Inclusive Language Research Articles

Slow and Steady: Using Inclusive Language to Enhance Academic Medicine’s Social Accountability

Abstract Language is more than the use of words for pragmatic purposes, and language and thought are intertwined in complex ways. In medical contexts, the relational and dynamic nature of language requires that individuals pay close attention not only to the information communicated but also to how its delivery and reception impact inclusion. Adopting inclusive language principles can play a key role in those in academic medicine living up to the values of equity and inclusion, as they manifest in each of the 5 missions of academic medicine: scientific discovery, education, clinical care, collaboration with communities and partners, and standards of equity, professionalism, and ethics. In this commentary, the authors explore inclusive language as it applies to 3 topics that have rapidly evolved in academic medicine: gender inclusivity, linguistic attributes, and trauma-informed language. For each of these topics, the authors describe practical examples of how inclusive language can be applied across multiple settings in academic medicine—including the patient-physician relationship, medical education, and scholarly writing—by centering the perspectives of those who have been marginalized or excluded. When holding scholars, physicians, and leaders in academic medicine accountable for their use of inclusive language, humility should be balanced with competence. Specifically, linguistic humility should be paired with skills-building efforts and an attitude of life-long learning, and reacting to mistakes should be coupled with restorative justice approaches to address harm and proactive strategies to maximize inclusivity. Inclusive language efforts must be like the slow and steady tortoise—to be effective and authentically rigorous, academic medicine must be intentional and consistent in driving equitable and inclusive practices that support sustained participation, engagement, belonging, and thriving.

Jembatan Kurikulum: Inklusi dan Pembelajaran Bahasa Arab dalam Konteks Multikultural

This study explores the implementation of inclusive Arabic language learning in a multicultural context, which includes all four language skills: listening, speaking, reading, and writing. This research uses a qualitative approach by collecting data through classroom observations, interviews with teachers, and analysis of curriculum documents. The findings show that the integration of inclusion values ​​and multiculturalism in the curriculum provides a basis for developing learning strategies that take into account student diversity. With a holistic approach, learning Arabic can be a bridge to strengthen intercultural relations and promote cross-cultural understanding among students from diverse backgrounds. The practical implications of this research underscore the need for learning approaches that are adaptive and responsive to students' needs by considering their multicultural context.

Childlike Goddess

This article examines the derivation of toy and game imagery in “The Elevation of Ištar.” I argue that the presence of these metaphors in a first-millennium text represents a late stage in the development of Ištar’s characterization as a childlike goddess. Tracing this development from Sumerian mythological and lexical texts into the Sumero-Akkadian and Akkadian traditions reveals Inanna/Ištar’s well-known attribute of violent rage in a different manner. This suggests that the characterization of the goddess as childlike existed over a significant period of Mesopotamian history as shown by the inclusion of toy and game language in a variety of texts.

LBTQ parents’ needs for support postpartum following a complicated birth: A matter of reproductive justice

LBTQ people have increased risks of complications during birth, risks potentially driven by minority stress and increased levels of mental illness and fear of childbirth. With the aim of exploring reproductive injustices in postpartum care for LBTQ people, we analyzed qualitative interviews where 22 LBTQ birth and non-birth parents shared their experiences of support needs during the postpartum period after births where complications had arisen. Results point to the importance of providing an LBTQ safe space, which includes the need to feel safe regarding one’s gender or sexual identity, by avoiding cisheteronormative assumptions and using inclusive language. In the context of recently experiencing birth complications, parents needed a space where they were able to focus on physical and mental healing. The results further show the need for validation of the non-birth parent and inclusive breast/chest-feeding support. Results emphasize the need for more psychosocial support around the birth experience, including better medical support and information during the whole process of childbirth.

Tumors, Treatments, and Trust: Cancer Characteristics, Outcomes, and Screening Uptake in Transgender and Gender-Diverse Patients.

