Episode 12 | Should You Stop Saying These Words? October 31, 2021

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GUEST: Bella De Soriano, Healthline Media’s Senior Public Health Integrity Manager, Medical Affairs

Peanut gallery. Master bedroom. Wheelchair bound. Birth defect. What do these terms have in common? They all have the power to offend – the first two because of their racist origins and the next two because they’re often considered ableist. As our guest Bella De Soriano points out, the words we use have the power to make people sick – but also to heal. In her work with Healthline Media, De Soriano recently created The Conscious Language Guide to improve patient-provider communication and advance their work toward health equity. Through conscious language, we can ensure better health outcomes for everyone. In this episode, we’ll talk about how an ever-evolving language can create challenges, as well opportunities that can bring everyone closer together.

GUEST BIO:

Bella De Soriano is the senior public health integrity manager for Healthline Media’s Medical Affairs team. She has spent nearly 10 years focused on health equity in research and community settings. Along with Healthline Media’s editorial team, she created The Conscious Language Guide as part of a broader Conscious Language Initiative to ensure Healthline Media’s content is nonjudgmental and inclusive of communities that have historically been excluded. Working across all of Healthline’s brands (Healthline.com, MedicalNewsToday.com, Greatist.com, and PsychCentral.com), De Soriano and her colleagues strive to make content more accessible and inclusive to more people, by addressing systemic bias and health disparities.

LINKS:

Conscious Language Guide – Healthline’s resource guide for health equity in language.

Diversity Style Guide – A resource for journalists and media professionals.

UCSF Transgender Clinic (Terminology) – Guidelines for the care of transgender and gender nonbinary people.

National Center on Disability and Journalism A comprehensive disability language style guide.

Autism Self Advocacy Network – Resources include books, guides, and articles.

National Association of Black Journalists – Stylebook for newsrooms and others, including students, educators, and researchers.

National Association of Hispanic Journalists – Cultural Competence Handbook

Some books that are specific to health and oppressive systems, language, and stigma:

Medical Apartheid, by Harriet A. Washington

The Power of Language: How Discourse Influences Society, by Lynne Young and Brigid Fitzgerald

Lazy, Crazy, and Disgusting: Stigma and the Undoing of Global Health, by Alexandra Brewis and Amber Wutich

Full Transcript

BRAD PHILLIPS, HOST, THE SPEAK GOOD PODCAST:

The most popular post we’ve published on our blog this year, which by the way can be found at throughlinegroup.com/blog, was something we posted back in March. The post, which has now been viewed more than 8,000 times, was called 21 Offensive Words You Should Avoid. In framing that piece, our head writer wrote:

Language is fluid, reflecting societal and cultural changes that impact the meaning and connotation of words, as well as an audience’s reaction to them. That’s why it’s important if you are engaged in any kind of communication – internal or external – to make yourself aware of terminology that some groups may find offensive.

To give you a sense of that post. Here are a few examples of the words and terms on our list of 21 and what we wrote about them at the time.

Peanut gallery. This is a classist and racist phrase that dates to the late 19th century. Originally this term described the cheapest seats in a theater. However, it was also used to describe the upper balcony seats in segregated theaters. A far better word is hecklers.

Gyp or gypped. It has long been tossed about in casual speech to describe someone who has been cheated, ripped off, or conned, but the word comes from the word “Gypsy,” which is considered a racial slur among some Romani or Roma people. Far better to use the words cheated, ripped off, or conned. .

Sexual preference. In referring to someone’s physical, romantic, and/or emotional attraction to another, the preferred term is sexual orientation, or, simply, orientation.

Tone deaf. Using this phrase to indicate someone misread a situation or said or did something inappropriate, thoughtless, or inconsiderate, links deafness with something negative – something that someone failed at. It’s part of a broader problem known as ableism – discrimination or social prejudice against people with disabilities.

Now, I wouldn’t be surprised if you think I’m being oversensitive. And, there’s always going to be that type of pushback during these kinds of conversations. Still, this came to life for me a couple of years ago, when I led a training workshop during which a participant jokingly gave me some grief about something I had said. I responded to her, also in the spirit of fun, by quoting a line from one of my favorite movies — Gene Wilder in Willy Wonka and the Chocolate Factory, in which Wonka, pretending he didn’t hear one of those annoying children, said this:

(SOUND CLIP FROM WILLY WONKA STARTS)

 I’m a trifle deaf in this ear. Speak a little louder next time.

