AMA Citation Guide

Any age: "person," "individual," etc.

Birth to 1 month: "neonates" or "newborns"

1 month to 1 year: "infants"

1 to 12 years: "child," "girl," "boy," "transgender girl," "transgender boy," "gender-fluid child," "children," etc.

13-17 years: "adolescent," "adolescent boys," "adolescent girls," "teenagers," "agender adolescent," etc.

>18 years: "adult," "woman," "man," "transgender man," "transgender woman," "genderqueer adult," "cisgender adult," etc.

18 to 24 years: "young woman," "young man," "young adult," etc.

Older adults: "older persons," "older people," "older adults," "older patients," "older individuals," "persons 65 years and older," and "the older population"; contrast older adults with other age groups specifically, such as with decade-specific descriptors ("octogenarian," "centenarian")

Any age: Avoid using "males" and "females" as nouns; instead use "men" and "women" or other age-appropriate words. ("Males" and "females" are appropriate when groups include individuals with a broad age range. You can also use these terms when discussing sex-based biological or physiological differences.)

Older adults: Avoid using terms such as "seniors," "elderly," "the aged," "aging dependents," "young-old," and similar "othering" terms. Please note that some organizations still use terms like "elderly," so be mindful of context and audience.

Person-first language: emphasize person, not the individual's disabling or chronic condition (e.g., "person with paraplegia," "people with substance use disorders," "people with intellectual disabilities")

Identity-first language: disability becomes the focus, which allows individuals to claim the disability and choose their identity rather than permitting others to name it or select terms with negative implications (e.g., "blind person," "autistic person," "amputee")

*It is permissible to use either approach or to mix person-first and identity-first language unless or until you know that a group clearly prefers one approach.

Refer to individuals with disabilities as "patients" or "clients" within the context of a health care setting.

Also, be mindful of cultural differences in how disability is perceived and described.

Avoid pictorial, metaphoric, or negativistic terms that imply restriction (e.g., "wheelchair bound"), excessive and negative labels (e.g., "AIDS victim"), and slurs (e.g., "cripple").

Avoid euphemisms that are condescending when describing individuals with disabilities (e.g., "special needs," "physically challenged," "handi-capable"). Avoid reducing people with disabilities to a "bundle of deficiencies."

Gender: refers to attitudes, feelings, and behaviors that a given culture associates with a person's biological sex; use when referring to people as social groups

Sex: refers to biological sex assignment; use when biological distinction of sex assignment is predominant

Gender identity: a component of gender that describes a person's psychological sense of their gender; distinct from sexual orientation

Cisgender: individuals whose sex assigned at birth aligns with their gender identity

Transgender: used as an adjective to refer to persons whose gender identity, expression, and/or role does not conform to what is culturally associated with their sex assigned at birth; other terms include "gender-nonconforming," "genderqueer," "gender-nonbinary," "gender-creative," "agender," or "two-spirit" ("two-spirit" is specific to Indigenous and Native American communities)

Transgender and gender-nonconforming (TGNC) people:: generally agreed-upon umbrella term Sex assignment: use terms "assigned sex" or "sex assigned at birth" Use specific nouns to identify people or groups of people (e.g., women, men, transgender men, trans men, transgender women, trans women, cisgender women, cisgender men, gender-fluid people). Use "male" and "female" as adjectives. To refer to all human beings, use terms like "individuals," "people," or persons." Use the singular "they" to avoid making assumptions about an individual's gender.

It's important to respect individuals' stated gender identity in all contexts, even if it differs from legal or medical records.

We also recommend consulting individuals or groups about preferred language when possible.

Avoid cisgenderism/cissexism (the belief that being cisgender is normative) and genderism (the belief that there are only two genders and that gender is automatically linked to an individual's sex assigned at birth).

Avoid the terms "birth sex," "natal sex," "tranny," "transvestite," and "transsexual."

When referring to all human beings, avoid terms like "man" or "mankind."

Avoid gendered endings such as "man" in occupational titles (e.g., use "police officer" instead of "policeman").

