People-first language or person-first language is the practice of distancing a person from a trait or condition they have by preferring phrases such as "a person with diabetes", "people experiencing homelessness", and "people with substance use disorders" as opposed to identity-first language like "diabetic people", "homeless people", and "substance abusers". As a form of disability etiquette, the practice is intended to avoid unconsciously stigmatizing or dehumanizing people with chronic illnesses or disabilities, by treating them as a secondary characteristics to their personhood rather than an essential or subsuming component of their identity. Some organizations have adopted style guidelines preferring or requiring person-first language when writing about disability, though some disabled communities have a majority or otherwise statistically significant preference for identity-first language, including the Deaf, blind, and autistic communities. APA style recommends using either identity-first or person-first language as appropriate for the community or individual being discussed. Phrases like "disabled person", "Deaf person", and "blind person" are generally accepted and often preferred.
Definition People-first language is a type of linguistic prescription. It aims to avoid perceived and subconscious dehumanization when discussing people with disabilities and is sometimes referred to (for example, by NHS England's style guide) 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, people-first language uses terminology that 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. 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," 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." 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. (See also: Distancing (psychology).)
History Recommendations and explanations to use person-first language date back as early as around 1960. In her classic textbook, Beatrice Wright began her rationale for avoiding the dangers of terminological short cuts like "disabled person" by citing studies from the field of semantics that "show that language is not merely an instrument for voicing ideas but that it also plays a role in shaping ideas" (p. 7). She concludes her arguments thus: "Since physique does stimulate value judgments, it is particularly important to use expressions insofar as feasible that separate physical attributes from the total person" (p. 8). Another influential rehabilitation psychologist, Carolyn Vash, who also spoke from the perspective of her experience living with quadriplegia from polio, advanced similar arguments for person-first language in an unpublished address in 1959. The term people-first language first appeared in 1988 as recommended by advocacy groups in the United States. The usage has been widely adopted by speech-language pathologists and researchers, with "person who stutters" (PWS) replacing "stutterer". It has been used in AIDS activism, appearing in the Denver Principles (1983), which stated in part, "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, and the American Academy of Orthopaedic Surgeons. Some advocacy groups and organizations such as Autism Speaks, The Arc and Disability Is Natural support using people-first language.
Rationale
In people-first language, preconceptions judged to be negative are thought to 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. A 2008 experiment researched teenagers' perception of epilepsy with respect to people-first language. Teenagers from a summer camp were divided into two groups. One group was asked questions using the term "people with epilepsy", and the other group was asked using the term "epileptics", with questions including "Do you think that people with epilepsy/epileptics have more difficulties at school?" and "Do you have prejudice toward people with epilepsy/epileptics?" The study showed that the teenagers had higher "stigma perception" on the Stigma Scale of Epilepsy when hearing the phrase "epileptics" as opposed to "people with epilepsy".
Usage guidelines
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