Person First or Identity First Language: the Debate

Updated: Nov 8, 2020

Autistic, Lesbian, Gay, Dyslexic, Transgender, Bisexual, Schizophrenic...

These are a few of the many common words we may use in clinical settings (and now also social media) when we address people we work with in the field and communities. For decades now, there have been vicious arguments about person first vs. identity-first language across different types of communities across the globe. In occupational therapy education and academic publications, person first language is the preferred choice. However, when out in the field, this really boils down to what each individual or family would prefer. And as a profession that is known for its client-centred and family-centred practices, this is a question we need to ask as soon as possible so that we can get this right from the start... not after treatment #5, #10, or when the series of treatments are all finished.

Yes, I am a person who is really caught in the middle of it all. On one hand, occupational therapy school has taught me about the importance of person first language. On the other hand, when I was diagnosed with autism in 2010, I began to be more aware about why many in the autism community prefers identity first language. Until I got my OTD, I truly had NO idea on what is "right".

After I got my OTD, I know I have to make a stand. So, I chose the easy going neutral stance in regards to autism. On one hand, I am using identity first language to identify myself on social media. I use the word "aspie" or "autistic" to describe myself. On the other hand, I have been advocating for us to ask what the families or clients prefer first before we do our initial evaluation or treatment, with the reason being that if we are claiming to be client and family centered, then the occupational therapy profession has to start from how we address our clients and their families. After all, both sides have their arguments, but the tiebreaker on what is right should be going to who we work with, which is our patients and clients.

Unfortunately, there are some occupational therapy students and practitioners who are sticklers of person-first language. When they see people use identity first language, they will often bash these people. (I was a victim of such from an occupational therapy student and she quickly blocked me on Twitter.) Usually I let stuff like this go, but since this is a near and dear subject to my heart, I decided send in a surprise LinkedIn message to one of her instructors so that the instructor could make an example of her on what NOT to do to not only disagree with an elder in the profession, but also somebody amongst the communities we serve.

But back to the subject... Remember, our clients and families are the experts of what they are dealing with on a daily basis. Also, if we have peers who belong in any disability and/or LGBTQ+ communities, we should consider ourselves lucky because we don't have to go far and wide to potential experts. Moreover, if we happened to inadvertently offend our peers, usually they are more forgiving (I know I had my fair share of such blunders over the years.) than other service users online and they can teach you what might be better ways moving forward both online and clinically. Also, the consequences are not as harsh when you accidentally offend a peer vs. a complete stranger or unknown family out in the field.

Next time you have a disagreement with a peer on identity first vs. person first language, please don't push the block button quickly on social media or other actions that you are trying to imply to the other person that he/she is flat out wrong. Talk it out and accept each other's differences. There is no right or wrong answer in this debate. However, a wrong response in this context will be acting rashly and believe the other person is 100% wrong.

Speaking of which... I also found an oldie, but goodie YouTube video where the late Ann Neville-Jan was in the panel:

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