(SOUND CLIP ENDS)

She, the participant in our training then told me that my retort was abelist. I’d never even considered that it could be. It was just a funny line from a movie I loved, but I haven’t used that line since. Not because I think every audience will have a bad response to it. In fact, I think most probably won’t. But, because there are too many other ways to express humor in that moment, without the risk of upsetting someone unintentionally. And context matters here. Stand-up comedians, for example, have more license to boundaries. People paying to see them should expect that they might hear material they deem offensive. They made the choice to attend that comedy show, anyway. But, the same isn’t true in a professionally mandated training workshop. There was one term on that list of 21 that I asked our writer to remove. It had the potential to be deemed so politically correct that people would dismiss the rightness of the other 20.

To her credit, our writer stood her ground. She defended its inclusion in the list, and I recognized the validity of her arguments, so we kept it. Mom or dad. Hear me out here. Here’s what the entry said:

In and of themselves, mom and dad are not offensive terms, and based on the context you are using them, your audience, and the purpose of your communication, they could work just fine. However, just be aware these words (as well as terms such as husband and wife) reveal an assumption of certain family structures, as well as “traditional” gender roles in the home, that may or may not resonate for some members of your audience.

And, you know what? I really do think that’s a valid point. To me, the father of two amazing boys, the word dad is about the greatest sound I could ever hear. Father’s Day is literally my single favorite holiday of the year, because it actually means something to me. It’s not just a date on the calendar. Not only would I never be offended by the term dad, but I actively embrace it. I love having conversations, especially with other fathers who are equally as passionate about their families. But, if I were to ask a relative stranger what their father did for a living, I’m making assumptions, assumptions that they knew their father, that they were raised by a father, that it is impossible that they could have been raised by two women. At the very least, it’s worth pausing to ask: Huh? What if I was raised by a single mother and my father split before I ever met him? How would I feel if people kept asking me about him, assuming he was in my life? Now, I’ll admit that I was aware that blog posts could touch a nerve. I also want to be clear that we didn’t run it for the explicit purpose of being provocative.

We ran it because we run a communication shop and we believe that language matters. But unsurprisingly, we got some feedback. One woman wrote: This is outrageous. Remove me from any of your emails. This world has become way too triggered and expectant for me to conform to unreasonable thinking. Frankly, that response told me that she probably wouldn’t be open to many of our ideas. So, her loss from our list didn’t especially trouble me, but then I got another email. This one read: These words or titles may be offensive to you, and I respect your personal opinion. However, I’d like to be appreciated for the decisions that I’ve made concerning my sexuality. These are my decisions, not yours. Therefore, I will inform my coworkers and peers, how I desire to be addressed as an individual. You’ve connected my sexuality to my identity and reduced me to an it, I find your attempt to normalize and promote your opinions as to how the masses should address or title me regarding my sexuality offensive. Opinions are private thoughts, and, regarding sexuality, they should remain so. That one gave me pause. He rightly pointed out that just because a group like GLAAD, which fights for acceptance for the LGBTQ community, publishes a language guide doesn’t mean that everyone within that community is going to agree with their suggestions.

As another example, the conservative writer, Andrew Sullivan wrote this in October:

The woke left (calls) all of us ‘queer’ to ensure our continued marginalization, merging us into postmodern categories like ‘LGBTQIA+’ to deny our distinctive human experiences, erasing gay men and lesbians whose politics are not far left and whose lives are not much different than our straight friends …

As you can hear, this is an extremely divisive and challenging topic. I don’t pretend to have all of the answers about which terms should be deemed acceptable and which ones shouldn’t be. But I do hope that lists like ours will make you think and consider the power your words have to make others, particularly those who are too often marginalized, feel more included or more excluded. And because language often evolves quickly, I also think we have to offer forgiveness for those who use outdated terms unthinkingly or out of ignorance rather than out of malice. Ultimately, it’s my belief that we should at least be aware of certain sensitivities, so that we can make more informed choices about the words we use, and how our audiences might respond to them.

I’ll discuss all of this with Bella De Soriano, the senior manager of public health integrity with Healthline Media, the number one online health information publisher in the United States. Their brands include healthline.com, medicalnewstoday.com, greatest.com, and psychcentral.com. They publish more than 1,500 pieces of content a month created by more than 250 writers. And, to make sure they use language that reflects their commitment to health equity, Bella wrote Healthline’s conscious language guide, which helps to make sure their content adheres to public health best practices. You can download the guide for free at transform.healthline.com/language.

(MUSIC PLAYS)

PHILLIPS:

Bella, thank you very much for joining me. As I said in the open to this podcast, I know this is a really challenging and difficult topic for a lot of people. And so, I really want to get into it and unpack the concerns people have with it, but also the reasons why it’s so important to be having this conversation about conscious language in the first place. And maybe to set that up, we can begin with just telling me a little bit about Healthline Media.

