Using Inclusive Language

In the Department of Pediatrics, we are committed to lifelong learning and ensuring that all the patients, families and communities we care for, learners and colleagues feel seen, heard and included. This guide is meant to provide our Pediatric community with inclusive language aligned with our mission: to provide the most compassionate, highest-quality care possible; perform clinical, laboratory and behavioral research to advance our understanding of diseases that affect children and adolescents; and educate medical students, residents, fellows, researchers and all learners to become leaders for the next generation of physicians and scientists.

Inclusive language is crucial to fostering compassionate care. Language is constantly changing as society changes; as our country and professions attempt to be more mindful of diverse populations, we find that health care providers may want to shift the words they use, but may not know how. This guide is designed as a resource for all members of the Department of Pediatrics to maximize supportive and inclusive to promote comfort and support for our patients and each other.

Guiding Principles

Inclusive language is a framework that allows you to be attentive to the preferences to the person or people you are speaking with. This framework includes:

Person-first language that focuses on a person rather than their characteristics. Instead of "sickle cell patient," use "a patient with sickle cell disease." Gender, religion, sexual orientation, racial or ethnic group, ability and other characteristics should be used only when relevant to the discussion.
Using universal language instead of catchphrases or sayings that are particular to medicine or a region of the country or world. This enhances shared understanding and ensures that everyone feels included and part of the conversation.
Avoiding language that uses mental health diagnoses to reference everyday behavior.
Gender-neutral language ensures that there is not a preferred gender (referencing 'you all' rather than 'guys' when addressing your team)
A growth mindset that supports everyone's development rather than focusing on natural talents or skills of individuals within group.
Not sure? It’s ok to ask. This gets conversation going and helps you to know more about who you are working with or caring for.

Adapted from: 70 Inclusive Language Principles That Will Make You A More Successful Recruiter

Gender Identity

Gender Identity is an individual's sense of themselves as male, female, both, something in between or neither. Gender and sex are not the same - sex is usually assigned at birth (often on the basis of external genitalia).

Instead of...	In the Department of Pediatrics, We Say/Do...	Additional Information
Assuming gender based on sterotypes (hair, clothing, appearance)	Respectfully ask how an individual identifies	Using gender-neutral pronouns and language avoids cisnormativity (assuming that everyone is cisgender). For example, even if the majority of a group of learners you are addressing is cisgender, it is important to be gender inclusive by using gender-affirming practices.
Boys and girls, guys, ladies and gentlemen	People, folks, friends, students, you all, y'all, etc.
Assumed Gender	Assignment usually made at birth on the basis of biological sex characteristics (anatomy, genetics, etc)
Gender perception	The way other people interpret someone’s gender expression
Agender	Someone who does not identify with any gender
Cisgender	Someone whose gender identify aligns with their sex assigned at birth
Gender diverse	A person who identifies and expresses themselves differently than what is socially expected based on biological sex
Gender fluid	Someone whose gender identity is not fixed and shifts either over time or in varied circumstances
Sexual Preference	Sexual Orientation
Homosexual	lesbian, gay, bisexual, queer, etc for individuals and LGBTQ+ is most up to date when referencing a larger community

Race/Ethnicity

Race is a false surrogate for genetics/biology. Additionally, studies show when we include a patient's race at the start of a medical presentation, implicit biases may be activated which may distort our thinking and care.

Instead of...	In the Department of Pediatrics, We Say/Do...	Additional Information
Noting patient race or ethnicity in the one-liner of case in clinical notes and clinical presentations	Race and ethnicity are not listed in one-liner by default, but may be listed in social history, if relevant. Other Terms- Latinx South Asian; North Asian
Racial Categories: Caucasian, Oriental	Current accepted terminology from US Census/NIH: American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or Other Pacific islander, White	For more on terminology from the NIH, visit their diversity statement.

Religion

Instead of...	In the Department of Pediatrics, We Say/Do...
Anno Domini (AD) and Before Christ (BC) when labeling years	Common Era (CE) and Before Common Era (BCE) when labeling years
Saying a specific religious holiday to indicate a time of the year or season	Saying the month or season to indicate a certain time of year
Saying “Merry Christmas” to someone without knowing their religious affiliation	Saying “Happy Holidays” or “Seasons Greetings” when you don’t know someone’s religious affiliation
Using the word “church” to mean any place of worship.	Using the term “place of worship” or “house of prayer”.

Person-first Language

Person-first language was introduced by disability advocates in the 1970s. The concept focused on language as a humanizing force to support and "see" people in their own wholeness rather than limited by an illness definition.

Instead of...	In the Department of Pediatrics, We Say/Do...
Obese, homeless, addict, sickler	Say: person who is overweight, person who doesn’t have a home, person with substance use disorder; child with sickle cell disease

Family Structure

Instead of...	In the Department of Pediatrics, We Say/Do...
Mom and Dad	Family, Folks
Parents	Family, Guardians
Nanny/babysitter	Caregiver
Is adopted	Was adopted
Husband, Wife, Boyfriend, Girlfriend	Spouse, partner, significant other
Real Family	Birth parents

Land Acknowledgment

A land acknowledgment is a formal recognition of and respect for Indigenous Peoples as the original stewards of the land. Land acknowledgments are an expression of gratitude to those on whose land we reside. For more information on land acknowledgments, visit landacknowledgments.org.

Additional Resources

The AMA offers a helpful guide on inclusive language on its website. The Columbia University School of Professional Studies (CUSPS) has created a comprehensive DEIA Equity Language Guide as a resource for the Columbia University community.

Below is a list of additional resources we used in compiling this page.

LGBTQI Language Glossary (BUMC)
Transstudent.org
Primary Care considerations for transgender and gender-diverse youth. (Peds in Review)
Gender Identity Expression Guide (NPR)
Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents (AAP)
Race Matters? Examining and rethinking race portrayal in preclinical medical education (Academic Medicine)
Race and Genetic Ancestry in Medicine (NEJM)
Racial and Ethnic Categories and Definitions for NIH Diversity Programs and for Other Reporting Purposes (NIH)
Northwestern Inclusive Language Guide (Northwestern)
Person-Centered Language at a Glance. (Resources for Integrated Care)
Person-first language: are we practicing what we preach? (Journal of Multidisciplinary Healthcare)
A Guide to Indigenous Land Acknowledgment (Native Governance Center)
Lenape Land Acknowledgment (Columbia School of Nursing)