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Health

Published onOct 20, 2022
Health
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Appearance

Seldom discussed, yet present in every interaction, whether in person or virtually, appearance discrimination is a barrier for any individual whose physical features don’t meet or aspire to the societal norms of what is considered attractive.

Inclusive writing devoid of appearance discrimination excludes descriptions or judgments of physical appearance unless essential and relevant to the topic. “Body neutrality” is a movement in which individuals speak of the physical body in positive-only terms. As a rule, avoid descriptions of appearance unless essential to the subject of the text.

Much of what is written about appearance discrimination is within employment law and practices, including recruitment, hiring, performance and retention. Writing in the Washington Law Review, Adamitis (2000) asserts, "An individual's personal appearance may reflect, sustain, and nourish his personality and may well be used as a means of expressing his attitude and lifestyle." Appearance ranks among the top three discriminatory actions routinely occurring within hiring. Economists estimate a “beauty premium” in wages of 4%-12% for attractive individuals. Conversely, there is also an “ugliness” penalty when individuals don’t meet beauty norms of any given culture or group. 

Appearance discrimination takes many forms:

Lookism

assessing an individual on their physical appearance

Beauty premiums

benefits conveyed consciously or unconsciously to an individual whose appearance meets or exceeds societal norms for attractiveness

Individuals encounter appearance discrimination primarily related to the following factors (Victorian Equal Opportunity & Human Rights Commission):

  • height and weight

  • body size and body shape

  • facial features, proportions, and overall relationship

  • body and facial hair

  • moles, scars, birthmarks, and other distinguishing body elements

Appearance discrimination may be observed as follows:

  • employees of a certain enterprise have similar appearances, build, or facial features

  • club goers seeking entertainment may be excluded entry if their physical features don’t conform to unspoken expectations

  • sports teams of similar builds and stature that seem to lack additional players beyond the physical norms visually apparent among a specific team

  • a teacher pointing out a specific attribute of a student’s physical appearance, such as a person with eyes that don’t fully align or a crooked nose

Avoid

Preferred

birth defect, defect

describe the specific disability or anomaly without the use of the word “defect”

body shape, stature, or size; weight, obese, overweight

avoid describing body size, stature, height, breadth, or shape unless relevant or essential to the context or information

References

Elizabeth M. Adamitis, Notes and Comments, Appearance Matters: A Proposal to Prohibit Appearance Discrimination in Employment, 75 Wash.  L. Rev.  195 (2000). Available at:  https://digitalcommons.law.uw.edu/wlr/vol75/iss1/6 

Adomaitis, Alyssa Dana Dana; Raskin, Rachel; and Saiki, Diana (2017) "Appearance Discrimination: Lookism and the Cost to the American Woman," The Seneca Falls Dialogues Journal: Vol. 2, Article 6.

The Diversity Style Guide. (2022). https://www.diversitystyleguide.com/

 

Weight and Size

Like many topics in these guidelines, a person’s weight or size should only be mentioned when it is directly relevant. Please see below for terms and practices to avoid and consider instead in the realm of weight- and size-related topics:

Avoid

Preferred

placing blame on an individual

acknowledge systemic root causes of obesity

medical jargon outside the medical profession

use accurate plain language

idealizing or pathologizing specific weights or body shapes

praising or criticizing changes in weight

characterizing foods as bad or good

commentary on clothing choice or body shape

body acceptance-oriented language; body acceptance- or positivity-oriented language as preferred by the community referred to. Also, consider additional factors (socioeconomic status, race, gender, sexual orientation, age, culture, etc.) that may bias your perception or impact the conversation about weight

weight stigma; weight bias

fatphobia

obese; extremely obese; morbidly obese; overweight; fat*

higher weight; unhealthy weight; larger. Person with obesity” may be acceptable in medical contexts.

midget; dwarf*

little person; person with dwarfism (if accurate); person of short stature; person of restricted growth

*Note that the terms “fat” and “dwarf” are not considered offensive by all people and may be used if that is the person’s preference.

References

Admin. (2018, March 23). The weight inclusive approach. Empowered Eating. https://empoweredeatingrd.com/maryland-eating-disorder-expert/the-weight-inclusive-approach/

Correct terminology. (2013). Understanding Dwarfism. http://understandingdwarfism.com/correct-terminology

FAQ. (2020). Little People of America. https://www.lpaonline.org/faq-#Midget

National Eating Disorders Association. (2019, February 22). Tips for responsible media coverage. https://www.nationaleatingdisorders.org/tips-responsible-media-coverage

Ospina, M. S. (2016, July 7). 11 influencers discuss the differences between body positivity & fat acceptance. Bustle. https://www.bustle.com/articles/170978-11-influencers-discuss-the-differences-between-body-positivity-fat-acceptance