BELLA DE SORIANO:

Very happy to be here, Brad, thank you. Healthline Media is the number one digital health information site in the U.S. And we reach over 90 million unique monthly visitors, which is a large number of people. And we do this through four distinct brands. That would be Healthline, Medical News Today, Psych Central and Greatest.

PHILLIPS:

Obviously, you had this idea, or you and your team had this idea, to put together a conscious language guide. Those millions of readers who you have each month, is it a policy of Healthline Media that you must use certain terms and not use other terms. Is the guide exactly? Something that should guide their thinking and that people should remain mindful of. How do you see that?

DE SORIANO:

The guide initially started as an internal resource for our editorial folks to aid in editorial judgment when looking through content and making changes and making edits. It’s not designed to be prescriptive. It’s not designed to say, you must use this word, or you must not use this word, because context is really important. It depends on who you’re talking to or who you’re talking about. And those considerations have to be top of mind when deciding what kinds of words and terms and phrasing should be used when talking about specific health topics. It’s not designed to tell people what to say or how to speak, that wouldn’t be our place, anyway. It really came from, Healthline has a great foundation for empathy,  person first, and a whole-person approach. This was just kind of an extension of that, as well. And I would really be amiss not to give a huge thanks to all of our editorial folks out there who are implementing not only our style guides, but the conscious language guide in all of our content every day. I have to give a shout-out to them for their work in the actual implementation of the guide.

PHILLIPS:

What was the origin story of this? What made you personally, but also as a group, decide that you wanted to create this conscious language guide, which you’ve referred to as the first digital guide of its kind for consumers and health professionals.

DE SORIANO:

If I’m being honest, we realized that we could do better. I think we started doing a lot of internal reflection, specifically around racism and health and how there’s a lot of … I’m going to use the term scientific racism. And so, we pride ourselves on you using research, scientific sources, but we also have to acknowledge that these don’t come without bias. So how do we make sure that when we’re writing content based on these trusted sources, that we’re not translating racial bias into our content? So, this was like a huge catalyst for us to think about other bias that might also be in our content as well. And also, just implementing best practice for health communication. I have a public health background, and so I’m really invested in health communication. How we do that effectively and efficiently? So, it draws on a lot of different places, to think about how all of these -isms might show up in health information and how we’re not doing our part in perpetuating any of that. Because, it can really have a detrimental effect on marginalized communities. We really want to work toward health equity in what we’re doing.

PHILLIPS:

I’m curious if you could give an example of how that unconscious bias can show up in some of your content, in ways that, as you said, are unconscious, not intentional and yet it might have a negative impact.

DE SORIANO:

Sure. One example that comes to mind is listing African American as a risk factor for a condition. For example, if we are talking about diabetes and then we have a list of risk factors, sometimes you might see African American listed as a risk factor for diabetes. What this does, is it places the onus on an individual body being responsible for that condition or that outcome. And what it doesn’t take into account is the context in which people live and the systems around them that influence health. And so, instead of putting African American in a risk factor for diabetes, we have started to make that change and saying like socioeconomic factors contribute to the prevalence of diabetes and it may be more common in some groups than others. So instead of focusing on the individual, it takes a broader look at the places people live, the systems in which they work and play and worship, to understand a little bit more of how people’s health behavior is influenced by all of this.

PHILLIPS:

Right. Being African American in and of itself doesn’t you more likely to get diabetes. It is the socioeconomic factors, regardless of the color of your skin, which might make you more susceptible to a certain condition. Is that a correct understanding?

DE SORIANO:

I would say so. Yes.

(MUSIC PLAYS)

PHILLIPS:

You say, and this jumped out at me in the conscious language guide, that using the wrong term literally can make people sick. How so?

DE SORIANO:

Yeah. So, just to clarify, if you use the wrong term, no one is going to suddenly develop a condition. But this can show up in a number of different ways. And, one research study that I read that was really eye-opening for me was that even the words used in medical records can create a stigmatized narrative of a patient that follows them throughout their health journey. This can create a stereotyped patient. We see this in things like if people don’t take their medications as prescribed, maybe that goes into a medical record as noncompliant, and then this might follow them along. And so, the next person that sees them sees the word non-compliant beforehand, and then certain assumptions are made, which could then potentially affect a clinician’s decision-making on how they treat that person. Also, when we think about things that are highly stigmatized like addiction, when we use a word that implies a moral failing in an individual, this also can affect how somebody treats them, the options that are given to them. It can affect policies that are made around that, which then limit the resources available to that person. So, the word affects health because it affects health behavior or people’s behaviors around health. And that’s how people can get sick.

