How Should We Address Individuals with a Diagnosis?

She is autistic. She has autism. Are these two statements the same?

For healthcare professionals and individuals alike, this question has been asked many times in the last two decades. “They’re autistic” uses a linguistic pattern known as identity-first language, whereas “they have autism” uses person-first language. While there has been a shift toward person-first language in recent years, identity-first language has not been left totally in the past. The reason may surprise you.

Option One: Identify-First Language

Identity-first language places precedence on a diagnosis or condition. It also tends to refer to individuals as patients. So, with identity-first language, a person might be described as “an autistic person” or “a cerebral palsy patient.” Similarly, “she is” or “they are” is a typical way to describe a person. In healthcare environments, the diagnosis is historically what matters most, so the default use of identity-first language is not meant to be disrespectful. However, at Boundless, we believe that while a diagnosis is important, the person is more important.

Option Two: Person-First Language

Person-first language acknowledges that a disability is something a person has but is not their identity. Examples are “a person with autism” or “an individual with cerebral palsy.” Instead of “she is,” someone using person-first language would say “she has.” This linguistic pattern changes the perception of people with disabilities by removing the disability as their primary identity. It recognizes that there is more to someone than just their diagnosis. Over the last two decades, there has been a push toward person-first language, both in general and in healthcare settings.

So, which is better? Well, before you decide, know there is a third option. 

Option Three: Person-Centered Language

Person-centered language recognizes that the person in question is, in fact, an expert on their own identity. If they prefer to be called an autistic person (identity-first language), then we should use that language with them. It is their identity, after all.

Person-first language is a great first step. As a default way to describe someone with a disability, it makes few assumptions and is considered polite. However, when learning of someone’s disability or meeting someone for the first time, the best course of action would be to ask them how they preferred to be described. They may have a strong preference or no preference at all.

At Boundless, this fits into our whole-person approach. The people we serve are people first; they are not their diagnosis. They know how they preferred to be described and have the right to decide how they are described, and it is our duty to respect that and provide care the best we can.

Words matter, and how we use them can have a huge impact on the people we serve. By moving away from identity-first language as a given, we move toward a world that sees the people we serve as people first.