This article explores the difference between person-first language and identity first language in relation to autism. It reviews the history of both person-first and identity-first language as well as data supporting the autistic community’s preference for identity-first language.
Language Is Always Evolving
Language is always evolving and changing, and “best practices” around language continue to evolve as well. As we learn, terminology shifts to reflect new knowledge. Traditionally, language surrounding “mental disorders” (conditions detailed in the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM) is decided by licensed medical and mental health professionals.
Why the Language You Use Matters
This means that much of the language around these diagnoses is created by those outside of the communities they are discussing. As mental health and disability advocacy have become more mainstream, communities have vocalized their preferences and values in these conversations.
What Is Person-First Language?
Person-First Language (PFL) refers to terminology that puts the person ahead of the diagnosis. It aims to frame the diagnosis as something the person “has” rather than something that they “are.” Referring to “people with disabilities” is an example of PFL.
Why Person-First Language Was Championed
PFL was popularized with the intent of reducing dehumanizing language and attitudes around many disabilities. PFL aims to “require the use of respectful language when referring to people with disabilities.” When PFL was first introduced in 1974, many members of the autistic community preferred this terminology because of the stigma that comes with being identified with a diagnosis. Autistic people experience the world differently than non-autistic people. Their perception and experience are fundamentally distinct due to their autism. Because many diagnoses lead to stigma, a shared way of referring to the diagnosis helps create a sense of community among people with the same condition.
What Is Identity-First Language?
Identity-First Language (IFL) is language and terminology that puts the diagnosis or identity at the forefront. Some communities find that, although well-intentioned, PFL can sometimes become dehumanizing and stigmatizing, such as referring to someone who “struggles with” a diagnosis. IFL pushes back against this by simply naming the diagnosis rather than commenting on how it impacts the individual. IFL also combats the shame associated with being neurodivergent or otherwise disabled, and it is a way to signify pride in one’s identity.
Identity-First vs. Person-First Language and Autism
Individual preferences are always the first priority when interacting with one person. However, when speaking about the community as a whole, the best practice is to determine what the majority of community members prefer. The writing style guide of the American Psychological Association, as well as special education, continues to use “people with autism,” despite recommendations from the community indicating a preference for identity-first language.
The Significance of Identity-First Language
In research and clinical work, PFL is typically used when taking a recovery orientation to treatment. For example, a doctor refers to “patients with cancer” rather than “cancerous patients” because the goal is to treat and eliminate the cancer. Many autistic people have written and spoken about why IFL is important to them and why it is generally preferred over PFL. PFL implies that the person is the same with or without their diagnosis, and the majority of the autistic community agrees that their autism is a fundamental part of who they are. Some autistic individuals prefer PFL or state that they have no preference, so when addressing them, use what they prefer. But when referring to the autistic community at large, the best practice is to determine what the majority of community members prefer because true allies value community voices. Multiple surveys conducted over the past decade have shown that, while context plays a role in what language is most appropriate to use, IFL is generally preferred by the autistic community.
Autistic Voices
In researching for this article, several autistic people provided their insight into their own preferences around PFL and IFL. Similar to the Autistic Not Weird survey, most indicated a strong preference for IFL. A few people indicated no preference or noted that PFL used to be the standard.
Resources
For more information about the autistic community, see the Autistic Self-Advocacy Network, the Autistic Women & Nonbinary Network, and the Asperger/Autism Network.
A Word From Verywell
The best practice when speaking to or about any community must emphasize community voices and needs above all else. Always prioritize individual preferences, but when speaking in general, the overall preference of the community should be the priority. When it comes to autistic voices, the current language preference is overwhelmingly identity-first language.
