Person First or Identity First?

Many neurotypical people struggle on what terminology to use when referring to autistic people. I, myself, have fallen victim to this issue. Person with autism, autistic person, person who is on the spectrum. What’s the difference between all of these? 

With person-first language, the person is emphasized before the disability. Examples include “has autism”, “person with autism”, “person with ASD”, or “person with ASC”. With identity-first language, the disability is stated before the person. Examples include “autistic person” or “autistic”. More neutral language would be saying “on the spectrum”. 

Surveys have found that autistic people largely prefer identity-first language. There may be a misconception that autistic people would prefer person-first language because they want to be considered as people rather than known for being disabled. However, this isn’t the case. Autism is not an accessory, like a handbag that you carry. It's not something that someone just has; it's a disability that is an essential part of their identity. Identity-first language indicates that being autistic is an inherent part of a person’s identity, not an addition to it. Autistic people want to celebrate and take pride in their identity. 

However, that doesn’t mean every single autistic individual prefers identity-first language. Some prefer person-first language; their unique life experiences may lead them to wish to not be so strongly associated with their disability. Some prefer completely different language altogether. 

An interesting phenomenon is that many experts who were surveyed prefer person-first language. This could be due to the fact that they are medical professionals, and they therefore use the medical model for terminology. For example, a doctor does not say “This is a diabetic patient”. They say, “This patient has diabetes”. The whole point is that they are making a diagnosis, so their goal is to answer the question of what affliction the patient has. Similarly, they would say “This patient has autism” rather than “This is an autistic patient”. 

If you accidentally use person-first language, there is nothing to worry about. For many autistic individuals, it is not deemed to be offensive. However, stating that one “suffers from autism” is highly problematic. Autism is not some disease that one suffers from. Yes, autistic people face their own life challenges due to our highly stigmatized society. But autism is not something that should be considered bad in any way. Our differences are meant to be celebrated. 

(Credit to Dr. Lawrence Fung for his wonderful lecture on this topic at Stanford SNP-REACH 2023)