PHILLIPS:

That is such a fascinating example of noncompliance, because the term noncompliance seems to suggest motive. The person is willingly refusing to follow medical guidance. Whereas, perhaps, there’s a reason for that action that has nothing to do with personal character or motive that is making it difficult for the person to comply. But using that term has now loaded the person with this negative baggage that carries around with them, that follows them from appointment to appointment. So that’s a fascinating example. One of the things I’ve been conscious of is the debate in different communities about whether you begin with what’s called person-first language or identity-first language. And first of all, could you define what those terms are and is there a best practice or is it really dependent from community to community? Which is preferable?

DE SORIANO:

Person-first language really came out of the disability rights movement of the sixties, seventies, and the eighties. It was in an attempt to put the person before the condition. So, you see the person and then you see the condition afterwards. This would be something like she has diabetes, or she was diagnosed with diabetes. Identity-first language says that the condition is so intricate, intricately intertwined with who the person is that you can’t separate them. For example, this would be – using the same example – Jane’s a diabetic. So, she becomes this identity, which is a diabetic. Whereas before, in person-first language, it is a thing that she has. There is no hard and fast rule for this as the answer to most language things. It depends.

PHILLIPS:

It depends.

DE SORIANO:

But there are some communities who have a preference for identity-first language, such as deaf communities, blind communities, the autistic community, as well. These folks see this aspect of them as intricately intertwined into who they are and how they experience the world, that it is impossible to separate that from who they are. I think as a general rule, I personally lean towards person-first language, unless I know that there’s a preference for identity-first language, and that’s what we tried to do in our content as well, is take person first, unless we know that there’s a community that wants identity first.

PHILLIPS:

So, you would lead with, she is a person who has this rather than she’s autistic, which is defining her specifically by that diagnosis. Am I understanding that correctly?

DE SORIANO:

Yes. Although autistic is okay because that’s identity-first language that the community has decided is for them.

PHILLIPS:

This is so fascinating, because I have to admit, I mean, a lot of this conversation and maybe people who have listened to earlier episodes of the podcast may even feel my discomfort a little bit here, because for example, you use the word blind, and I have started referring to that as visually impaired because is it blind? Is it visually impaired? I don’t know. What does that community prefer? And is it even a community that gets to decide or is it the individual? I feel so often like I am on slippery ground and my intention is always, I hope, good, but I don’t know if the outcome of my choices are good or not. And so, I guess the question I’d like to pursue is I see this, because I spend way too much of my life on Twitter. I’m trying to …

DE SORIANO:

(LAUGHS)

PHILLIPS:

But that aside, I will see somebody very innocently, without ill intent, using a term of some sort that somebody else finds offensive. And sometimes there’s this pile-on where people just attack that person’s character entirely for the linguistic choice, not even stopping to ask the question was this intentional? Was it an act of malice? Was it an act of ignorance? Was it non-thinking? And should there be a difference in how we react to people, especially given how quickly language evolves? I’m curious what your thoughts are in terms of how much forgiveness should we give each other, as we’re all trying to navigate these often, very quickly changing preferences in language?

DE SORIANO:

I would like to pick up on something that you mentioned a little bit before the end of that question. And I think you bring up a really great point of like, who is the community, right? So, we use this term community, and it doesn’t really have one definitive definition. So, we have to really think about who is included in, when we say community, who are we really talking about? And we see this, and I agree with you that sometimes it can feel strange and unfamiliar to use terms that have historically had a negative connotation, but are now potentially favored by a group, such as autistic. And the autism community is actually made up of a large number of people. You have parents. You have caregivers. You have advocacy groups. You have autistic people themselves. And all of these people might be the autism community, but they will all have different language preferences. And so, it can be really difficult to figure out what word to use and how to use it, considering there are so many people to take into account. And I just want to acknowledge that difficulty, before we think that it’s really easy to define who we mean when we say community.

PHILLIPS:

It’s a good point. And, it’s been a recurring theme on the podcast where we like to think about audiences in the aggregate when really, it’s such a sweeping overgeneralization that sometimes it doesn’t lead to any helpful outcome.

DE SORIANO:

It is definitely a balance between speaking to a large number of people, but not becoming so narrow that things only can apply to a few numbers of people. So, there’s definitely this balance that needs to happen. And I think that’s a constantly changing line and figuring out what that means all the time, rather than thinking that you figured it out once and then you’re done (LAUGHS).