More than 2.5 million adults in the United States identify as transgender or gender-diverse (TGD), but little data exist on cancer screening and care for this population. We examined cancer characteristics, screening adherence, genetic testing, and provider inclusive language for TGD patients with cancer. This single institution retrospective cohort study identified TGD patients with cancer between 2000 and 2022. Demographic, clinicopathological, treatment, and screening data were collected, as well as data on gender-affirming care (GAC) and use of patients' personal pronouns in medical records. Descriptive statistics and regression analyses were used to report outcomes. Sixty unique patients with 69 cancer diagnoses were included: 63.3% were transgender women, 21.7% transgender men, 6.7% nonbinary, and 8.3% were genderqueer. Sixty-five percent had a family history of cancer. Only 46.2% of thosewho met genetic testing criteria were referred. On review of recommended cancer screening, colorectal screening had the greatest uptake (62%), followed by breast (48.3%), lung (35.7%), cervical (33.3%), and prostate (32%); 8.5% of cancers were diagnosed on screening. Individuals with Medicare had reduced odds of screening uptake (OR 0.07, 95% CI 0.01-0.58) versus private insurance. With respect to GAC, 73.3% used gender-affirming hormone therapy and 41% had gender-affirming surgery. After initiating GAC and asserting personal pronouns, 75% were referred to by incorrect name/pronouns in provider documentation. Our TGD cancer patient cohort had low rates of disease-specific cancer screening and inadequate genetic referrals.Many providers did not use appropriate patient names/pronouns. Provider and patient interventions are needed to ensure inclusive preventative and oncologic care for this marginalized population.

Understanding sex and gender: concepts and terminology for gender affirming care.

Lesbian, gay, bisexual, trans, queer, intersex, asexual, and other diverse individuals (LGBTQIA+) people face lower healthcare utilization rates due to discrimination, poor experiences in healthcare, and barriers to accessing care. There is an increasing need to improve care and reduce health care disparities for the LGBTQIA+ population. The medical community can begin by educating themselves on LGBTQIA+ terminology, using inclusive language and developing cultural competence in clinical settings. In order to achieve this, it is first important to understand that sex and gender are distinct and that both sex and gender exist on continuums. This article will build on this understanding by introducing basic and widely accepted terminology that will provide a foundation for providing care to LGBTQIA+ populations. By thoughtfully incorporating this knowledge into our research and clinical practice, the radiology community will enhance the healthcare experiences of all patients.

Gender inclusivity of ophthalmology journal submission guidelines and associated research metrics.

This cross-sectional study evaluated the prevalence of inclusive author submission guidelines across ophthalmology journals. Journals were identified from the 2021 Journal Citations Report (Clarivate Analytics). Independent reviewers rated each author submission guideline as "inclusive" for satisfying at-least one of six criteria: i) included examples of gender inclusive language; ii) recommended the use of gender-inclusive language; iii) distinguished between sex and gender; iv) provided educational resources on gender-inclusive language; v) provided a policy permitting name changes (e.g., in case of gender and name transition); and/or vi) provided a statement of commitment to inclusivity. The primary objective was to investigate the proportion of journals with "gender-inclusive" author submission guidelines and the elements of the gender-inclusive content within these guidelines. A secondary objective was to review the association between "gender-inclusivity" in author submission guidelines with publisher, origin country, and journal/source/influence metrics (Clarivate Analytics). Across 94 journals, 29.8% journals were rated as inclusive. Inclusive journals had significantly higher relative impact factor, citations, and article influence scores compared to non-inclusive journals. Of the 29.8% of inclusive journals, the three most common domains were inclusion of an inclusivity statement (71.4% of inclusive journals), distinguishing between sex and gender (67.9%), and provision of additional educational resources on gender reporting for authors (60.7%). A minority of ophthalmology journals have gender-inclusive author submission guidelines. Ophthalmology journals should update their submission guidelines to advance gender equity of both authors and study participants and promote the inclusion of gender-diverse communities.

