The Problem With Person-First Language

A woman speak to a man using person-first language.

Person-first language was created in response to a perceived dehumanization in the medical community. It aimed to shift the focus of language from the diagnosis to the person. However, it has come under criticism for establishing too firm boundaries between the two.

There are benefits to person-first language, but the issues can’t be ignored. To create a respectful environment within your practice, you must closely consider the use of language.

What Is Person-First Language?

Person-first language, sometimes known as PFL, is intended to put the person before their diagnosis. It’s a linguistic device, prioritizing the person, instead of placing the focus on their disability or condition. Person-first language has become popular in many circles, as it can potentially help avoid dehumanization.

An example of person-first language is saying “a person with autism”, instead of “an autistic person”. In this sentence, the person leads the description, followed by their diagnosis. 

Person-First Language Vs Identity-First Language

The inverse of person-first language is identity-first language (IFL). This places the focus on the condition or disability. For example, saving “a blind person” instead of “a person who is blind”. 

Person-first language grew as a response to identity-first language. Some found identity-first language could be dehumanizing, as it emphasized the diagnosis, rather than the person themselves. By switching to person-first language, the assumption is that the diagnosis is only a small part of an overall identity

While there are certainly good intentions behind the use of first person-language, it isn’t a perfect solution to a complex issue. For many, being described using person-first language fails to acknowledge the community within their diagnosis, and how it influences their personality. 

The Positives Of Person-First Language

Person-first language was created and defined as a method to prevent discrimination (both conscious and subconscious). By separating the person from the diagnosis, it’s potentially easier to view the diagnosis as just one small characteristic of a complex human being.

It’s seen as a form of disability-etiquette, focusing on how the person is, rather than what they have.

For those with a condition or disability with largely negative connotations (within the wider public), person-first language is intended to separate the person from this negative assumption. As an example, “an alcoholic” might receive less understanding than “a person with a substance abuse issue”.

In the U.S., government organizations have often promoted the use of person-first language. It’s considered the correct etiquette by the AMA Manual of Style. Various U.S. federal and state governmental institutions have ruled that person-first language should be used in a medical context.

The Problems With Person-First Language

There are certainly benefits to person-first language. Many groups and individuals prefer person-first language, and it’s often recommended for use in a professional context.

However, person-first language has come under criticism for separating the individual from their diagnosis. While person-first language aims to distinguish the diagnosis from the person, in doing so, it can erode how important the diagnosis is to an identity. 

Below, we’ll explore in detail some of the criticisms towards person-first language.

A therapist speaking in person-first language.

PFL Separates The Person From Their Diagnosis

The very thing that person-first language was created to do is one of the major downfalls of this linguistic choice. A person’s diagnosis is key to how they perceive and experience the world. It might not be the only characteristic of a person, but it does shape their lives.

By separating the person from the diagnosis, person-first language can overlook just how important the diagnosis is to the person. For some, this division adds shame to the disability. It assumes the person would want to be separated from their diagnosis, rather than embrace it as part of who they are.

PFL Can Add A Negative Connotation To A Diagnosis

Person-first language must be used when identifying certain illnesses and conditions. For example, a person has the flu—there is no identity-first method of describing the diagnosis. 

By using this same method to describe mental health issues and disabilities, person-first language is potentially placing a negative connotation on the diagnosis. Most identities described using person-first language are not contagious, and they can rarely be “cured”.

However, using language that shifts these conditions into the same category as illness and disease can create a negative implication.

PFL Can Potentially Erode Community

Many people with a disability or mental health condition see their diagnosis as an indicator of community. It provides a common link, allowing for a shared identity. 

But using person-first language can remove that sense of community. By designating the diagnosis as something that a person experiences, rather than an inherent part of the self, it can damage the communal aspect.

Person-first language prioritizes individualism. This isn’t necessarily a bad thing, but it can be limiting to a community. 

PFL Is Linguistically Tricky

Perhaps not the most important reason, but a reason worth considering: person-first language isn’t always natural to the English language. By bending linguistics, it can create complex and unwieldy sentences that are difficult to digest.

This might not seem like a key concern, but this can be another way of alienating those being described. When person-first language erodes the readability of a sentence, it can appear that the writer is tip-toeing around a description. Again, this potentially adds a negative connotation.

Should I Use Person-First Language?

There’s no clear answer to whether person-first language or identity-first language is the right choice. Both styles have their benefits, but there are also some clear drawbacks to their usage.

In an academic setting, person-first language is generally preferred. Check your state guideline to determine exactly what you should use in your paperwork.

In a session, it’s better to discuss with your client which option they would prefer. For many, PFL vs IFL is a personal choice. And while some might be comfortable using IFL in an informal setting, they might prefer PFL in a professional setting.

Similarly, some clients might be comfortable using IFL as part of the community, but prefer PFL on an individual basis.

Final Thoughts

Person-first language was created to prevent dehumanization, by prioritizing the person over the diagnosis. However, this separation of condition and person can potentially add negative connotations to the diagnosis, and erode a sense of community and pride. 

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