PHILLIPS:

Yes. And the other part of the question about forgiveness, I’ll tell you where I’m coming from with that, because I have seen, again on social media, a lot of people … I’ll give you an example after the George Floyd murder saying, and this was in some cases the person I’m thinking of specifically was an African American woman, who said, it’s not my job to teach you about racism. It is your job to learn about it and inform yourself. And the point she was making, I think is it’s exhausting having to be the person to educate everybody else. And that’s a role that maybe an unfair burden that’s placed on that person. So, I take that point and I take very seriously. And that’s part of the purpose of this podcast to inform myself selfishly, in addition to hopefully the rest of the audience, to inform myself. On the other hand, does there not have to be some forgiveness for the fact that people who are not in a community as fraught as that word is, who are not a part of a community and are not part of the conversation about evolving language preferences, maybe shouldn’t be the victim of a social media pile-on if they inadvertently used the wrong term.

DE SORIANO:

I think the fact that this is about social media just adds another level of complexity, because you really don’t know who’s on the other side. You really don’t know in the immediate moment where they’re coming from. And, you really don’t know like anything about them. And so, without getting too into it in the specifics, I feel like we should all just come from a place of assume like good intent or assume the best of the other person. I think it’s really easy not to do that on social media. And I think taking that approach might help come with some empathy and understanding that you really don’t know what the other person is going through, either that day or in their life. And I completely agree with what you said earlier about this idea that it often falls on marginalized communities and folks with a marginalized identity to become the educator.

And it can be absolutely exhausting. If you have multiple people asking you in a day or in a week or over time, all of this builds up to the point where you’re like, I’m just tired. I don’t want to do this anymore. Then suddenly you have this interaction on social media and maybe it’s all just come and culminated in that one comment. And folks might think this is it. This is the time when I feel like I have to say something. Or, it’s all been too much, and I want to say my piece now. And so, there’s kind of like this idea of microaggressions, where it’s like a thousand cuts and you just get to the point where it’s too many cuts. You have a reaction and somebody else doesn’t understand this, maybe because they don’t have the background. They don’t understand. And then suddenly it becomes, this person blew up at me or like this person had this reaction to me and I don’t understand why. And I think they were rude, and they should have been nicer to me. And if this person really doesn’t know, then you know, now you know. Now you can go and ask somebody else. There are a lot of resources out there for folks to do their own research and to ask their friends who might know, who might not be part of a marginalized identity. So, I can see both sides.

PHILLIPS:

I think that’s a really compassionate and smart answer. And I mentioned in the open of the show that I received an email after we ran this post about 21 offensive terms you should avoid. And it said these words, titles may be offensive to you, and I respect your personal opinion. However, I’d like to be appreciated for the decisions that I’ve made concerning my sexuality. These are my decisions, not yours. Therefore, I will inform my coworkers and peers, how I desire to be addressed as an individual. You’ve connected my sexuality to my identity and reduced me to an it. That was a really interesting comment. And the reason I’m bringing this up now is I thought it was a thoughtful comment coming from a place of good faith. I responded to him. He responded to me. I responded to him. And I think that is just a great model of two people of good faith who see the world just through life experience in different ways, but who are still, as you said, approaching each other with some empathy and trying to learn from each other.

I’d like to get into some of specific terms in the conscious language guide, because I think a lot of these things, and I will admit I’ve used some of these terms, are just they’re part of our common vernacular. And you point out why some of these things are problematic and I’d love maybe to do a lightning round of sorts, where you could just explain to people who are listening, why a word or a term might hit the ear of somebody the wrong way. I’ll start with this. And these are all in the Conscious Language Guide. First, wheelchair bound.

DE SORIANO:

Okay. The consideration here is ableism. Bound implies that somebody is confined to that chair,  whereas some folks who use a wheelchair see this as a device that lets them go out and explore the world and gives them an element of freedom. And so, we don’t want to take this abelist approach of assuming that somebody feels confined to a wheelchair.

PHILLIPS:

Birth defect.

DE SORIANO:

Again, ableism. This implies that somebody is defective or sub-par, and we don’t want to apply that to people. So, another term here, I believe might be like congenital condition. That’s something that somebody is born with. So again, avoiding ableist language here.

PHILLIPS:

Food stamp.

DE SORIANO:

This term carries stigma and it’s also out of date, because the program has now been renamed to the supplemental nutrition assistance program. And people will no longer get paper or physical stamps. Folks will get like a debit card, an EBT card, which their benefits are loaded onto.

PHILLIPS:

And I suspect that term has also been co-opted by politicians who are against social spending on what were formerly called food stamps and being used to represent a group of people who they don’t want to offer that support to. That was my absolute editorializing.