Diagnosis of Schizophrenia and Psychosis in Māori People Using Speech Assay: A Natural Language Processing Approach

Indigenous peoples and ethnic minorities worldwide have a higher incidence of psychosis, primarily schizophrenia. In New Zealand, Māori individuals experience greater rates of anxiety and depression compared to non-Māori, with a significantly higher incidence of mental illness among Māori. We propose natural language processing (NLP) trained on speech samples from Māori patients as a potential solution to the problem of culturally biased psychometric screening tools for psychosis and schizophrenia. This research examines NLP's ability to diagnose psychosis in Māori patients by analysing speech and language abnormalities as indicators of severe mental illnesses such as schizophrenia. Our research emphasizes the need for inclusive language models and investigates cross-cultural applicability. We employed a three-part method: conducting clinical interviews, pre-processing data with the Natural Language Toolkit (NLTK) and applying language classifiers. The study's results demonstrate the promise of NLP, but limited patient data necessitates further research, including standardizing datasets and integrating NLP with indigenous languages. This research represents a step towards improving diagnostic accuracy and support for Māori people suffering from psychosis, aligning with healthcare's goal of fair and culturally responsive mental health screening.

For Da Brothas: a call for fat, black male and masculine folx literature

PurposeThis study rigorously explores the intersectional challenges faced by black fat males, emphasizing the amalgamation of anti-fat bias, gender and sexuality and racial discrimination within educational contexts. The purpose of this study is to dissect the complex dynamics of this intersection, shedding light on the nuanced experiences of black men. Central to this exploration is the advocacy for creating inclusive educational sanctuaries, providing a safe space for these individuals to thrive, learn and engage in holistic personal development.Design/methodology/approachTo accomplish our objectives, this paper reviewed existing literature on anti-fatness, intersecting with issues of race, gender and sexuality. Drawing upon qualitative data, this study incorporated personal narratives and experiences to offer a comprehensive perspective. Our research methodology also involved an analysis of metrics like body mass index (BMI) and its impact on health-care practices and policies, particularly concerning the black community.FindingsThe research discerns that black fat males encounter multifaceted challenges in educational settings, often rooted in societal prejudices and systemic biases. It highlights the inadequacy of conventional metrics like BMI in capturing the complexity of these experiences. The study identifies the urgent need for safe school spaces, emphasizing the importance of inclusive language, varied seating arrangements and tailored educational content. These findings underscore the imperative for proactive measures in dismantling anti-fatness within academic institutions.Originality/valueThis research contributes significantly to the academic discourse by pioneering an in-depth exploration of the intersectional challenges black fat males face in education. This study offers a novel perspective by focusing on the unique amalgamation of anti-fat bias and racial discrimination. The proposal for educational sanctuaries tailored to the needs of this demographic represents an innovative solution, bridging gaps in the existing literature. Through its nuanced approach and advocacy for inclusivity, this study stands as an original and pioneering contribution to the field, urging educators and policymakers to reevaluate their practices and create equitable learning environments.

Psycho-Sociocultural Determinants of Code-Switching among Igbo- Speaking English Language Undergraduates in Southeastern Region, Nigeria

The present investigation aimed to ascertain the psychological, social, and cultural determinants propelling code-switching behaviours among Igbo-speaking English Language undergraduates in the southeastern region of Nigeria, as perceived by students enrolled at Nnamdi Azikiwe University, Awka, in Anambra State, and Alvan Ikoku Federal University of Education, Owerri, in Imo State, Nigeria. Employing a quantitative descriptive survey research design, the study comprised the entire population of regular Igbo-speaking English language students from the aforementioned region, with a sample size of 735 participants selected through a multi-stage sampling technique. Guided by four research questions and two null hypotheses, data were collected utilizing a 34-item researcher-structured questionnaire entitled the Psycho-sociocultural Determinants and Code-switching Questionnaire (PDCQ). The validity of the instrument was established through extensive use of relevant literature and also peer-reviewed by experts in English, Research Methods, and Psychology all from the Faculty of Education at Nnamdi Azikiwe University, Awka. The reliability of the instrument was established using Cronbach's alpha coefficient (α = 0.76). Analysis of the research questions relied on measures of central tendency and dispersion, while Simple Linear Regression was employed to test the hypotheses. Findings unveiled a prevalent pattern of code-switching among undergraduates, attributed to a complex interplay of psychological, social, and cultural incentives, including the desire to foster solidarity and belongingness within diverse social circles, the conveyance of bilingual prestige, and the authentic expression of personal identity and ideas. In light of these findings, recommendations were proffered for governmental, policy-making, and university administrative entities to collaborate in formulating inclusive language policies that acknowledge and respect the cultural diversity of students, thereby fostering an educational milieu that is both inclusive and culturally attuned.

