Content style guide - Inclusive language

Writing for and about people in a way that is inclusive and respectful.

Age

Only include age if it's relevant, for example, with vaccination, screening or testing programmes for particular age groups. An example of this is chlamydia testing as tests are free for under-25s.

Here are some of the terms we use for different stages of life with some guidance about the ages they relate to.

When you need to be more specific, for example if you're writing about medicines dosage, give the actual age. For example, "teenagers aged 16 and over".

We use:

  • fertilised egg: from conception to 14 days
  • embryo: from 2 to 6 weeks
  • baby: during pregnancy, at birth and up to 1 year. (Read more about how we use "baby" in the A to Z of NHS health writing.)
  • toddler: 1 to 3 years
  • child: 4 to 12 years
  • teenager: 13 to 19 years
  • young people: 16 to 24 years
  • adult: generally from age 18 but this may vary. Be specific, for example: "adults aged 19 to 64"

With babies and toddlers, we count their age in weeks up until 6 months, then months up until 2 years. Our research shows that this is how people talk about their child's age. Healthcare professionals also use weeks and months in this way. It means we can be consistent and accurate when writing about a baby's milestones, vaccinations and development reviews.

Older people

We prefer to specify ages: over-65s, over-75s, over-80s.

In some contexts, we use "older person" or "older people", for example, where a health condition might affect people in their 60s or in their 90s.​

Example

Anyone can have a fall, but older people are more vulnerable and likely to fall, especially if they have a long-term health condition.

We do not use the words:

  • elderly
  • middle aged
  • OAP
  • old age pensioner
  • pensioner
  • senior

Disabilities and conditions

We use positive language and do not label people when talking about disabilities and conditions.

Content designers should be familiar with the social model of disability. Read more about the social model on Scope's website.

We do say things like:

  • people living with a disability, or disabled person
  • people with diabetes
  • wheelchair user

We do not say:

  • afflicted by
  • suffering from
  • victim of
  • confined to a wheelchair
  • handicapped
  • diabetic person
  • sick or diseased person

NHS digital services should be accessible to everyone who needs them. Read our guidance on accessibility for content designers, writers and editors in the digital service manual.

Mental health

We do not describe people as mentally ill.

We do say:

  • mental health condition
  • mental health problems

Race, ethnicity, religion and nationality

We only refer to people's ethnic heritage or religion if it's relevant to the content.

Example

You're more at risk of developing type 2 diabetes if you are of south Asian, Chinese, African Caribbean or black African origin (even if you were born in the UK).

Sex, gender and sexuality

The language around sex, gender and sexuality changes all the time and it's an area that people hold strong and differing opinions about. We try to make sure that we are in touch with the communities we are writing for and we update this guidance regularly. This section should help you get started but the best thing is to test your content and services with the people who use them.

Only mention sex, gender or sexuality if they're relevant, for example, to signpost people and help them get the health information and access to treatment they need.

When to use "sex" and when to use "gender"

Many people think that sex and gender are the same but they mean different things. It's important to be clear about the difference.​

Sex

Sex is biological (male or female). It's based not only on the genes we inherit, but also on how our external and internal sex and reproductive organs work and respond to hormones. Sex is the label that's recorded when a baby's birth is registered.

We use "sex" or, better still, the body part associated with biological sex when we're writing about things like screening that is sex specific, for example, breast and cervical screening.

Sex assigned or registered at birth

We use the phrase "sex assigned at birth" when we're talking about trans health and gender dysphoria, as this is the language our audience uses. In other cases, we use "the sex someone was registered with at birth" because user research shows that most people understand this better as it refers to an actual event.

Intersex

We use "intersex" in some content about people with differences in sex development (DSD) because some people prefer it to DSD.

DSD involves genes, hormones and reproductive organs, including genitals. A person's physical sex development, internally, externally or both can be different to most other people's.

Most people with DSD have a clear sex that is registered at birth. Some adults with DSD prefer the term "intersex" to DSD but they may want to keep their legal sex as male or female. Other people see "intersex" as distinct from male and female.

Gender

Gender is more complex. It refers to our internal sense of who we are and how we see and describe ourselves.

Someone may see themselves as a man, a woman or neither (non-binary). Being non-binary can mean having no gender, a different gender, or being in between genders. Gender can be fixed or fluid. Some people identify with a gender opposite to the sex they were registered with.

We use the word "gender" when we're:​

  • discussing the social idea or identity as opposed to the biological sex, for example, if we're writing about gender dysphoria or transgender​ health and social care
  • writing about a survey or report based on gender, such as gender diversity​
  • writing about the results of a national census, where there is a question about gender identity as well as sex to identify the trans (including non-binary) population​

Gender neutral language

We make content gender neutral as far as possible. In general, we word our content to avoid masculine and feminine pronouns ("he" or "she"). Instead we use "you" where appropriate and sometimes "they" when we need a gender-neutral pronoun (unless this is confusing).​

Example

You should see the GP if you have persistent symptoms of osteoarthritis so they can confirm the diagnosis and prescribe any necessary treatment.

Avoid asking users for their title, such as Mr, Miss, Mrs, or Ms.

Transgender

We use "trans" as an umbrella term to describe people whose current gender identity or way of expressing their gender differs from the sex they were registered with at birth. Some, but not all, trans people want to transition (change) socially or medically or both.

We use "trans woman" for someone who was registered male at birth and now identifies as a woman and "trans man" for someone who was registered female at birth and now identifies as a man.

We use "trans woman" or "trans man" in content about the particular health needs of trans people - for example, screening or treatments that trans people need to be aware of, like advising a trans man about cervical and breast screening.​

Otherwise, we leave out the word "trans" and just refer to men and women, if relevant.

Note: we use "sex assigned at birth" when we're writing for a trans audience. Read more about sex assigned or registered at birth.

Sexuality

We use language about sexuality when it's helpful to signpost or help people get the health information and access to treatment they need.​

For example, when we're talking about specific sexual health services or sexual health content, we use words like:​

  • lesbian
  • gay
  • bisexual
  • men who have sex with men (MSM includes men who may not identify as gay)​

Get in touch

If you’ve got a question about the NHS digital service manual or want to feedback, get in touch.

Updated: March 2020