Died of aids.

DE SORIANO:

AIDS is acquired immunodeficiency syndrome. It refers to a stage of HIV where the immune system is no longer able to function as well. And so, people may often pass from an infection that they get that their body can’t fight off anymore. So, people wouldn’t die of AIDS. People would potentially die of an opportunistic infection rather than AIDS itself.

PHILLIPS:

So beyond potentially being offensive, it’s just plain inaccurate.

DE SORIANO:

Correct. It is not medically accurate.

PHILLIPS:

So, here’s what I hear a lot. And the term is struggling with depression. And before I ask you to explain why that’s troubling to some people, it seems like the intention is good. Struggling is almost an empathic term, trying to acknowledge that the person is going through something. And yet that too could be seen very differently.

DE SORIANO:

Yeah. So, the alternative here might be something like living with depression, experiencing depression. And while, this, I think, will cause a little bit of conversation for people, the intent here is not to assume that somebody is struggling with depression. Some people certainly are. But, we don’t want to assume somebody’s experience. And we also don’t want to imply this idea that you have to be struggling with something to seek out treatment or seek out care or seek out help. Like if you have depression, you can seek out help at any time. You don’t have to get to the point where you feel like you’re absolutely struggling with it.

PHILLIPS:

So that, too, I think is a great example of what we were talking about earlier about how using the wrong term can literally make people sick.

DE SORIANO:

Right.

PHILLIPS:

It’s hard for anybody in the best of circumstances to express vulnerability and the fact that they’re struggling with anything. And so, if you then label the term, struggling with depression, you now have probably made it even a higher barrier before people are willing to seek help.

DE SORIANO:

Right. And that reminds me of, just on that previous question, another way that words can affect health behavior is if words inflict shame or judgment or stigma on a person, this can affect their willingness to interact with healthcare, seek out healthcare, you know, even be honest with a healthcare professional about what they’re doing, because they’re afraid of judgment. That’s another way that words can influence the health behavior on the patient side. And so we really don’t want to have any of that or have any words that would contribute to that.

PHILLIPS:

Sometimes my wife and I will be watching TV and a commercial will come on for some kind of medical treatment. And it’s something that’s very personal in nature, whatever it is. And we’ll sometimes give each other a look like, whoa, that’s different, that’s new. But the immediate follow-up thought is: Good by putting that in a national ad, it serves a really useful purpose of removing stigma. And presumably makes people more likely to seek help for it than they would if it wasn’t something spoken about. By the way, along the lines of the struggling with depression, one of my linguistic pet peeves is when somebody says, they lost their battle with cancer.

DE SORIANO:

Oh, yes.

PHILLIPS:

Norm McDonald, the comedian who passed away recently had a bit about this, where he said, not only is it ridiculous because it assumes that if you end up dying of cancer, that you lost your battle, you didn’t succeed. And, it assumes that those who survived cancer are somehow stronger than the ones that didn’t. But he also just pointed out how inaccurate that is too, because he says, look, when you die, the cancer dies, too. So, at best, it battled you to a draw. I thought that was a pretty good way of putting the flip on that. Did you have a comment on that battling cancer phrase?

DE SORIANO:

I was actually thinking about this yesterday because we see this combative, warlike language come up in health all the time. And I think cancer is a great example of that, of like they’re battling cancer, they’d lost their battle. It implies this combative nature between your body and something else. And I just ask myself, and I don’t have an answer for this, what would health and healing look like if that narrative was different? Like, if we had a different way of talking about that, what would health and healing look like? Not just for cancer, but for other conditions, as well. And so, this is one of those like winding roads I go down of thought sometimes. How can we reimagine potentially how we talk about things and then that re-imagines how we conceptualize and then how we treat and how we cure or how we, you know, even just approach disease and health.

PHILLIPS:

I’m fascinated by this idea. If you don’t mind me following you down this rabbit hole for a second.

DE SORIANO:

Of course.

PHILLIPS:

So, I hope this never happens, but should I receive a cancer diagnosis at some point in my life, rather than saying, I now have to battle this foreign invader that’s living in my body, do you have an idea about the kind of language that you would even use for yourself to maybe create a different, more productive mindset?

DE SORIANO:

That’s a really great question. I don’t think that I have thought that far down this road, the initial thing that comes to mind is like living with, which is what we tend to use, like living with depression, as well. It implies this kind of coexistence. But yeah, I don’t know the answer to that. Have you?