Stakeholder perceptions of cervical screening accessibility and attendance in Ireland: a qualitative study

Abstract Organized cervical screening programmes are commonplace in high-income countries. To provide an equitable cervical screening service, it is important to understand who is and is not attending screening and why. Promotion of screening and service improvement is not possible without recognition and identification of the barriers and needs of communities that are less engaged with screening. This study explored stakeholder perceptions of cervical screening attendance and accessibility in Ireland. Semi-structured interviews were conducted with 12 healthcare professionals, policymakers and academics. Interviews were conducted online in 2022. Reflexive thematic analysis was used inductively to generate themes, supported by NVivo. Three themes were developed: (i) getting the right information out the right way, (ii) acceptability and accessibility of screening and (iii) trying to identify and reach the non-attenders. Participants felt public knowledge of cervical screening and human papilloma virus was low and communication strategies were not adequate. Individual, cultural, structural and service-level factors influenced the accessibility and acceptability of screening. Identifying and reaching non-attenders was considered challenging and community outreach could support those less likely to attend screening. Stakeholder perspectives were valuable in understanding the complexities of screening accessibility and attendance from individual to service-level factors. Cultural competency training, inclusive language and visual cues in waiting rooms would support engagement with some populations who may be hesitant to attend screening. Collaboration with community organizations has opportunities to promote screening and understand the needs of those less likely to attend screening.

Gender-inclusive language in midwifery and perinatal services: A guide and argument for justice.

Effective communication in relation to pregnancy and birth is crucial to quality care. A recent focus in reproductive healthcare on "sexed language" reflects an ideology of unchangeable sex binary and fear of erasure, from both cisgender women and the profession of midwifery. In this paper, we highlight how privileging sexed language causes harm to all who birth-including pregnant trans, gender diverse, and non-binary people-and is, therefore, unethical and incompatible with the principles of midwifery. We show how this argument, which conflates midwifery with essentialist thinking, is unstable, and perpetuates and misappropriates midwifery's marginalized status. We also explore how sex and gender essentialism can be understood as colonialist, heteropatriarchal, and universalist, and therefore, reinforcing of these harmful principles. Midwifery has both the opportunity and duty to uphold reproductive justice. Midwifery can be a leader in the decolonization of childbirth and in defending the rights of all childbearing people, the majority of whom are cisgender women. As the systemwide use of inclusive language is central to this commitment, we offer guidance in relation to how inclusive language in perinatal and midwifery services may be realized.

A 'smear campaign' against patient-excluded policy changes: a reflection on the language used in cervical screening programmes.

Cervical screening has transformed the diagnosis of cervical cancer. However, uptake within the national screening programme is not uniform across demographics. This raises the question of whether medical language, which conveys essential information but also shapes attitudes towards engaging with healthcare, is part of the problem. The term "smear test" has been used for generations and is embedded in colloquial and medical vocabulary. However, there is a danger that the phrase may conjure images of an unpleasant or even reckless ordeal, potentially contributing to unnecessary patient anxiety. To evaluate patient attitudes towards the terms "cervical smear" and "cervical brush". Female participants from a single GP surgery were randomly sampled. Data from questionnaires were then subjected to thematic analysis. Half of patients interviewed did not feel either term would significantly influence cervical screening uptake. Equal numbers of patients expressed an overall preference for each of the two terms, and the remaining 28% expressed no preference. Qualitative data revealed some patients favoured the familiarity of the term "cervical smear", and others preferred the descriptive accuracy of "cervical brush". It is imperative to consult target groups and use inclusive language that minimises stigmatising or negative connotations. Modifying language alone is unlikely to remedy the current access barriers in UK cervical screening. Instead, a multifaceted approach that also targets education and addresses systemic issues could offer a more sustainable strategy. Ultimately, prioritising a patient-centred approach could improve access to life-saving screening.

