Person first language vs identity first language practice

Language is one of the most essential skills in healthcare. It enables patients to communicate their concerns and condition and health practitioners to identify their needs quickly.

By Ashleigh Knowles on Feb 29, 2024.

Fact Checked by Ericka Pingol.

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An evolving mindset: Importance of language in health care

Language is one of the most effective tools in healthcare. It ensures that patients can communicate their concerns and condition and that health practitioners are able to identify their needs with ease. Language has power through its ability to guide treatment and provide each client with a voice to be able to share their thoughts and feelings. Although it’s sometimes easy to forget, healthcare is a human-centered discipline that requires empathy, and an acute ability to listen. Language is the vessel through which patients are connected to the right treatment at the right time. 

However, with language comes plenty of rules that change constantly. One of these is whether to use person-first or identity-first language. No matter whether you’re in a group or private practice, or operate in a specialty clinic or not; quite simply, if you work in healthcare, then you need to be educated on the appropriate ways to choose how you’re communicating with patients. 

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What is identity-first language?

Identity-first language, as the name suggests, is where an individual’s identity is the core component of how you represent them within your practice. Cultural diversity lies at the center of identity-first, with the language working towards fostering positive diversity in connecting individuals to their diagnosis. For example, an identity-first approach includes terms such as ‘deaf man,’ ‘cancer patient,’ and ‘autistic child,’ where the disability is a fundamental part of one’s identity. Using identity-first language can help patients come to terms with their diagnoses, and can provide individuals with more context and definition of their health conditions. 

What is person-first language?

On the other hand, person-first language presents disabilities as only one piece of the puzzle of an individual’s identity. Disabilities are only one aspect of the patient, and this language approach does not aim to define clients within disabled terms. Rather, it places a person before their diagnosis and works towards a goal of separating the two. The disability part serves as a descriptor of the individual as opposed to an embodiment. This may mean describing individuals as ‘patients with cancer,’ ‘an individual with autism,’ or ‘a woman who is deaf.’ 

History of identity-first and person-first language

Both identity-first and person-first language approaches have had a long and complicated history. They have divided healthcare practitioners and sparked controversy since the 1970s, from where the ‘People First’ movement first originated. 

After its launch during the first self-advocacy conference, in the early 1970s, People First aimed to focus on the uniqueness and personhood of patients, as opposed to their limitations and disabilities. This proposed language reinvention was so well-received, that it quickly became integrated within medical organizations, communities, advocacies, and disability services. The marginalization of disabled individuals decreased, derogatory language quickly disappeared, and the disabled community was finally given a platform to express their needs freely and without institutionalization. Academics believed they were depersonalizing negative terminology, and creating an equal plane in healthcare. 

However, emerging studies began to discredit the Person First movement, stating that disabled communities actually preferred viewing disabilities as part of their identity. Since then, many healthcare practitioners, both licensed and unlicensed therapists, turned a new leaf when it came to person-first language, and incorporated terms that emphasize identity over pathology.

So what now? Well, the healthcare space is a bit of a mixed bag. Some strongly prefer the newer identity-first approach, while others stick by the person-first. And spoiler alert, society still has no right answer when it comes to what one should be used today.  

Determining the pros and cons of person-first language

In deciding what practitioner terms to use, there are multiple pros and cons to the use of person-first language, with the advantages first including that this type of language allows others to understand that those with disabilities are still like anyone else. There tends to be a segregative tendency when discussing disabilities and health restrictions, which can create a lot of stigmas and ‘us vs. them’ situations, which doesn’t help anyone. Using person-first can help break down these barriers and foster an equal plane when it comes to viewing and treating others in healthcare. Disabilities do not define a person. No disability is inferior, and the same respect can be applied to all persons. After all, it is a human right! 

However, there are some cons to using person-first language, including that it suggests that disabilities are a secondary ‘add-on’ aspect, much like a sickness. This implies that disabilities are able to be cured and that they can maintain existence as a separate entity, when the reality is, many disabilities can morph into one’s identity over time. Not all disabilities need to be eliminated, and many within the community certainly do not feel that they should be. Some feel that using person-first terms brings shame to what it means to have disabilities, which is another clear disadvantage to its use. 

Identifying the pros and cons of identity-first language

Identity-first language also brings about positive benefits to the healthcare space, including that it represents the fundamentals of being human. For many in the disabled community, their disability is perceived as an essential part of them and how they operate. Quite frankly, it would be nearly impossible to separate their identity from it. Many accept their disorders and find the identity-first approach a healthy way to cope with the additional life stressors that they may carry. Using person-first hinders this process for some, and makes it more difficult to acknowledge their differences. Identity-first can facilitate greater inclusion, and it brings another advantage in that it creates communities where disabled individuals feel they belong. 

We would be remiss to not also mention the drawbacks to using identity-first language, including that it can perpetuate negative stereotypes. If disabilities define a person, then some may not be able to look beyond what disabled individuals have to offer. It can lead to others thinking negatively about their health condition and can widen the gap that many advocates try to close. Using identity first broadly can also dismiss those who feel disheartened by disabilities being an all-encompassing identity concept, which is also harmful.

Should people use person-first or identity-first language? 

In light of this evidence, you may be wondering, which language should I use? And unfortunately, there’s no clear-cut right answer. 

For something as important as disability language, you should never make assumptions. Every individual has their preferences, with many preferring person-first, and a multitude of others preferring identity-first. To stick with one is to dismiss an entire community, which is a big no-no. When approaching this topic, we recommend that you ask each client who walks into your clinic what they prefer. Healthcare is all about approaching patients with empathy and care, and with historical institutionalizations of disabled individuals, the least you can do is respect what they want to be called. There are equally valid pros and cons to both language schools, so when in doubt, simply ask. Doing so can contribute to a more collaborative and positive culture within your practice, which will help you grow in the long run. 

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