Do not refer to pronouns as "preferred pronouns" because this implies a choice about one's gender. Use the terms "identified pronouns," "self-identified pronouns," or "pronouns" instead.

Avoid "he" or "she" as alternatives to the singular "they" because such contractions imply an exclusively binary nature of gender.

Avoid referring to one sex or gender as the "opposite sex" or "opposite gender"; appropriate wording may be "another sex" or "another gender."

Participation in research

Descriptive terms such as "college students," "children," "respondents," "participants," "subjects," and "sample" Use the term "patient" to describe an individual diagnosed with a mental health, behavioral health, and/or medical disease, disorder, or problem who is receiving services from a health care provider. In academic, business, school, or other settings, the term "client" might be preferred instead. An added note, while the AMA still approves of the use of "subjects," we recommend considering the preferences of your audience or institution's standards.

Case: an occurrence of a disorder or illness

Person: affected by disorder or illness and receiving care from a health care professional

Avoid broad clinical terms such as "borderline" and "at risk," unless they are part of a specific clinical or diagnostic context.

Avoid passive voice (e.g., "the trial was completed by the subjects" and "the participants were run") and use active voice instead (e.g., "the subjects completed the trial" and "we collected data from the participants").

Avoid the term "failed" (e.g., "eight participants failed to complete the Rorschach test") and instead use "did not complete."

Racial or ethnic groups

Race: uses the Oxford English Dictionary's (OED) definition of "a group of people connected by common descent or origin" or "any of the (putative) major groupings of mankind, usually defined in terms of distinct physical features or shared ethnicity."

Ethnicity: uses the OED's definition of "membership of a group regarded as ultimately of common descent, or having a common national or cultural tradition."

Racial and ethnic groups are designated by proper nouns and are capitalized. Use "Black patient" and "White woman" instead of "black" and "white." However, when capitalization may be considered inappropriate, you should avoid capitalizing these terms, such as "white supremacy."

When writing about people of Asian ancestry from Asia, the term "Asian" is appropriate. For people of Asian descent from the United States, the appropriate term is "Asian American" or "Asian Canadian," respectively. To provide more specificity, "Asian origin" may be divided regionally, for example, into South Asia, Southeast Asia, and East Asia. The corresponding terms (e.g., East Asian) can be used; however, refer to the specific nation or region of origin when possible.

When writing about people of Middle Eastern and North African (MENA) descent, state the nation of origin when possible. In some cases, people of MENA descent who claim Arab ancestry and reside in the United States may be referred to as "Arab Americans."

When writing about people who identify as Hispanic, Latino/x, Chicano, or another related designation, authors should consult with their participants to determine the appropriate choice. The term "Latino" might be preferred by those originating from Latin America, including Brazil. Some use the word "Hispanic" to refer to those who speak Spanish; however, not every group in Latin America speaks Spanish. Note that the word "Latino" is gendered, and the use of the word "Latin@" to mean both Latino and Latina is becoming widely accepted (although not specified in the Manual). "Latinx" can also be used as a gender-neutral or nonbinary term inclusive of all genders. There are compelling reasons to use any of the terms "Latino," "Latina," "Latino/a," "Latin@," and/or "Latinx."

When writing about people of European ancestry, the terms "White" and "European American" are acceptable.

When writing about Indigenous Peoples, use the names that they call themselves. In general, refer to an Indigenous group as a "people" or "nation" rather than as a "tribe." Appropriate terms listed by region, but specify nation or people if possible:

• United States: "Native American" and "Native North American" (avoid the term "Indian")
• Hawaiian Natives: "Native American," "Hawaiian Native," "Indigenous Peoples of the Hawaiian Islands," and/or "Pacific Islander"
• Alaska: "Alaska Natives"; avoid the term "Eskimo"
• Canada: "Indigenous Peoples" or "Aboriginal Peoples"
• Latin America and Caribbean: "Indigenous Peoples"
• Australia: "Aboriginal People" or "Aboriginal Australians" and "Torres Strait Islander People" or "Torres Strait Island Australians"
• New Zealand: "Māori" or the "Māori people"

To refer to non-White racial and ethnic groups collectively, use terms such as "racial and ethnic minority groups" or "racial and ethnic minority individuals" rather than "minorities" or "non-White." "Underserved populations" or "underrepresented populations" can be used if the categories have already been defined.

