Person-first language? Am I a "diabetic" or "person with diabetes?"
Let's dance into the minefield that is person-first language!
Person-first language has been researched extensively and is found to influence people’s ideas about disability. That is, as the idea goes, I am not a “diabetic” whose identity is a disease, but a “person with diabetes.”
The difference may seem unimportant at first, but paying attention to language is how things could change, and person-first language may be a step in the right direction.
Laughing it off at the picnic. She happens to have T1D. Would you even know?
Some might argue, as a psychologist questioning “person-first” language did, that there’s no problem with the word diabetic. People with diabetes tattoo the word “diabetic” on themselves after all—inking this word permanently on their skin, so what’s the big deal? Even people with diabetes call themselves diabetics. Some people with diabetes might not be offended at all by the term, and that “if you are going to be a jerk … you can be just as much of a jerk using person-first language as using the direct label.”1
As a “person with diabetes,” you have choices, and you have some agency over your condition: to put your best foot forward, focusing on your attributes, your skills, your abilities, along with living with a chronic condition. I don’t feel diabetes defines me. I’m an author, teacher, cyclist, guitarist, and a swimmer among many other things if you like labels. Being defined by any one of those labels is not all of who I am. While I happen to have T1D, I’m not a “diabetic.” Who wants to be that?
Diabetes Australia puts it this way, regarding the term “diabetic:”
Evidence shows 1 in 2 people find the label unacceptable and 1 in 4 find it harmful. People with diabetes are free to use whatever words they wish. Other people – whether they are working in healthcare, media, research, industry or anywhere – have a responsibility to engage all people affected by diabetes in positive, constructive ways. Labelling a person as ‘diabetic’ runs the risk of causing offense or alienating that person. People are rarely offended by being referred to as a person. This is just one small part of why our language matters. It is so much more than whether we use the words ‘diabetic’ or ‘person with diabetes’. 2
Despite this position on using more empowering language, and in the hope things would get better, the term is still used extensively. A research study of diabetes coverage in Australian newspapers from 2013 to 2017 found that the labelling of people with diabetes as “diabetic” and as a group as “diabetics” continues to occur.3
The point is that you may not want to play into what other people, including those in the healthcare system and media, not to mention your immediate family and friends, have pigeonholed you as, and emphasize your reality beyond diabetes.
Some have also criticized the “person-first” language in that it unnecessarily dissociates the disability from the person. This is considered “identity-first” language that allows individuals or groups to own the disability and reframe it as a point of pride. This position argues that disability:
… is not a state of bodily impairment, inadequacy, failing, misfortune, or excess—that it is not about marking the things gone ‘wrong’ with the body … it is a culturally composed (and shared) narrative of the body … a study of the unequal distribution of power, material and economic resources, and status (class, etc.) within both social and architectural environments. 4
They said it was a good idea.
That being said, I’d rather not have it tattooed on my wrist, thank you, and I prefer not to be addressed as such, especially by people who have little to no understanding of diabetes.
Why? Because I know the stigma and judgement that currently goes along with that label. If a person who has diabetes can choose how they express their identity, there is a sense of autonomy and agency. This allows “choice over one’s disability destiny” and that the “person-first approach subtly implies that there is something inherently negative about disability and that it … unnecessarily dissociates the disability from the person.”5
So what can we do?
Why not ask the person their preference?
People in roles of authority, such as a health care worker, a physician or a nurse, for example, should be aware of their language and the research that has proven it directly affects treatment outcomes—in other words, they “have a responsibility to engage all people affected by diabetes in positive, constructive ways,” and the “diabetic” label risks “causing offense or alienating that person.” The onus is on the person who does not have diabetes to ask the preference, and not to assume. A person who has a disability can call themselves anything they want.
Thank you for reading!
You too can support my writing a book about diabetes by subscribing for free or for a paid subscription.
Share this with your friends! Do you know someone who has diabetes? I’m sure they’d like to read Time in Range!
Until next week, dear readers!
Collier, R. (2012) Person-first language: Noble intent but to what effect?, CMAJ, 184(18), pp. 1977-1978. https://doi.org/10.1503/cmaj.109-4319
Speight J., Skinner T.C., Dunning T., Black T., Kilov G., Lee C., Scibilia R., Johnson G. (2021)Speight J., Skinner T.C., Dunning T., Black T., Kilov G., Lee C., Scibilia R., & G. Johnson (2021) Our language matters: Improving communication with and about people with diabetes. A position statement by Diabetes Australia. Diabetes Research and Clinical Practice, 173. https://doi.org/10.1016/j.diabres.2021.108655
Bednarek, M. & G. Carr (2020) Diabetes coverage in Australian newspapers (2013‐2017): A computer‐based linguistic analysis, Health Promotion Journal of Australia. 31(3), pp. 497-503. https://doi.org/10.1002/hpja.295
Brueggemann, B. J. (2013). Disability studies/disability culture. In M. L. Wehmeyer (Ed.), The Oxford handbook of positive psychology and disability, Oxford University Press, p. 283.
Dunn, D. S., & E.E. Andrews (2015). Person-first and identity-first language: Developing psychologists' cultural competence using disability language. The American psychologist, 70(3), p. 257. https://doi.org/10.1037/a0038636