The Flaws of Person-First Language

I’ve been getting a lot of questions (and sometimes outright attacks) lately about why I don’t use person-first language, so I thought perhaps it was time to articulate some of the problems with person-first and some of the reasons I am turning away from it. For those not familiar with this particular language controversy, in the US, people tend to prefer a person before impairment model; ‘people with disabilities,’ ‘person with mental illness,’ as opposed to ‘disabled person’ or ‘autistic person,’ seen in regions like the UK. This may seem like splitting hairs, but it’s actually the subject of heated discussion in disability rights circles and academia, and it can be difficult to navigate.

Person-first language is based on the medical model used in the States. While I live in the States and do much of my work here, I don’t subscribe whole-hog to the medical model. The social model is more nuanced, examining both individual impairments and the way in which society interacts with people. Lady Bracknell points out that the social model is often misunderstood (I once made the same errors she discusses in her post myself), especially by advocates for the medical model who want to insist that a medicalised approach to disability isn’t flawed. One system provides room for the variation of human experience, while the other labels some bodies as wrong.

As a disability rights activist, it’s pretty obvious which model I believe in. And I want to be conscious of how I use my language, because the fact is that person-first language reinforces a medicalised view of disability, and doesn’t embrace disability as part of natural diversity. If I’m advocating for a world where impairments are not viewed as a wrongness, I need to not shoot myself in the foot, so to speak, with my language.

Lisa Egan neatly illustrates the difference between the two terms:

Person with disability = the person has something wrong with them, it’s their body that prevents them from being equals.

Disabled person = person is disabled by barriers (social, architectural, environmental, etc) preventing them from living an equal life.

She goes on to articulate the point with a fantastic analogy:

I’m a person with an impairment. I am disabled by steps, stairs, escalators, lack of computer access, inaccessible housing, and so on. To me a flight of stairs without a lift as an alternative is the equivalent of right-clicking me and selecting “disable Lisa.” I’m not disabled by my osteogenesis imperfecta.

These distinctions, again, may seem subtle, but they are important. The social model doesn’t erase the presence of impairments, it simply forces people to examine them in context:

The social model of disability recognizes both the existence of impairments and the depth and breadth and extent of their impact on the individual. But it doesn’t dwell on that aspect of being a disabled person because that’s not what it was designed to illustrate. Instead, it differentiates between impairment (a lack of, or difference in, function – the stuff that can’t be changed) and the oppressive and exclusive nature of disability (society’s failure to treat people who have impairments as equals – the stuff that can be changed.)

Some critics within specific disability communities argue very strongly against the use of person-first language because they note that it devalues their culture or suggests people can be separated from their disabilities. Deaf people, for example, don’t see Deafness as an impairment, and reject person-first language; for them, Deaf identity is part of a holistic identity and culture, not a problem that requires fixing. Many blind people also resist this framing, as do some autistic people.

People approaching me with demands that I use person-first language are asking that I subscribe to, and reinforce, the medical model of disability, which would be more accurately characterised the medicalised model. This is a model developed by outsiders to disability culture to describe disabled people, and it’s heavily focused on what is wrong with us; over time, the disability rights movement in the US took up person-first language in an attempt to get people to look at people first and disabilities second, but this, too, is part of the medicalised model of disability.

And it’s not a model I subscribe to, hence I’m not going to use that language. Especially not when it comes to mass media, where I have an opportunity to make a real impact on readers and open up conversations about these issues.

People thrusting language guides and other documentation at me are missing the larger picture; yes, some people fought long and hard to set up these guidelines, and to specifically replace hateful and demeaning terms with person-first language, but they did so on the basis of a model I don’t believe in. I’m not going to allow outsiders define disability, define me, or limit the language I use in reference to myself and the community I live in. The reason I talk the way I do is because I believe the medicalised model is inherently limiting, and it’s time for US disability activists to move away from it.

Part of that move away involves educating people about what the social model actually is and how it works, and by embracing more subtle acts of activism like changing the language I use to open up conversations about what terms people use, how, and why. Some people may want to continue using the medicalised model and advocating for it, but that doesn’t mean I’m going to quietly give in and go with the flow, any more than people in other minority groups who don’t favor the externally-defined models of their communities are going to sit still and allow someone else to have the last word.