NICE style guide

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

Always be specific when talking about people's age, for example 'people aged 90 and over'.

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. 

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.

Do not use age groups if possible, because they mean different things to different people. If you need to, we stratify them as follows, but you should usually define them at first use: 

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.

Ethnicity

Use a capital letter and be specific when talking about someone's ethnic background. For example, 'levels of diagnosed ill health are higher in Pakistani, Bangladeshi and Black Caribbean groups'. Use the UK Government's list of ethnic groups for how to refer to specific ethnicities or broader ethnic groups.  

If you cannot be specific, use 'ethnic minority'. For example, 'The study included 13 people from ethnic minority backgrounds'.

Do not use Black, Asian and minority ethnic, or the abbreviations BME or BAME. 

Skin colour

Only use skin colour if it's essential to make sense of what you're discussing. Use lowercase 'black', 'white' or 'brown', not 'dark' or 'light'.

If talking about a condition that affects the skin, be specific if it looks different on different skin colours. For example, 'pressure ulcers in people with brown or black skin tend to present as purple or blue patches, whereas in people with white skin they tend to present as red patches'.

Sex, gender and sexual orientation

Do not confuse sex, gender and sexual orientation, but remember that these can intersect. See NHS.uk for definitions of sex, gender and sexual orientation. 

Use 'sex' if talking about biology. For example, 'there is not enough evidence to know if these treatments affect people differently based on sex'.  

Use inclusive language. This usually means using 'people', 'they' and 'them' or rewording. See table 2 for examples.  

If being neutral would be unclear, unsafe or inaccurate, be more specific. This might mean talking about one population, if you're referring to statistics or clinical trial evidence. For example, 'gender surgery for trans men may include construction of a penis', 'the clinical trial included 44 men', or 'women living in the most deprived areas are more than 2.5 times more likely to die than women living in the least deprived areas'. Or, it might mean adding populations if the content applies to different groups: For example, 'lower urinary tract symptoms in men, trans women and non-binary people with a prostate', or 'This guideline is for pregnant women and pregnant trans men and non-binary people'. 

Use man, woman, or trans person, trans man or trans woman if you are referring to someone whose gender identity differs from the sex they were registered with at birth. Do not use transwoman, transman, transgender or transsexual.

Use anatomical terms like vagina, penis, uterus, prostate. For example, 'The device is circular and encloses the penis'.

Do not change words that describe broad services or medical specialties. For example, 'maternity services'.

Use sexual orientation not sexuality. For example, 'residential care should reflect sexual orientation and cultural preferences'.

Be specific, and remember that sexual orientation and gender can intersect, when talking about sexual orientation. You can use, for example, lesbian, gay, bisexual, asexual, or pansexual. For example, 'Ensure staff are aware that bisexual and asexual people are also at risk of forced marriage'. Use Stonewall's glossary on LGBTQ+ terms for how to refer to specific sexual orientations.

If it's not possible to be specific, use the abbreviation LGBTQ+ (no need to spell it out). For example, 'Consider providing services for particular groups experiencing homelessness, such as LGBTQ+ people'.  

Disfigurement

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'.

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 to remove the nose'. You could also use 'surgery that causes a visible difference to a person's face'.

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.

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.