Person-First or Identity-First Language?
Language matters, especially when it comes to how we describe identity.
You may have heard debates about whether it is better to say “autistic person” or “person with autism.”
While some professionals and parents insist on using person-first language—saying “person with autism” to emphasize that autism does not define an individual—many autistic people themselves prefer identity-first language, such as “autistic person.”
This article explores the origins of person-first language, why many autistic people reject it in favor of identity-first language, and why the best approach is to respect the preferences of the people we are talking about.
The Origins of Person-First Language
Person-first language emerged in professional fields such as healthcare, education, and mental health with the intention of emphasizing the humanity of individuals before their diagnosis.
The goal was to avoid reducing people to their medical conditions and to promote respect in language.
Examples of Person-First Language in Medical Settings
In medical environments, shorthand language often dehumanizes patients. For example, a doctor might say, “I have a new hip on my caseload,” referring to a person with a hip fracture.
Similarly, phrases like “the new spine” or “the stroke patient” removed the person from the condition entirely.
Outside of medicine, similar issues arose with other diagnoses. People might say, “a Down syndrome kid” instead of “a child with Down syndrome,” or worse, use pejorative slang.
Person-first language sought to address this by placing “person” before the condition:
- A person with a hip fracture
- A person with Down syndrome
This approach was widely adopted in many professional fields and is still considered best practice in certain communities. In fact, the ADA Guidelines for Writing About People with Disabilities specifically emphasize person-first language to avoid reducing individuals to their diagnoses.
However, while this guideline is widely used in medical and professional settings, it does not reflect the preferences of all disability communities, including many autistic people.
Disability Communities and Different Preferences
Disability is not a singular experience, and different communities have different perspectives on language.
While many individuals with Down syndrome prefer person-first language (e.g., “a person with Down syndrome”), this is not a universal preference across all disability communities.
Why the Autistic Community Prefers Identity-First Language
Autism as an Inherent Trait
Many autistic people prefer identity-first language, meaning they refer to themselves as “autistic people” rather than “people with autism.” The reasoning behind this is that autism is an integral part of their identity—it is not something separate or removable.
Using identity-first language aligns with how we describe other identities.
For example, we don’t say:
- “A person with gayness” → We say “a gay person.”
- “A person with Blackness” → We say “a Black person.”
No one questions whether these phrases dehumanize people because being gay or Black is understood as part of who someone is, not something they “have.”
Autistic people view their identity the same way.
Rejecting the Implication That Autism Is Negative
Person-first language implies that autism is something external to a person—something they “have” rather than something they “are.”
This can feel as though autism is being framed as an unfortunate burden, similar to a disease or an affliction.
By contrast, identity-first language affirms autism as a valid way of being.
Autism is not an accessory, a separate entity, or something to be distanced from—it is an intrinsic part of who an autistic person is.
Individual Preferences Matter
Even within the autistic community, not everyone feels the same way about person-first language. Some people prefer to be called “a person with autism.”
In one-on-one interactions, it is always best to respect the specific language that a person prefers.
That said, when speaking about the autistic community as a whole, identity-first language is generally the most widely accepted and affirmed choice.
Addressing Parental Language Preferences
Many non-autistic parents of autistic children tend to use person-first language when referring to their children. This may be due to professional influence, personal belief systems, or discomfort with seeing autism as an identity rather than a condition.
When speaking with parents, I may use their preferred terminology or gently educate them about why many autistic people prefer identity-first language—depending on the context and the nature of our relationship.
Language shapes perception. While person-first language was created with good intentions, many autistic people prefer identity-first language because it better reflects their lived experience.
Autism is not something separate from an autistic person—it is part of who they are.
When writing or speaking about autism in general terms, using “autistic person” to align with the preference of the majority of the autistic community is best practice.
However, as with any identity, the best approach is always to respect how individuals choose to describe themselves.
