More Than Words: Inclusive Language & Communicating with Compassion

By Amy Agarwal, Principal Writer and Editor

Inclusion is a core value for EngenderHealth and we work thoughtfully to ensure our language deliberately and explicitly reflects and respects the agency and dignity of the diverse populations with whom we work in order to support our vision of a gender-equal world where all people achieve their sexual and reproductive health and rights. Employing inclusive language is not always as simple as knowing which words to say or not to say. Indeed, I understand the ire against the “words matter” champions, like myself, who espouse the importance of language but perhaps fail to appreciably incorporate a “context matters, too” subtitle. Further, I have yet to see a single, consolidated list explicitly cataloging every word that may cause offense to some individual or group—much to the chagrin of those who have come to me as their “language expert friend” expecting me to share such a resource. I understand this consternation. How can we “follow the rules” without a rulebook? Yet, style guides that offer rules for how we communicate are most often designed to and are most effective when they establish absolutes; and, for certain situations, there simply are no absolutes. But there is no need to abandon hope; with a little learning (and unlearning), a willingness to accept ambiguity, and an acknowledgment that putting people first sometimes means literally putting “people” last, we can all champion compassion and inclusion with our communication.

To the left is a photo of a woman. To the right, text reads "We must care about people, first and foremost, and we must recognize that our words can communicate compassion as easily as they can create harm." Below that, the quote attribute reads "Amy Agarwal, Principal Writer and Editor." The EngenderHealth logo is in the lower-right corner.

Learning, Unlearning, and Evolving

I have stated, and repeated, and will remind readers again: the words we use reflect and shape our thinking. Therefore, it should not be surprising that through time, new words have come into popularity, antiquated words have been renounced, and other words have significantly shifted in connotation if not necessarily in denotation—as we as a society have evolved in our understanding and appreciation of the world around us. We can explore the evolution of the word “queer” as one example. While the term originated in the 1504, it was not until the 1894 that it was first recorded as a slur—with negative connotations that continued until the 1990s when activists reappropriated the term. Understanding this evolution, we included “queer” in our Gender, Sex, and Sexuality Language Guide, along with a selection of other terms that may have been used pejoratively once and have similarly been reclaimed by the LGBTQ+ community, as well as appropriate alternatives for terms that remain—or have become—derogatory.

Appreciating the Ambiguity

Further, it is important to recognize that language progression infrequently follows a simple, linear path—from acceptable to disrespectful, or the opposite—and inclusive, respectful language often exists in the grey areas of communications. Let’s unpack the terms “victim” and “survivor” for a moment as an example. The word “survivor” was initially (several centuries ago) defined as “continuing in existence after the death of another,” reflecting its origins in inheritance law. In the health sector, the term “survivor” has become popular and is frequently used to recognize those who have recovered from a significant health challenge, for instance, a “cancer survivor.” In our recent Gender-Based Violence Language Guide, we expressed a preference for “survivor” to reflect that people can heal from and regain their agency after experiencing violence (including physical, emotional, or any other form of violence) and that we aim to support them in that process. The term “survivor” suggests a sense of power and pride: I faced this incredible obstacle, I persisted, and I won! Yet, it’s an imperfect term. Within the medical community, detractors note that this language evokes a binary of positive and negative—winners and losers—and explains that this results in those who do not survive potentially being labeled as weak. In the context of gender-based violence, this matter is further complicated as “victim” is often the official term for a person who has experienced violence and who therefore is eligible to seek legal recourse and receive various forms of support. Furthermore, we also understand descriptors like these are deeply personal and honoring the preferences of affected individuals is paramount. Therefore, we must support individuals as they define themselves and respect their decisions and definitions. And, building upon the theme of respecting how affected communities define themselves, it is worth unpacking the concepts of person-first and identity-first language—which we will do next.