The Health at Every Size® (HAES®) Principles. (2020, August 29). Association for Size Diversity and Health. https://www.sizediversityandhealth.org/health-at-every-size-haes-approach/

World Obesity Federation. (n.d.). The do’s and don’ts when talking about obesity. https://www.worldobesity.org/downloads/healthy_voices_downloads/HV_Language_guidelines.pdf

Disability and ableist language

Disabilities, disorders, diseases, and other health conditions. There is no consensus on what differentiates a disability from a disorder, disease, or other health condition. Different places have legal definitions of “disability,” but no universal definitions exist. Some people with disabilities prefer one term over another (Mattlin, 2019). Some people don’t consider their condition an impairment, so the term “disability” might not be appropriate (O’Reilly, 2015). For example, under the social model of disability, the environment, not a physical or cognitive difference, is disabling.

Although people with disabilities, disorders, and other conditions have diverse experiences and needs, this section discusses all disabilities and health-related conditions together because they share some considerations related to language. Not all guidelines will apply in the same way to people with disabilities versus those with mental illness, for example. In all cases, use respect for people as a guide, and refer to the general guidelines of this resource.

Mention only when necessary. Mention someone’s disability or health condition only when it is necessary for readers to know and when you have confirmation of the diagnosis. Never disclose someone’s health information without their knowledge or consent.

Content framing. Carefully consider how you frame someone’s disability or illness. Avoid “inspiration porn,” which objectifies people with disabilities by treating them as inspirational simply for having a disability and by using them to make nondisabled people feel better about themselves (Pulrang 2019). In addition, referring people with disabilities or other health conditions as “patients is not appropriate. If you are not discussing a context in which someone is receiving medical care, the term “person” is more appropriate; even in some medical contexts, people may prefer to be called a “person” more than a “patient.”

Respect how people want to be described. Defer to people’s preferences when deciding how to describe someone’s health, whether a disease, disability, mental illness, or other condition. This deference applies to all aspects of description, including the specific terms to use (e.g., “blind” versus “low or limited vision” ), whether to use people-first or identity-first language, and whether to describe someone as a “survivor” (Perry , 2021 ; Berry, 2019). When you cannot ascertain someone’s preference, use the preference associated with groups of people with a condition. For example, many in the Deaf community and autism community have been outspoken about preferring identity-first language (National Association of the Deaf, Organization for Autism Research, 2020 ; Brown, 2011). In contrast, when preference is not known, person-first language is generally preferred for people with mental illnesses (American Psychiatric Association).

Capitalization. In general, follow a standard dictionary for the capitalization of health conditions. An exception is distinguishing between “Deaf,” which denotes people who identify with the Deaf community, and “deaf,” which refers to the audiological condition or people who do not identify with the Deaf community (National Association of the Deaf). 

Avoid objectifying people. Avoid using “the” or “a” or “an” plus an adjective to refer to groups. Instead, use descriptions that refer to people.

Use neutral, non-stigmatizing terms. Do not portray people with disabilities, disorders, or health conditions as powerless or helpless. For example, avoid the terms “victim,” “suffering,” “afflicted,” “stricken,” “damaged,” and “impaired.” Similarly, avoid militaristic terms, such as saying someone “lost a battle” with a health problem. Opt instead for neutral terms like “has” or “person with.” 

Do not use terms that stigmatize people with physical, cognitive, or mental illness. For example, avoid terms associated with crime, such as “committed suicide” and “drug abuse”; use “died by suicide” and “drug use” instead. 

Be specific. Avoid generalizing about large groups of people and using nonspecific words that blur important distinctions or assume deficits. For example, avoid using the word “normal” as a contrast with people with disabilities or disorders. Also take care when using “healthy” as a contrast, especially when discussing disabilities. Use specific wording instead (Bottema-Beutel 2021).

Avoid slurs, outdated terms, and euphemisms. Use clear, direct, accurate terms to describe people. Do not use slurs or outdated terms (e.g., “mental retardation,” “handicapped”). Avoid euphemisms, like “handicapable,” “special needs,” “physically challenged,” and “differently abled.” Instead, use the terms “disabled” and “disability.” Also avoid “able-bodied” to refer to people without disabilities, as that term assumes that all people with disabilities do not have able bodies. Use “nondisabled” or “people without disabilities” instead.

Ableism. Do not use terms related to disability, mental illness, or disease flippantly or metaphorically to mean something negative. Even words that are no longer used to refer to people with disabilities or health conditions should still be avoided if their historical use was to denigrate disabled people or enforce stereotypes. See the glossary of ableist terms and phrases from Lydia X. Z. Brown on the blog Autistic Hoya for examples of words to avoid. While some people with disabilities and diseases are reclaiming terms (e.g., “crip” and “crazy”), care should be used to avoid offense, especially when people outside those communities use the terms (Kirby, 2016; Raving, 2019).

