labels to define individuals with a health issue, it is more appropriate to use terminology, which describes individuals as being diagnosed with an illness or disorder. People first language puts the person before the diagnosis and describes what the person has not what the person is.^[2]

The basic idea is to use a sentence structure that names the person first and the condition second, for example, "people with disabilities" rather than "disabled people" or "disabled," in order to emphasize that "they are people first." Because it is a common practice in English to place an adjective before a noun, the adjective might be replaced with a relative clause, e.g., from "an asthmatic person" to "a person who has asthma". Furthermore, the use of to be is deprecated in favor of using to have.

By using such a sentence structure, the speaker articulates the idea of a disability as a secondary attribute, not a characteristic of a person's identity.

History

The term people-first language first appeared in 1988 as recommended by advocacy groups in the United States.^[3] The usage has been widely adopted by speech-language pathologists and researchers, with "person who stutters" (PWS) replacing "stutterer"^[4] Although it is believed that People-first language originated in the mental health community, its origin dates back to the Denver Principles (1983), which states, "We condemn attempts to label us as "victims," a term which implies defeat, and we are only occasionally "patients," a term which implies passivity, helplessness, and dependence upon the care of others. We are "People With AIDS."

Use has been recommended in other increasingly common chronic conditions, such as asthma and diabetes. Non-profit organizations, such as the Obesity Action Coalition have expanded advocacy for People-First Language to obesity. As of 2017, 5 U.S. medical societies had pledged for it, and use it in their communications: the American Society for Metabolic and Bariatric Surgery, The Obesity Society, American Society of Bariatric Physicians, Academy of Nutrition and Dietetics, American Academy of Orthopaedic Surgeon.^[5]

The most common alternative to person-first language is usually called identity-first language, as it places the identifying condition before the personal term. For example, while someone who prefers person-first language might ask to be called a "person with autism", someone who prefers identity-first language would ask to be called an "autistic person". There is no common term for use of identifying conditions as nouns, but it is not usually preferred apart from select communities, such as dwarfs. Others have proposed "person-centered language", which, instead of being a replacement linguistic rule, promotes prioritizing the preferences of those who are being referred to and argues for greater nuance in the language used to describe people and groups of people.^[6]

Rationale

The Sapir–Whorf hypothesis is the basis for ideologically motivated linguistic prescriptivism. The hypothesis states that language use significantly shapes perceptions of the world and forms ideological preconceptions.

In people-first language, preconceptions judged to be negative arise from placing the name of the condition before the term "person" or "people", such as "white person" or "Jewish people". Proponents of people-first language argue that this places an undue focus on the condition which distracts from the humanity of the members of the community of people with the condition.

In a 2008 publication about an experiment on teen's perception of people with disabilities, scientists gathered evidence to prove why people-first language, or word order, matters. the scientists divided teenagers from a summer camp into two groups; one group was asked questions using the term "people with epilepsy" and the other group was asked using the term "epileptics". They asked the teenagers questions such as "Do you think that people with epilepsy/epileptics have more difficulties at school?" and "Do you have prejudice toward people with epilepsy/epileptics?" The studied showed that the teenagers had a higher "stigma perception" on the Stigma Scale of Epilepsy when it came to "epileptics", as opposed to "people with epilepsy".^[7]

Usage guidelines

Some U.S. organizations like the United Spinal Association have published disability etiquette guides, which prescribe people-first language.^[8][9] The 2007 For Dummies guide to etiquette prescribed people-first language.^[10]

As of 2017, the rules of people-first language have become normative in US governmental institutions on the federal (e.g. CDC) ^[11] and on state levels in the heath departments´ Developmental Disabilities Councils e.g. Michigan^[12] West Virginia^[13] Idaho,^[14] Missouri ^[15] Georgia,^[16] or Texas.^[17]

As of 2017, it has been a requirement in AMA Manual of Style for academic journals.^[18][19]

Criticism

Critics have objected that people-first language is awkward, repetitive and makes for tiresome writing and reading. C. Edwin Vaughan, a sociologist and longtime activist for the blind, argues that since "in common usage positive pronouns usually precede nouns", "the awkwardness of the preferred language focuses on the disability in a new and potentially negative way". According to Vaughan, it only serves to "focus on disability in an ungainly new way" and "calls attention to a person as having some type of 'marred identity'" in terms of Erving Goffman's theory of identity.^[20]

In 1993, the National Federation of the Blind adopted a resolution condemning people-first language. The resolution dismissed the notion that "the word 'person' must invariably precede the word 'blind' to emphasize the fact that a blind person is first and foremost a person" as "totally unacceptable and pernicious" and resulting in the exact opposite of its purported aim, since "it is overly defensive, implies shame instead of true equality, and portrays the blind as touchy and belligerent".^[21]

In deaf culture, person-first language has long been rejected. Instead, deaf culture uses deaf-first language since being culturally deaf is a source of positive identity and pride.^[22] Correct terms to use for this group would be "Deaf person" or "hard of hearing person".^[23] The phrase "hearing impaired" is not acceptable to most Deaf or hard of hearing people because it emphasizes what they cannot do.^[24]

Autism activist Jim Sinclair rejects person-first language, on the grounds that saying "person with autism" suggests that autism can be separated from the person.^[25] Other advocacy groups and organizations such as Autism Speaks,^[26] The Arc^[27] and Disability Is Natural^[28] support using people-first language.

However, identity-first language is preferred by many autistic people and organizations run by them.^[29][30] One of those organizations, the Autistic Self Advocacy Network, has this to say on the issue:

In the autism community, many self-advocates and their allies prefer terminology such as “Autistic,” “Autistic person,” or “Autistic individual” because we understand autism as an inherent part of an individual’s identity...It is impossible to affirm the value and worth of an Autistic person without recognizing his or her identity as an Autistic person. Referring to me as “a person with autism,” or “an individual with ASD” demeans who I am because it denies who I am...When we say “person with autism,” we say that it is unfortunate and an accident that a person is Autistic. We affirm that the person has value and worth, and that autism is entirely separate from what gives him or her value and worth. In fact, we are saying that autism is detrimental to value and worth as a person, which is why we separate the condition with the word “with” or “has.” Ultimately, what we are saying when we say “person with autism” is that the person would be better off if not Autistic, and that it would have been better if he or she had been born typical.^[31]

— Lydia Brown

See also

• Political correctness

References

Further reading

• La Forge, Jan. "Preferred language practice in professional rehabilitation journals". The Journal of Rehabilitation 57 (1): 49–51.
• Lynn, V. A. (2017). Language and HIV communication. HIV/AIDS (Auckland, NZ), 9, 183.