PHILLIPS:

Well, no. Because the truth is that I would see it as a foreign invader living in my body that I want to exterminate at all costs and yet, I think the compassion of living with is along the right lines. We have an email address, comments@speakgoodpod.com. So, if anybody listening has a better idea than I do, feel free to drop a line and we’ll include it in a future episode. Two more terms here. One I heard in a broadcast in the past week or so, talking about, it was in the context of COVID, and certain communities being vaccinated more or less than others, and they use the term minorities, which kind of hit my ear pretty harshly. And it’s on your list of words to avoid in the Conscious Language Guide, how come?

DE SORIANO:

This is about systemic? Sorry, I get systemic and systematic confused, sometimes. Systemic oppression. And minorities reduces this down to a numbers game, and that’s not the right framing that we want to use for this. It also creates an identity. Somebody is a minority. And what this does is, again, it focuses on the individual rather than the systems that are in place that marginalized folks, regardless of how many of that group there are. For example, globally, most people might be in the U.S. standards of how we categorize race, called people of color, right? White folks are in the minority. But, you could say that globally white folks are kind of at the top of this racism hierarchy that has been created. And so, we don’t want to reduce marginalization and systemic oppression down to numbers.

PHILLIPS:

The final word here … the term is transgendered and this is one of those very quickly moving areas where I think language has changed very quickly. So, can you help to give us kind of the lexicon, as much as there is agreement within any one community, what the agreement there is?

DE SORIANO:

Yes. From my understanding, trans or transgender should be used as an adjective rather than a noun or verb. Somebody isn’t doing transgender and they’re definitely not a transgender. And so, we want to use trans as in like trans man trans woman, trans person, as an adjective to describe them rather than a thing they are or a thing that they’re doing.

PHILLIPS:

I suspect that most people who have made it this far in our conversation, who endured my monologue and all of this, are probably on board with this as an idea. But if somebody has stuck around, who’s kind of gritting their teeth and dismissing all of this stuff as politically correct nonsense or progressivism running amok or leftist nonsense or whatever the term they might use is, what would you say to them as a way of just maybe getting them to reconsider that view?

DE SORIANO:

Yes. So, when I hit politically correct, which is itself a term that has changed its meaning many times over the last few decades.

PHILLIPS:

Yes, you bet.

DE SORIANO:

So, when I hear this most now today, I understand it to mean people are concerned that they can’t say the things that they want to say, that they can’t express themselves in the way that makes most sense to them, or they’re afraid that somebody’s going to come and tell them that they’re wrong. And I would say like what I perceive to be behind that is some kind of fear. And so just acknowledging what’s behind that is if its fear and if folks are trying to grapple with an ever-changing world where they don’t know how to keep up, or they feel like what they want to say isn’t valid, I want to acknowledge that because that’s a real feeling.

And, just reassure folks that it’s not about limiting what people can say. Even the guide isn’t saying, you have to say this, or you have to say this, it’s saying here, have you considered there are some other ways that you could say this? And it’s not saying you need to, it’s saying, let’s expand representation here by expanding the options of words that we can use. So, we’re free to use the language that we want. And if you want to use something that’s in the guide that says don’t consider using this, we’re not going to come and knock on the door and say you were using the wrong word. And I don’t think that’s going to happen to people. But it is about expanding representation and allowing people to express their lived experience in a way that feels most authentic to them and being able to define themselves. I think one really important thing for people is to feel heard and understood, and to be known when we have more words for this, we can just increase the likelihood that we as people can be known and understood to others. And I think that’s just a great gift that people can give each other.

PHILLIPS:

Yes, I have one more question I’d like to explore with you. And that is the question of groups versus individuals. Because as that email I read an excerpt of a few minutes ago, indicated a group like GLAAD, which represents the LGBTQ community, and by the way, it was interesting to me when I went to their website, they represent the LGBTQ community, not the LGBTQ, is it T a plus a community, or at least that’s not the language that they use on their websites. So that’s just an interesting example of language, not having these very clear boundaries that are easy to navigate. But the email that I got from that gentleman was basically saying, look, GLAAD, despite the fact that I am a part of that very big community, I don’t agree with them. And I don’t want to be identified just because they say. Who are they? Who is this group to tell members of the press or other writers the terms that they should use to define me? Of course, language can’t make millions of different choices depending on that many different individuals. So, what do you do, do you start with, look, here’s a shared community standard of what works for a plurality of people, and yet you should approach conversations with each individual separately?  I mean, how do you think about that group versus individual preference question?