Teacher Perceptions on Using Translanguaging for Teaching Second and Foreign Languages in Sri Lanka

Abstract The linguistic landscape of Sri Lanka underwent dramatic transformations owing to the influence of Indic languages and the colonization which resulted in increased language contact and hybridization of local languages. Advancements in digital and commercialization of language learning increased the demand for second and foreign language education. Whether language planning and education have undergone changes in par with the transformations in the linguistic landscape is questionable. Approaches and methodologies of second and foreign language learning in Sri Lanka remain entrenched in hegemonic practices of post-colonial language education. Taking on a convergent parallel design, the present study explored the potentials of incorporating translanguaging into second and foreign language education in Sri Lanka. Teachers of English as a second language and three other foreign languages were selected as the key informants of the study. Recognizing language as a transformative entity from a sociolinguistic stance, the study employed dynamic systems theory to evaluate the significant transformations of the linguistic landscape in Sri Lanka juxtaposed with developments in language studies. The findings have revealed that although the teachers have identified the need for shifting towards inclusive language education that recognizes the significance of learners’ native language repertoire, the language education system is still entrenched in the conservative approaches. Teaching learning material and ideologies attached to second and foreign languages education have become ‘leg irons’ that constrain adaptation into the new language environment. National scale linguistic landscape surveys, transformations in methodologies, localized learning material and long-term language policy and planning initiatives are key requirements for ensuring inclusive, equitable and decolonized language education.

Study on Inclusive Language in Chinese and Thai News Report from the Perspective of Critical Discourse Analysis

News report, an important way of disseminating information, is always readily accepted without any prejudice. However, the ideology embedded in it is often ignored by readers. In response to the call for people’s ideology among inclusive language, this research draws on the perspective of critical discourse analysis to investigate what the similarities and differences of inclusive language used in Chinese and Thai news report and the reasons behind the discrepancy. Based on Fairclough’s three-dimensional framework, this research collects 4 separate news reports from People’s Daily and Siam Daily to examine the hidden ideology in inclusive language. The analysis reveals that both media are aware of the importance of inclusive language and use it to reduce ambiguity and stigma in reports. These findings have significant implications for institutions such as public spaces or the media should standardize the use of inclusive language, where necessary.

Making for “strange bedfellows”: the Women, Peace and Security agenda after UNSCRs 2467 and 2493

ABSTRACT In 2019, a year before the twentieth anniversary of the adoption of United Nations Security Council Resolution (UNSCR) 1325, the United Nations Security Council (UNSC) adopted two more resolutions – UNSCRs 2467 and 2493 – under the Women, Peace and Security (WPS) thematic agenda. The WPS agenda is considered revolutionary for bringing women’s rights and security into the UNSC; however, it also reflects the precariousness of the alliance between feminist activists and the UNSC. During the drafting of UNSCRs 2467 and 2493, the United States (US), Russia, and China – all permanent members of the UNSC – objected to the inclusion of certain language in the final texts. The US pushed for the deletion of language on sexual and reproductive health from UNSCR 2467, while Russia and China challenged the definition of women human rights defenders in UNSCR 2493. These objections epitomize and contribute to the global pushback on women’s rights and security, which foregrounds concerns that the UNSC and feminist activists make for “strange bedfellows.” In this article, we consider whether the UNSC has been used as a forum to damage women’s rights and security.

P.019 A shared decision-model toolkit for pregnancy related care in neurology

Background: Shared decision-making (SDM) is a dynamic, patient-engaged approach to collaborative medical care. Limited SDM tools exist in pregnancy. We aimed to examine the need and usability of a novel SDM tool for pharmaco-therapeutic treatment of neurological conditions in pregnancy. Methods: This is an exploratory mixed-methods study. Non-pregnant women of any age were recruited using convenience, purposive sampling from an academic neurology clinic in Toronto. Participants reported the user friendliness of the SDM by completing the systems usability (SUS) questionnaire and participated in a focus group to further elaborate on their experience. Results: Eleven participants completed the survey 45% each between age 31-40, and 51-60. Median time spent on the tool was 17.2 minutes, and median SUS score 70 (<68 being not usable). Thematic data analysis from 2 focus groups, identified technical and content improvements: use of inclusive language, simplified design, and importance of patient engagement in SDM. Conclusions: Based on our preliminary results, a SDM web-tool for medication-related concerns of pregnant patients with neurological conditions is needed and usable. With integration of patients’ lived experiences, this novel tool may serve as an anchor point for future work in this field.