Do not use hyphens in multiword names (e.g., write "Asian American participants," not "Asian-American participants").

"African American" should not be used as an umbrella term for people of African ancestry worldwide because it obscures other ethnicities or national origins; in these cases use "Black." The terms "Negro" and "Afro-American" are outdated.

It is problematic to group "Asian" and "Asian American" as if they are synonymous. The older term "Oriental" is primarily used to refer to cultural objects and is pejorative when used to refer to people.

The use of the term "Caucasian" as an alternative to "White" or "European" is discouraged because it originated as a way of classifying White people as a race to be favorably compared with other races.

"Hispanic" is not necessarily an all-encompassing term, and the labels "Hispanic" and "Latino" have different connotations.

Nonparallel designations (e.g., "African Americans and Whites") should be avoided because one group is described by color, whereas the other group is not. Instead, use "Blacks and Whites" or "African Americans and European Americans." Do not use the phrase "White Americans and racial minorities."

Avoid essentialism. For example, phrases such as "the Black race" and "the White race" are essentialist in nature and considered inappropriate.

Avoid the term "minority." Rather, a "minority group" is a population subgroup within ethnic, racial, social, religious, or other characteristics different from the majority of the population. If a distinction is needed, use a modifier when using the word "minority" (e.g., ethnic minority, racial minority, racial-ethnic minority.")

Do not assume members of minority groups are underprivileged. Terms such as "economically marginalized" and "economically exploited" may be used rather than "underprivileged;" however, these terms should also be used carefully and with context. These refer to economic situations, not inherent characteristics of a group.

Sexual orientation: part of individual identity that includes a person's sexual and emotional attraction to another person and the behavior and/or social affiliation that may result from this attraction. Conceptualized first by the degree to which a person feels sexual and emotional attraction and second as having a direction.

Sexual orientation terms: lesbian, gay, heterosexual, straight, asexual, bisexual, queer, polysexual, and pansexual (also called multisexual and omnisexual). Sexual orientation label is predicated on a perceived or known gender identity of the other person (e.g., lesbian women or gay men), when possible.

Abbreviations such as LGBT, LGBTQ, and LGBTQAI may also be used to refer to multiple groups (if used, define the term and ensure it is representative of the groups you are writing about).

The terms "straight" and "heterosexual" are both acceptable to use when referring to people who are attracted to individuals of another gender.

Do not use the term "sexual preference;" instead, use the term "sexual orientation."

Avoid the terms "homosexual" and using "gay" as a noun. Instead, use specific, identity-first terms to describe people's sexual orientation (e.g., bisexual people, queer people).

Also avoid stereotypes or outdated assumptions about sexual orientation when providing scientific context.

When writing about SES, income ranges, or specific designations (e.g., below the federal poverty threshold for a family of four) are more specific than general labels (e.g., low income). SES encompasses income, educational attainment, occupational prestige, and subjective perceptions of social status and social class.

When you're talking about SES terms, we encourage you to include context, such as explaining systemic barriers or social determinants of health.

Use specific, person-first language such as "mothers who receive TANF [Temporary Assistance for Needy Families U.S. welfare program] benefits" (rather than "welfare mothers"). Include racial and/or ethnic descriptors within SES categories.

When possible, use data-driven thresholds (e.g. income quartiles or percentiles) where possible to provide clarity.

Avoid using broad, pejorative, and generalizing terms, such as "the homeless," "inner-city," "ghetto," "the projects," "poverty-stricken," and "welfare reliant."

Avoid deficit-based language. Do not label people as "high school dropouts," "being poorly educated," or "having little education." Provide more sensitive and specific descriptors such as "people who do not have a grade school education."

Instead of writing about an "achievement gap," write about an "opportunity gap."

Avoid stereotypes or assumptions about SES categories, such as associating "inner-city" with poverty or crime.