People/person-first speech, quite simply, places the word “person” first when describing someone, instead of some other description, characteristic, diagnosis, or condition which the person may be experiencing.

• A person who uses a wheelchair.
• A person with a substance use disorder.
• A person with diabetes.
• A person with a diagnosis of bipolar disorder.

Generally speaking, people-first language is preferred.  If you are unsure, ask the person to whom you are speaking. People generally prefer to be up front and open (but respectful!) as opposed to avoiding the issue.

As a rule, if you think someone may take pride in their identity or the identity language has been reclaimed from some derogative history, use identity-first language.  If the identity language is dehumanizing, carries strong negative connotation, use person-first language.

When we describe someone with a specific mental health condition as “a person with schizophrenia” instead of a “a schizophrenic” we don’t reduce that person’s entire human identity to their schizophrenia.  When you refer to someone as “a person with a substance use disorder,” you put the person first and make them sound more human.  When you refer to someone as “an addict,” you put their condition first and make them sound less human.  In the person-first examples, the conditions are things they carry with them.

Person-first language should be used when the description, characteristic, diagnosis, or condition has a negative connotation or when referring to entire groups of people.

People have different opinions about person-first and identity-first language.  While some identity-first language may seem dehumanizing, other language makes that identity valid.  Some people much prefer identity first language, because their personal experiences are very much filtered through the lens of their identity.  For example, many “people with autism” would much prefer to be referred to as “autistic.”  After all, we avoid identity first language when the identifier has negative connotations.  Saying a “person with autism” has something wrong with them.  If this is confusing, ask yourself this: would you ever say, “person with homosexuality”?  Of course not!  It’s not an illness!

If the identity language is not relevant at all, don’t use it.  The most common examples are when people say things such as, “my black friend and I were hanging out,” or “I was talking to my gay friend,” or “I was having lunch with my deaf classmate.”  This cues the reader in that your friend’s race, sexual orientation, or hearing impairment is relevant to the story.  If your story doesn’t involve your friend’s race, sexual orientation, or hearing impairment (for example, a stranger said something racist, homophobic, or ableist to your friend), why are you bringing it up?  If someone has not been formally diagnosed, don’t use the language, and never use any identifying language to negatively describe someone or something else.  Obvious examples include saying, “Are you deaf?” (referring to someone who isn’t paying attention), “He’s psychotic,” (describing someone merely acting emotionally irrational), or, “They’re just OCD” (referring to someone who is merely well-organized).

Many people tend to use the phrases “suffering from,” “afflicted with,” “battling,” or “struggling with.”  This language tends to assume that the person has a reduced quality of life or should be pitied.  Instead of saying “He is struggling with dementia,” say “He has dementia.”  Instead of saying “She is afflicted with Down syndrome,” say “She is living with Down syndrome.”

Also, general rule, don’t correct someone using self-identifying identity-first language.  Even if you know the language is inappropriate or insensitive, try to respect their right to self-identify.  For example, if someone says, “I used to be a drug addict,” it’s not really anyone else’s place to correct them.

Note: for people with substance use disorder, the phrases “recovering from,” or “in recovery from” are preferable to “abuse” or “problem.”

Absolutely, the main purpose of this language movement is to reduce stigma, so the more prevalent it becomes, the more comfortable people become in hearing and reading it.  Harmful written and spoken identity-first language does one of three things:

1) Harmful language teaches listeners who have never heard it before that the language is okay to use.

Ex: Pointing and saying “that addict over there” to a child.

2) Harmful language reaffirms to listeners who have already heard it that it is still okay to use.

Ex: The R-word (“retarded”) has persisted for decades despite strong efforts to remove it from language for the obvious slur that it is.  Why?  Because people use it every day in jokes, and to describe things other than a mental illness.

3) Harmful language, regardless of your intent, signals information about the speaker.  Harmful language acts as a signal that you do not view the person you are describing as a human being.

Ex: Three friends, Person A, Person B, and Person C, are approaching an intoxicated person on a narrow sidewalk, head-on, early in the afternoon.  Person A is recovering from alcoholism, but her friends don’t know it.  Person B drinks socially, but openly stigmatizes people with alcohol problems.  Person C drinks socially, has limited experiences with anyone with alcoholism.

Person C, quietly: “Should we cross?”

Person A, “No, it’s fine.”

Person B, “Do what you want, I’m crossing.  I don’t want to smell that drunk.”

(Persons C & B cross the street.)

Here, Person B’s language acts as a signal to Person C.  Yes, Person C stigmatizes the intoxicated person by crossing the street, but Person C feels justified in the reaction through her solidarity with Person B.  Person C is more likely to say something similar in the future.

Person B’s language acts as a red flag to Person A.  Person A will likely never feel safe opening up around Person B, and Person A learns that if the tables were turned, Person B, or someone like Person B, may not treat Person A much better than Person B treated the intoxicated person.

Some members of the LGBTQ+ community reclaimed words like “queer,” while others may have vivid or even traumatic memories of the word being used as a slur.  How does a straight, cisgender person navigate words like that?  Avoid them.  Just like racial slurs or sexist language that has been reclaimed, the language does not belong to people outside of the group that reclaimed the word.

Finally, remember that language is always changing.  In fifty years, many things that are considered acceptable today may be unacceptable, or vice-versa.  For example, “on the spectrum” has become an offensive way to refer to autistic people, and people are coming to embrace the term “neurodivergent.”   At the end of the day, people who speak different languages can still understand nonverbal communication, intent, and tone of voice.  Treating people like people is much more important than using perfect language.  Having said that, don’t resist the natural change of acceptable, respectful language simply because it’s new or challenging.

The National Center on Disability and Journalism offers a helpful guide.

The CDC has other resources.