The Power and Perils of Person-First Language and an Exploration of Identity-First Language

The term “person-first language” emerged more than 30 years ago and steadily became accepted as linguistic law in the United States, particularly in the health sector. But what is person-first language and why do we care? Person-first language places the person before their characteristic or condition, for instance: people living with HIV, people who use wheelchairs, and people with developmental disabilities. The intent is to humanize rather than marginalize or stigmatize—to see an individual as a person first and the characteristic or condition secondary, and to recognize a characteristic or condition does not define person. And we should be seeing people as people first, right? In many cases, this is a perfectly lovely approach; however, language and identity are complex constructs and exceptions abound. For instance, many communities—including the blind community and the deaf community in the US—have rejected this approach for themselves, despite its origin in the disability community (more on this later). Additionally, critics have long argued that person-first language is awkward and unnecessarily tedious; and in many cases, I would agree. Is there a significant difference between “teenagers” and “people aged 13 to 19,” other than the aforementioned tedium? If I wish to present myself as “an Asian American woman,” will these grammarians condemn me until I admit to being “a person who is female and of Asian heritage”? While I am being somewhat facetious, I hope this point will be memorable—person-first language is often, but not always, appropriate. So where do we go from here? Let’s talk about identity-first language and proponents who argue agency comes from visibility.  

Identity-first language leads with a descriptor or label. In some cases, an affected population may prefer identity-first language. And, when a person or group chooses identity-first language, they are often seeking to be seen, to be recognized, and to be respected for their identity—in spite of historic oppression. For instance, similar to the blind and deaf communities, person-first language has come under considerable criticism within the autistic community in the US. A 2020 survey of autistic persons (who comprised more than 80% of the survey population) and allies (family members and professionals working in the autism space) concluded that 81.4% of respondents prefer identity-first language and 88.1% refer to themselves or a loved one as “autistic” or as “an autistic person”—a notable (but not unanimous) shift from when the organization was founded in 2001 and person-first language was preferred.

Simply stated, not all groups subscribe to person-first or identity-first language and not all individuals within groups subscribe to proposed group etiquette. Additionally, preferences can change over time and vary from place to place and from person to person. For instance, in the US, “blind person” is acceptable and often preferred, whereas in Tanzania, “person who is blind” is preferred, and “blind person” is considered inappropriate. Learn more about identity-first and person-first language for people with disabilities in our new People with Disabilities Language Guide.

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Intention and Impact: Moving Beyond “Correct” to “Compassionate”

Popular culture frequently promotes the idea of “correct” and “incorrect.” But that is not how language works; it is too complex and it is not as easy as right or wrong—for all the reasons discussed above. The idea of “politically correct” in terms of communication, for instance, allegedly aims to avoid offending to certain populations; however, it not only perpetuates the myth that adopting certain absolutes is enough, it is also reductive and fails to accept that inclusiveness is more about impact than intent.

If our goal is to respect people with our words and grammatical guidance developed for that purpose has the opposite effect, we have a problem. Respecting actual people is more important than respecting the rules. We must care about people, first and foremost, and we must recognize that our words can communicate compassion as easily as they can create harm. We must center the voices of those most affected. Sometimes that means using person-first language and other times that means using identity-first language; sometimes that means disregarding well-intentioned style guides; and sometimes that means accepting that even when we try our best, we may still find ourselves being corrected by those audiences we tried in earnest to respect. No one is perfect, just as language is imperfect, and mistakes happen—but the only true failure is the refusal to learn and evolve.

Commit to Compassion: Choose Your Own Adventure

Just as language continues to change and we must continue to unlearn outdated rules, compassionate communication takes practice. It is not always easy, but it does not have to always be arduous either. We are all busy (special thanks to those who have taken the time to read this far!)—so how can we incorporate this work into already hectic schedules? I implore you to think outside of the box. If you love a good style guide—read one of ours or take a moment to find one addressing a topic that interests you. If you’re a bibliophile like me, follow authors from diverse communities and read how they describe themselves and their communities. If music is more your jam, listen to the lyrics from artists from cultures and groups different from yours. Or, share the experience with friends or family by watching movies or television shows featuring groups you are looking to learn more about. Choose your own adventure!

Finally, please remember: words matter, but context and compassion matter, too.