Take care with details. Consider your content’s purpose, platform, and audience when deciding what details to include about people’s mental illnesses. Suicide prevention organizations urge writers to not discuss details about suicide or self-harm methods (Time to Change). Similarly, organizations on eating disorder awareness recommend not including details such as specific weights and food eaten, as they can trigger others (Beat). The needs of various authors will differ, but in each case, the writer should take care to treat the topic with respect and avoid unnecessary details that could lead others to harm themselves.

Avoid

Preferred

The student, who has muscular dystrophy, requested extended office hours.

The student requested extended office hours.

The student, who has muscular dystrophy, has written a petition requesting university officials make dorm rooms more accessible for people with disabilities. [ The context is relevant]

The disabled

People with disabilities, disabled people

An epileptic

A person with epilepsy

An addict

A person with substance use disorder

Confined to a wheelchair

Uses a wheelchair

The person failed chemotherapy.

Chemotherapy was not successful.

He’s been clean for two months.

He has been in recovery for two months.

The trial included 100 people with bipolar disorder and 95 healthy controls.

The trial included 100 people with bipolar disorder and 95 people without bipolar disorder.

They are a high-functioning autistic person.

They are an autistic person who requires support in managing sensory overload but little support in expressive communication.

The speech was tone deaf.

The speech didn’t acknowledge people’s frustrations with the process.

Your presentation is schizophrenic.

Your presentation lacks transitions between ideas.

That policy crippled the economy.

That policy damaged the economy.

The new requirement is moronic.

This new requirement is pointless.

A double-blind study

A double-anonymized study

References

American Psychiatric Association. (n.d.). Words matter: Reporting on mental health conditions. https://www.psychiatry.org/news-room/reporting-on-mental-health-conditions

Beat. Media Guidelines for Reporting Eating Disorders. https://beat.contentfiles.net/media/documents/beat-media-guidelines.pdf

Berry, L. L., Flynn, A., & Davis, S. (2019, February 4). People diagnosed with cancer often don’t embrace the term ‘survivor.’ The Conversation. https://theconversation.com/people-diagnosed-with-cancer-often-dont-embrace-the-term-survivor-110942

Bottema-Beutel, K., Kapp, S. K., Lester, J. N., Sasson, N. J., & Hand, B. N. (2021). Avoiding ableist language: Suggestions for autism researchers. Autism in Adulthood, 3(1), 18–29. https://doi.org/10.1089/aut.2020.0014

Brown, L. X. Z. (2011, August 4). The significance of semantics: Person-First language: Why it matters. Autistic Hoya. https://www.autistichoya.com/2011/08/significance-of-semantics-person-first.html

Brown, L. X. Z. (2021, November 16). Ableism/Language. Autistic Hoya. https://www.autistichoya.com/p/ableist-words-and-terms-to-avoid.html

FAQ. (n.d.). National Association of the Deaf. https://www.nad.org/about-us/faq/

Kirby, A. (2016, August). Crip: A story of reclamation. Now Then. https://nowthenmagazine.com/articles/crip-a-story-of-reclamation

Mattlin, B. (2019, March 7). Disability and disease aren’t interchangeable. Washington Post. https://www.washingtonpost.com/opinions/disability-and-disease-arent-interchangeable/2019/03/07/5c904946-d325-11e8-b2d2-f397227b43f0_story.html

O’Reilly, M., Karim, K., & Lester, J. N. (2015). Should autism be classified as a mental illness/disability? Evidence from empirical work. In M. O’Reilly & J. N. Lester (Eds.), The palgrave handbook of child mental health (pp. 252–271). Palgrave Macmillan. https://doi.org/10.1057/9781137428318_14

Organization for Autism Research. (2020, September 30). 1,000 people surveyed, survey says. . .. https://researchautism.org/1000-people-surveyed-survey-says/

Perry, R. (2021, July 6). Person-First vs. Identity-First Language. AccessATE. https://accessate.net/features/2519/person-first-vs-identity-first-language

Pulrang, A. (2019, November 29). How to avoid “inspiration porn.” Forbes. https://www.forbes.com/sites/andrewpulrang/2019/11/29/how-to-avoid-inspiration-porn/?sh=589ecc215b3d

Raving, S. (2019, January 28). To fight mental health stigma, we need to reclaim the word crazy. Medium. https://medium.com/invisible-illness/to-fight-mental-health-stigma-we-need-to-reclaim-the-word-crazy-dec3a3cda70f

Time to Change. Guidelines: Media and mental health. https://www.time-to-change.org.uk/sites/default/files/Time%20to%20Change%20Media%20Guidelines.pdf

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