The way we refer to people with diseases or conditions has changed in the last few decades.
A few months ago in a segment about the difference between “continuously” and “continually,” I wanted to give an example of something that is done continually, so I wrote, “Many type I diabetics have to give themselves shots multiple times a day. They are continually giving themselves shots.”
And soon after, I received an email from Rick in Kelowna, British Columbia that read,
“You refer to those of us with diabetes as ‘diabetics.’ Diabetes does not define our life (that is, there is much more to us than a disease we have) so the modern trend apparently is to refer to ‘people with diabetes’ rather than ‘diabetics.’ Do you refer to people with cancer as ‘cancerics’? People with a cold as ‘coldics’?”
That is an excellent point, Rick, and the term you hear a lot for that kind of rephrasing is “person-first language,” which coincidentally was something I started looking into right after I wrote that piece about “continuously” and “continually” and wish I had done a week earlier.
Should you say ‘diabetics’ or ‘people with diabetes’?
“Person-first language” means that you’re putting the emphasis on the person and not on the disease. It’s a little longer to say “people with diabetes” than “diabetics,” but it honors them more as people, and that’s certainly worth a few extra words.
Person-first language may be a new concept to some of you, but it’s not actually that new. A Google Ngram search, which shows how often words and phrases appear in edited books, shows that around 1980, the use of the word “diabetics” started to fall, while at the same time the use of the phrase “people with diabetes” started to rise. The change was pretty dramatic from 1980 to 1990, and then kind of leveled out, with “diabetics” still being more common than “people with diabetes,” but much less dominant than it had been before.
Still, in 1990, the far-reaching Americans with Disabilities Act, the ADA, included the phrase “people with disabilities” instead of using something like "the disabled," which also likely helped bring person-first language even more into the mainstream.
For example, a search of the Washington Post website covering the last 12 months shows 13 instances of the phrase “people with diabetes,” and what appears to be none for the term “diabetics.”
What is person-first language versus identity-first language
Unfortunately, as with many things, person-first language isn’t as simple or black-and-white as it initially seems.
For example, you may remember that last year I talked about whether you should put an apostrophe in the name “Alzheimer’s disease” and concluded that it’s best to leave it out and write “Alzheimer disease,” but that some advocacy groups strongly disagree. The same thing sometimes happens with person-first language.
Should you say ‘autistic people’ or ‘people with autism’?
The most common example I’ve seen is with “people who have autism” versus “autistic people.”
Many sites say that people with autism usually prefer to be called “autistic” or “autistic people,” which is referred to as “identity-first language,” with “autism” being seen as an identity in the same way that “American” is seen as an identity when you call someone an “American” or an “American person.”
Identity-first language can reflect a sense of pride among a group of people in who they are, and some advocacy groups see person-first language as stigmatizing because it treats the disease as a problem or a bad thing that is tacked on to a description of a person. It can actually be a problem when advocates of person-first language try to force that person-first wording on a group that doesn’t want it like “autistic people.”
The bottom line, which applies to many situations, is that most people don’t want someone outside their community telling them what they should be called.
So as I often advise in my courses, if you can, it’s best to ask the people you are writing about what they prefer. Just ask.
If you can’t ask, it’s probably better to go with person-first language, but it’s worth the extra minute or two to do a quick internet search to see if the people you are writing about, such as autistics, might generally prefer something else.
Make sure it’s relevant
Finally, I can’t end without saying you also should only mention a person’s identity if it’s relevant to the story. If there’s no compelling reason to mention that a person has diabetes or is autistic, leave it out. That has been the Associated Press’ recommendation for decades.
Mental health counselors had kinder and less authoritative reactions to statements that used the phrase “person with schizophrenia” instead of “schizophrenic.” (Sept. 2021)
How the AP Stylebook Considers Language on Disability Publishers Weekly (Sept. 2021)
Person-First Language vs. Identity-First Language: An Examination of the Gains and Drawbacks of Disability Language in Society, Journal of Teaching Disability Studies
Identity-First Vs Person-First Language, People with Disability Australia
How to Use and Promote Inclusive Language at Your Organization, HubSpot
Guidelines for Writing About People with Disabilities, ADA National Network
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