Corporate document

Talking about people, including deaf and blind, age, faith, family background, gender

Talking about people, including deaf and blind, age, faith, family background, gender

Use person‑centred language. Be respectful, empathetic and inclusive. Person-centred language reflects good manners and sensitivity, not political correctness. There are some examples in table 1.

Avoid labelling people. Conditions describe what a person has, not what a person is. Diseases are treated, not people. Diseases, not people, respond to treatment. Conditions, not people, are monitored. People are not unsuitable for treatments: treatments are unsuitable for them. People have diseases, they do not suffer from them.

Important exceptions are 'autistic people' and 'disabled people'.

Table 1 Person-centred language

Do use

Do not use

People with diabetes

Diabetics

People with schizophrenia

Schizophrenics

People who smoke

Smokers

People who use drugs

Drug users, drug addicts

People who are dependent on alcohol

People who misuse alcohol

Alcoholic

People who abuse alcohol

A person with depression

A person suffering from depression

People with behaviour that challenges services

People with challenging behaviour

People with a learning disability

People with learning disabilities, people with intellectual disabilities

Disabled people

People with a disability

Autistic people

People with autism

Surgery is unsuitable for some people

Some people are unsuitable for surgery

If the disease has already been treated

If the person has already been treated

The disease did not respond to treatment

The patient did not respond to treatment

When monitoring the disease

When monitoring the patient

Also see GOV.UK's inclusive language: words to use and avoid when writing about disability.

Try to use people, not patients or service users. Sometimes it will make sense to use other terms (for example, when talking about clinical trials or to distinguish from other groups), but even then, consider people in the trial or people who use X services.

Deaf and blind

Deaf can be used to mean any range of hearing loss, but Deaf (with a capital D) may also refer to people who consider themselves to be part of a cultural or linguistic minority. Most members of this community use a sign language as their preferred language. People with hearing loss or people with hearing impairment may be more suitable.

Blind refers to total loss of vision. Visual impairment refers to any kind of partial sight that is below 'normal' levels. Remember to use whichever is appropriate for the context.

Age

Use young people and older people (not adolescents, teenagers, the elderly or old people). It's often better to be specific: say 'people aged 90 and over', not 'very old people'.

Be accurate: men over 65 is different from men aged 65 and over (1 includes men aged exactly 65, the other does not).

Do not use the age of… or …years of age. Saying X‑year olds or over Xs is fine as long as it's accurate.

Do not use neonates. If you mean newborn babies, say in newborn babies. If you specifically mean the neonatal period (that is, up until 28 days), say in newborn babies under 28 days.

If you need to use specific age groups, we stratify them as follows. Define them at first use:

  • babies: 1 year and under

  • children: up to 12

  • young people: between 12 and 17

  • adults: 18 and over

  • older people: 65 and over.

Faith

Avoid faith-specific language or terminology that may exclude some of our users (use first name not Christian name).

Use faith groups to refer to people with religious beliefs collectively. Take into account the customs and practices associated with particular beliefs, but avoid stereotyping or making assumptions. Give examples if possible, but do not try to list every possible faith group that shares a particular belief.

Family background

Use family background not race. For example, 'Sickle cell disease is particularly common in people with an African or Caribbean family background'.

Only use skin colour if essential to make sense of what you're discussing. For example, 'pressure ulcers in people with pale skin tend to present as red patches, whereas people with dark skin tend to get purple or blue patches'.

Only use ethnicity generally. For example, 'there is no link between mental health problems and ethnicity'.

Do not use BME or BAME abbreviations. Try to be more specific. If you cannot be specific, spell it out and say black, Asian and minority ethnic. For example, 'if a person is from a black, Asian or other minority ethnic group they have a higher risk of becoming severely ill from COVID-19'. This should only be used if necessary because it covers a diverse group of people.

