Person-first versus Identity-first Language

In academic writing, it is essential to be sensitive to language in the context of a wider research commitment to inclusivity and health equity. “Person-first language” and “identity-first” language refer to two ways of describing people living with a specific disability, diagnosis, or condition.

Person-first language refers to describing a person as having or living with a condition rather than as defined or identified with it. “Patients with cancer” is an example of person-first language, while “cancer patients” is an example of identity-first language.

Person-first language

Person-first language is strongly preferred and sometimes required by most English-language journals. This emphasis stems from a desire to move away from language that reinforces existing social stigmas and health care disparities and toward language that emphasizes people before conditions.

In the 1960s and 1970s, advocates and groups such as People First raised awareness of the personhood of people with disabilities, who had long faced discrimination. In the 1980s, activists used the term “people with AIDS” to advocate for the agency of people living with the disease as an alternative to more passive and potentially dehumanizing terms such as “AIDS victim”.

Today, person-first language is widely used in academic research and government documents. Conversations over person-first language are ongoing, and it is increasingly being used to describe other groups and individuals that have faced stigma and difficulty in accessing medical treatment, including people with substance abuse disorders.

Identity-first language

Although person-first language is usually the most respectful way to refer to people with disabilities, this preference varies by group and for individual people with disabilities, for whom identity-first language can reflect that a disability is an essential aspect of their identity.

For example, deaf people widely prefer identity-first language, including to recognize their participation in Deaf culture and use of American Sign Language. Most autistic people also strongly prefer and use identity-first language; autistic self-advocates have written that identity-first language reflects that autism is a valued and intrinsic part of their experience. Currently, identity-first language is recommended when writing generally about deaf and autistic people in academic research.

Recommendations for usage

An easy way to check whether you have used person-first or identity-first language is that in person-first language, the noun precedes the characteristic, as in “women with depression,” or “patients with AIDS.” (Try to avoid the construction “person suffering from,” which can read as pejorative but may be appropriate in limited circumstances). In identity-first language, the characteristic precedes the noun, as in “autistic people” or “deaf children.”

If you are unsure whether to use person-first or identity-first language, best practices include engaging with people from the community of focus directly, such as by asking the subject of a case study about their preferences. Unfortunately, this may not always be feasible or appropriate for researchers working with large groups of people or for research in translation. Another recommended approach is to have your paper reviewed by a native English speaker with the disability or condition discussed.

You may also wish to research self-advocacy groups for the disability or condition discussed in your research to familiarize yourself with preferred English-language terminology. Additionally, it can be useful to read recent articles in your target journal and top journals in your field to determine whether there is a scholarly consensus.

Academic language is ever-evolving, and people with the same condition can disagree on how they prefer to be referred to. In academic writing, broadly speaking, person-first language is recommended when describing a person with a specific diagnosis, such as cancer or diabetes, and in most situations when describing a person with a specific mental health disorder, such as schizophrenia. However, specific individuals and groups may prefer identity-first language. When writing about people in the Deaf and autistic communities, identity-first language is currently recommended.

References and Additional Reading