Should I Use Person-First Language or Identity-First Language? A Guide to Language and Disability

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So you’re having a conversation about disability, and you’re not sure what type of language to use. Some say you should always use person-first language (e.g. “person with a disability,” “person with autism,” etc.). Others prefer identity-first language (e.g. “disabled person,” “autistic person,” etc.) 

You want to be respectful, so which type of language should you use? Well, it depends on the situation. I know, I know. That’s not what everyone wants to hear. We prefer one-size-fits all answers. It’s easier to have a single, hard and fast rule to memorize. That way, you never have to worry about getting it wrong. That’s probably why the “always use person-first terminology” rule refuses to go away. But the truth is that disability terminology is a lot more complicated than that.

Don’t worry, though. If you’re confused about respectful disability language, there are certain clues that can tell you how to use the most inclusive language. Here is a guide on how to choose between person-first and identity-first language. The questions below can help you make the right choice.

What Does the Person or Community Prefer? 

When talking about a condition or disability, those who actually have that disability are the final authority on language. Not their loved ones. Not their caregivers. Not the “experts.” Not people who have “worked with” them or written textbooks about them. Always defer to the actual community whenever it’s possible. 

Otherwise, your person-first terminology doesn’t actually put the person first, does it? And isn’t that the whole point to person-first terminology to begin with? The idea is to respect the disabled person as a person, right? If that person prefers identity-first terminology, and you don’t use it, then you’re saying that they don’t matter. Their wishes should be ignored. Some textbook matters more than their actual, lived experience. If you truly want to be person-first, then you’ll, well, put the person first. Listen to what they have to say. Treat them like a person.

This means that if you want to talk about autism, you use the language that autistic people prefer. If you want to talk about Down syndrome, you use the language that people with Down syndrome prefer. 

Notice that I used identity-first language for autistic people and person-first language for people with Down syndrome. That’s because these communities have different preferences. Autistic people tend to prefer the identity-first approach. And so far, most people with Down syndrome I’ve talked to have used “person with Down syndrome” to describe themselves. 

Keep in mind that disabled communities are not monoliths. Some people have different language preferences. If someone refers to themself as a “Down syndrome person” or “person with autism,” you should follow their lead. 

Am I Using an Adjective or a Noun? 

There’s an argument for person-first language that drives me up the wall. It goes like this: 

“You wouldn’t say that a person was asthma, would you? You wouldn’t say that your daughter was diabetes. Or that your uncle was anemia. So why would you call a person autistic?” 

No, I wouldn’t call them those things. But I would 1000% describe them as asthmatic, or diabetic, or anemic, assuming they were all cool with that. Because the equivalent of calling someone “asthma” isn’t calling someone “autistic.” It’s calling them “autism.” 

And that’s another reason why I say “autistic person” and “person with Down syndrome.” It’s the same reason why I say “blind person” (identity-first) and “person with cerebral palsy” (person-first). Because some of those words are adjectives, and some of them are nouns. 

Let’s go back to our third grade English classes. We all remember what a noun is, right? Exactly. It’s a person, place, or thing. It’s something that we can name. 

An adjective is something that describes a noun. Greenery is a noun because it refers to actual trees and shrubs. Green is an adjective because it’s a word we can use to describe those trees and shrubs. 

Some nouns have a corresponding adjective. Autism is a noun because it’s the name of a disability. Autistic is an adjective because it describes a person. Blindness is a noun, and blind is an adjective. Asthma is a noun, and asthmatic is an adjective. Disability is a noun, and disabled is an adjective. 

Because all of these words have corresponding adjectives, person-first language can sound clunky and unnatural. Ironically, this clunkiness can cause more stigma. If you insist on person-first language, even when identity-first grammar works best, you’re saying that this disability is shameful. It’s so shameful that you should take extra effort to separate the person from it. 

And we only apply that clunkiness to the most stigmatized disabilities, anyway. At least once a week, I see somebody on Instagram insisting that people say “with autism” instead of “autistic.” I’d bet actual money that these same people have no problem saying “blind person” instead of “person with blindness.” 

Now, some nouns don’t have corresponding adjectives. Down syndrome is one example. It makes sense to say “people with Down syndrome” because there’s no good adjective to go with it. 

Is This Word an Insult or Slur? 

This should go without saying, but I’m including it anyway. Just in case someone wants to chime in with “But there IS an adjective for Down syndrome! It’s [insert slur or insult here]!” Yeah, we’re not doing that. 

To be fair, there are words that have become slurs because a certain type of person ruined them. And there are words that many people just didn’t realize are slurs or insults. 

Sometimes, people do use a word innocently without realizing that it’s not okay. If you do that, just apologize and remind yourself not to use that word again. If you’re not sure about a word, you can look it up to double check. 

Is the Disability Part of Their “Hardware?”

“You wouldn’t call someone a cancerous person, would you?” sneered someone on Facebook. “So why would you call someone autistic?” Well, my dude, because cancer and autism are not the same thing. And it’s super disrespectful to compare the two.

But wait, “cancerous” is an adjective, right? Sure. But it doesn’t describe a person, it describes the illness itself.

Plus, cancer isn’t a part of the person. It is, by definition, something that doesn’t belong there. If you remove the cancer from a person, they’re still the same person. Something like autism is very different. Autism is baked into the person’s hardware. It’s literally how their brain developed. It impacts everything, including how they think, what they enjoy, how they act, and how they experience the world. You can’t get rid of the autism without getting rid of the person. And that, my friends, is why autistic people get so angry when others talk about finding a “cure.” The “cure” is eugenics.

In many cases, when the disability is such a key part of the person’s life, that person will use identity-first terms.

The Best Resource on Disability Terminology

Still looking for disability language resources? I’ve got you. The most helpful one is social media. Genuinely, TikTok is the BEST guide to disability language etiquette. Instagram and Threads are up there, too.

But here’s the key: You have to follow people who are actually disabled. There’s nothing wrong with following the mom of an autistic kid or sibling of wheelchair user on social media. But again, the people who actually have those disabilities get the final say. Follow people with Down syndrome, people with chronic illness, blind people, Deaf people, etc. That’s how you learn what these communities prefer. And you get to learn it in an easy, casual way that lets you absorb the information slowly. No textbook required.

Respectful Disability Language: an Exercise in Empathy

“It feels like the rules are always changing!”

“Why can’t everyone agree on the right language?”

“I hate being scared to get it wrong all the time.”

“What if I mess it up and everyone hates me?”

I know. I get it. It’s tough because you want everyone to feel respected and included. You don't want to offend anybody. And it’s really, really hard to have to pay such close attention to your words.

Well, since I’ve already mentioned autism so many times, I’ll go ahead and bring it up again. Trying to follow the social rules of people who aren’t like you? Constantly worried that you’ll upset someone, even with good intentions? Trying to memorize a list of guidelines while stressing out over context? Worried about when the rules apply and when they don’t? That’s how autistic people feel all the time. And they feel it in almost every context, not just this one. For an autistic person, following neurotypical social rules can feel the way you feel about disabled language rules.

One Final Note 

Remember that there is some nuance to this conversation. We’re talking about general guidelines, for the most part. Sometimes, there are exceptions. 

Take ADHD, for example. ADHD doesn’t have a corresponding adjective. Or at least not one that doesn’t make autocorrect yell at me. I still sometimes call myself an ADHD-er. 

Some communities use a mix of identity-first and person-first language, like those who describe themselves as both “little people” and “people with dwarfism.” 

Remember, the goal is not to be perfect. Everybody is going to make mistakes. The goal is to be inclusive and respectful. As long as you’re doing your best, you’re on the right track.