Examining Biases in ABS-CBN Online News: A Framing Analysis of Reporting about President Ferdinand Marcos Jr.

ABS-CBN, a leading media entity in the Philippines, has often found itself embroiled in controversies surrounding accusations of bias, particularly in its coverage of President Ferdinand "Bong-Bong" Marcos Jr., commonly known as BBM. Various entities have often criticized the media for exaggeration, framing, and misinformation, whereas others have praised the media for fulfilling an informative and educational function for the public. To address this dilemma, this study specifically examined its linguistic devices and language bias to discern patterns of news framing. This was done using the Linguistic Devices Analytical Framework, the Epistemological and Framing Bias Tool, and Goffman's Theory of Framing. Findings reveal the exclusion of the inclusive language 'we,' and language bias reveals linguistic devices, such as factive verbs, entailments, assertive verbs, subjective intensifiers, and one-sided terms. With the interplay of these outcomes, ABS-CBN headlines exhibit a combination of positive, negative, and neutral news coverage, which aligns with the norms of balanced reporting, essential for audiences to understand the story from various perspectives. Generally, findings reveal an impartial framing of news headlines. Future research may conduct a longitudinal study with a comprehensive dataset of news headlines to explore the media’s intentions revealed through framing strategies.

Toward a More Diverse and Equitable Food Distribution System: Amplifying Diversity, Equity and Inclusion in Food Bank Operations

This article provides an evidence-based discussion of an ongoing effort within the operations of hunger relief organizations to address diversity, equity, and inclusion (DEI) by sourcing and distributing more culturally relevant food. Through nearly 100 interviews with food bank personnel in diverse roles (from partner agency relations to executives) representing various regions of the United States, we explore the challenges faced by different functional units within the organization. These interviews indicate a shift to more inclusive language, more personalized metrics, and more inclusive operations. We critically analyze the related literature and identify opportunities for infusing DEI practices in the study of hunger relief supply chains.

Investigating the Linguistics Features, Impacts, and Corresponding Strategies of Translation in Feminist Literature

With the growing interest in feminism, feminist translation has become an important field of study. This review provides a comprehensive analysis of feminist translation, focusing on its impact, linguistic characteristics, translation strategies, and applications. It explores how feminist translation critically engages with language to address gender biases and patriarchal norms. The analysis underscores the significance of feminist translation in promoting gender equality and empowering marginalized voices. The discussion on linguistic characteristics highlights how feminist translation scrutinizes gendered language, stereotypes, and linguistic bias. It emphasizes the need to challenge the use of gender-specific terms and advocates for more inclusive language practices. Alternative strategies, such as gender-inclusive language and cultural adaptation, are examined as effective means to challenge linguistic biases and promote equality. Furthermore, the examination of translation strategies delves into the interventions employed by feminist translators. These strategies aim to disrupt patriarchal narratives, expose gender biases, and foster critical dialogue. They include amplifying women's visibility and agency, introducing alternative readings, and incorporating cultural adaptations. The applications of feminist translation in various domains are explored, revealing its impact and transformative potential. Specifically, in literature and arts, feminist translation amplifies marginalized voices, challenges traditional gendered narratives, and facilitates cross-cultural exchange. In legal and political discourse, it addresses gender biases in laws and policy documents. Additionally, feminist translation plays a role in media and activism, disrupting harmful representations and promoting social justice. Feminist translation emerges as a dynamic and transformative practice that confronts gender biases, challenges oppressive discourses, and advocates for gender equality. It recognizes the power of language to shape societal norms and actively employs strategies to subvert gender biases within translation.