DE SORIANO:

That’s a good consideration and there is no easy answer to this. I think when you are referring to groups and you’re having an individual conversation, there are very different things to think about here. So, you are talking to a person, you are able to ask them outright, sometimes, if it feels appropriate, what terms would you like? For example, it is perfectly okay to ask someone what pronouns do you want me to use for you today? Or, you know, just a very simple question like that. So, you can ask them if you’re on an individual level. They can tell you, so if somebody tells you, this is the word I want you to use, respect that and use that. And then you can also listen, if you don’t want to ask, you can also listen to how people are describing themselves in conversation and some of the words that they use maybe to describe their experiences. That’s another way to understand maybe what language that person would use.

For communities, it’s got a couple of other different considerations. And I think understanding, really, you know, depending on where you’re coming from, what you’re doing, your intended audience. And I think the first place to start is really understanding the history of oppression for that group. And then you can understand that this term may not resonate with older adults, which may not be true for a younger generation. And our intended audience is the younger generation. So, this is how we’re going to decide to use this word. And some of the brand differentiation that we’ve done is with the term, queer, right? That has a history of being a very negative word for folks. And so, in some content, it might be appropriate to use that if we’ve got a younger audience that we’re trying to reach and in other content, it might not. And so, this is some of that kind of differentiation that we’re trying to do on our part to speak to who we’re really trying to get information across to.

PHILLIPS:

You know, one thing that occurs to me, just another potential motivator for people paying attention to this, even if they might, in some part of their brain, say, really, we have to focus on all of those words, is, and maybe I’m stereotyping here, but I know it’s true, at least for my grandparents, one of my grandparents used a term – I think both of them – used a term to describe an ethnic group when they would go to one of the restaurants, they would use a pejorative term to describe that ethnicity. Now I can tell you as someone who loved my grandparents dearly and thought that they were, it’s such a cliche, but good people, that if somebody were to call them on it and say, that term is really harmful, I prefer you don’t use it anymore, I am pretty certain they would say, oh, I’m so sorry. I won’t. And they wouldn’t use it again. I think one other motivator is I know as I’m getting older, I’m finding it more challenging to keep up, which is part of my motivation to have a conversation like this one. I think people sometimes go, that’s for the next generation to deal with, or even the other generation may (say of the older generation) he’s just old. He doesn’t get it. I don’t want to fall into that. Professionally, I really can’t because we’re a communications firm. But, I suppose for our listeners too, not wanting to match that stereotype is another reason why people should pay attention to all of this. Your Conscious Language Guide is available for free at transform.healthline.com/language. Are there any other resources for our listeners that you might offer, especially considering so many of them are either in executive positions where the terms they use really matter, or communications professionals, who are disseminating information to their audiences.

DE SORIANO:

Yes. And just to note your comment about grandparents, as well, I found something similar with my own grandparents. And, I think it brings up an interesting conversation around intent versus impact. People can be very well-meaning, and not mean any harm, but that doesn’t mean the impact of somebody’s words wasn’t very real for that person and we can hold space and acknowledge both of those things. So, it’s not an either, or it has to be an and. And, I think that’s a really critical part of this conversation, as well. It’s just acknowledging that. And, in terms of resources, it can be tricky because there isn’t really one definitive guide for all topics on language. There are lots of different kind of individual guides depending on topic. So, for example, I think the diversity style guide is a really great resource. It’s not just focused on health. There are some health things in there, um, but it has a lot of information about how to cover shootings or journalism considerations. There’s also, what am I thinking of now? I know that UCSF has a transgender clinic and they’re really well known in this area. So, looking for them for some of the language that they use on their websites, as well. And I encourage folks to also look at the websites for advocacy groups. So, if you’ve got a specific group in mind, you can go and look at their website and see how are these folks using their language to describe themselves? Do they have blogs that people write? I think that’s one really good way to also keep up to date with things. And, I think, the long answer to that is read a history, to understand these systems of oppression and how words have been used as tools of oppression and how language has been used to uphold these hierarchical power systems that play some at the bottom and some at the top. And having that foundational understanding, it won’t tell you exactly what words to use, but it will give you the ability to figure out what terms to use. And I think that is a more important skill here, is to figure out how do I find this and how do I even know what I should be considering?

PHILLIPS:

Well, Bella, I cannot tell you how much I enjoyed this conversation. Thank you for sharing your expertise and your knowledge. Those resources you just listed; we will link to those from our website throughlingroup.com/podcast. So, if you are driving right now and couldn’t capture all of those, we link to all of those from our site. Bella, De Soriano, the senior manager of public health integrity at Healthline Media, thank you so much for joining us.

DE SORIANO:

Thank you so much for having me. This has been a really great experience and a wonderful opportunity to share some of the work that Healthline Media is doing that I know I am certainly very proud of, and I know that our editorial folks also are very proud and invested in, so thank you.

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