Use Gypsy, Roma and Travellers to talk about Romany gypsies, Irish travellers, and other Traveller communities. For example, 'Gypsy, Roma and Traveller communities face some of the most severe health inequalities among the UK population'.

Gender

Use trans not transgender or transsexual. Trans is an umbrella term that refers to people whose gender identity or expression differs from their birth sex.

Use sexual orientation not sexuality. Do not confuse sexual orientation with gender identity.

Use gender-neutral language. This means using 'people', 'they' and 'them' instead of 'women', 'men' and 'his' or 'her'.

Sex-specific language may be more appropriate in some cases:

  • If there are anatomical differences that are important for the recommendations (for example, if penile or vaginal surgery is used). In this case, it's usually better to use 'men and women' instead of 'people with a penis' and 'people with a vagina'.

  • When referring to pregnancy. Use 'pregnant women' (not 'pregnant people') for consistency with the NHS website.

  • When describing sex-specific risk factors that could lead to inaccuracies in how the guidance is used. For example, if there are different treatment pathways based on biological factors.

  • It's sometimes best to reword the sentence to avoid referring to 'people', 'men' or 'women' at all. See table 2 for some examples. Ask the editorial team for advice if you are unsure.

Table 2 Gender wording examples

Original

Gender-neutral

Reworded

Offer hormonal treatment to women with suspected, confirmed or recurrent endometriosis.

Offer hormonal treatment to people with suspected, confirmed or recurrent endometriosis.

Offer hormonal treatment if there is suspected, confirmed or recurrent endometriosis.

Warn men undergoing radical treatment for prostate cancer of the likely effects of the treatment on their urinary function.

Warn people undergoing radical treatment for prostate cancer of the likely effects of the treatment on their urinary function.

Explain how radical treatment for prostate cancer may have negative effects on urinary function.

Diagnose gestational diabetes if the woman has a 2-hour plasma glucose level of 7.8 mmol/litre or above following an oral glucose tolerance test.

Diagnose gestational diabetes if the person has a 2-hour plasma glucose level of 7.8 mmol/litre or above following an oral glucose tolerance test.

Diagnose gestational diabetes if an oral glucose tolerance test shows plasma glucose levels of 7.8 mmol/litre or above.

Disfigurement

'Disfigurement' is a protected characteristic under the 2010 Equality Act, under disability. Although it is a contentious word, using the word 'disfigurement' is accepted, so you can use 'disfigurement' to talk about a group of people, for example, 'people with disfigurements often experience unwanted staring'.

But, if referring to an individual, avoid 'disfigurement' and do not use 'disfigured person', 'defect' or 'deformed'. Instead, use a term that describes the individual, such as 'scars from a cancer operation', or 'Moebius syndrome'. This helps people understand the cause as well as the effect.

If describing a cancer, or surgery, avoid using the word 'disfiguring'. Use neutral words, such as 'skin cancer, which can change the appearance of the face if it spreads'. Or specifically describe what the surgery is, for example, 'surgery that would remove the nose'. You could also use 'surgery that causes a visible difference to a person's face'. This is because the person with the cancer or having the surgery may not have identified themselves as having a disfigurement.

Other terms

Try not to use clinician. Healthcare professional is preferable if you want to specify a qualified professional, or healthcare worker for more general use.

Table 3 Social and care terms

Do use

Do not use

End of life care

Terminal care

Socioeconomic status

Class

Poor people

Wealthy people

People who are under served

(but be more specific if you can)

People who are neglected

Hard-to-reach people

Disadvantaged people

People who are homeless

The homeless

People who sleep rough

People without homes

People who take their own life

People who die by suicide

People who commit suicide

People who kill themselves

Use frailer people for people whose age or physical characteristics may prevent their having certain treatments ('Older, frailer people for whom chemotherapy is not suitable').

Asylum seeker, refugee and migrant worker are not interchangeable.

Refer to Think Local Act Personal's Care and Support Jargon Buster for other helpful social care definitions.