As part of my 11th Month of Service project, AIF gave me the opportunity to visit Restless Development in Delhi. There, I led a facilitator training workshop on substance misuse and participated in a youth session on contraception. Both sessions aimed at deepening community understanding around sensitive topics like SRHR (Sexual and Reproductive Health and Rights) and substance misuse. These sessions were designed to raise awareness and promote empathy, tackling two issues often addressed with judgment rather than understanding.
The substance misuse training was structured into two parts: one that explored social, gendered, and health-related factors underlying substance misuse and another that highlighted community-based strategies to help individuals struggling with misuse. The SRHR session was crafted for youth aged 15 and above and, using a light-hearted introductory activity, encouraged them to talk openly about contraception, relationships, and the importance of consent and choice.
Throughout these sessions, I noticed that language played a powerful role in shaping attitudes and responses toward these issues. Certain terms used by default—such as “substance abuse” and “menstrual hygiene”—revealed underlying biases that could inadvertently reinforce judgmental or dismissive perspectives. For me, this underscored the critical need to rethink and reframe the language when discussing topics as impactful as substance misuse and SRHR.
Framing the Issue
The language used in public health dialogues often reflects societal attitudes, but it can also actively shape those attitudes, influencing how communities perceive and respond to issues. The terms we use, consciously or not, reveal biases and set the tone for conversations about sensitive topics.
The words we choose can either promote empathy or reinforce stigma, directly impacting how effectively a community can address issues like substance misuse or SRHR concerns. If a term unintentionally conveys judgment, it risks alienating those it is meant to support. Reexamining and refining our language, therefore, is essential for building inclusive, supportive, and empathetic frameworks for social change.
Moving Beyond “Abuse”
In my workshop on substance misuse, the term “substance abuse” came up frequently—a term so widely used that it’s almost synonymous with addiction or dependency. However, the more I engaged with the facilitators, the more we discussed how “substance abuse” carries a layer of judgment, suggesting willful harm and irresponsibility, rather than focusing on the socio-psychological challenges behind substance use.
The National Alliance of Advocates for Buprenorphine Treatment in 2008 recommended the term “substance misuse” over “substance abuse” to avoid stigma (NAABT, 2008). When we label an individual’s behavior as “abuse,” we risk obscuring the systemic and personal struggles leading them to substance misuse, such as mental health issues, trauma, or socio-economic stressors. Reframing the conversation as “misuse” rather than “abuse” allows for an empathetic approach that centers on harm reduction and support rather than blame.
During the session, we examined various lenses—gender, SRHR, and social factors—that contribute to substance misuse. For example, societal pressures may push men to substance misuse to conform to norms of masculinity, often due to suppressed emotional expression. In contrast, women dealing with misuse often face stigmatization that discourages them from seeking help. Through a language shift that embraces “misuse,” we can focus on the person’s journey, viewing them as someone requiring support rather than condemnation.
This shift might seem subtle, but it has profound implications. Individuals are more likely to seek help when they feel supported rather than judged. By using non-judgmental language, facilitators and community health workers can create safe spaces for individuals grappling with substance misuse, ultimately encouraging better outcomes for treatment and recovery.
Reclaiming “Hygiene” to “Health”
In the SRHR session, I observed how certain terminologies, such as “menstrual hygiene,” subtly reinforce outdated or negative perceptions of natural bodily functions. By focusing on “hygiene,” we risk framing menstruation as inherently “unclean,” creating a barrier to open discussions about menstrual health.
The term “menstrual hygiene” tends to place emphasis on cleanliness and management, which can stigmatize menstruation and discourage conversations about associated health issues. A report by the World Bank highlights that around 500 million women lack adequate resources for menstrual health management, underlining the need for serious engagement with menstrual health as a public health priority, not merely a matter of “hygiene” (World Bank, 2022).
In the SRHR session, we discussed the importance of consent and choice, particularly in contexts of contraception and relationships, to reinforce sexual and reproductive rights. Reframing “menstrual hygiene” as “menstrual health” aligns with this perspective, positioning menstrual care as a matter of health equity rather than cleanliness. This distinction empowers women and menstruators to approach their health without shame, promoting access to adequate resources and support.
Language and Inclusivity
Language can also directly impact access to health resources. In both substance misuse and SRHR contexts, language affects how services are presented, who feels comfortable seeking them, and whether they will continue using them. For instance, a queer-friendly healthcare approach might be undermined if services employ heteronormative or binary language, excluding or alienating members of the LGBTQIA+ community. Inclusive language, therefore, is not only respectful but essential to making services genuinely accessible.
Inclusive language improves trust and service uptake among marginalized communities. For example, using terms like “people with substance use disorders” rather than “addicts” and “menstruators” rather than strictly “women” signals that service is inclusive, welcoming individuals from various backgrounds without assumption or judgment.
Moving Toward Empathetic Communication
Reflecting on the language used in these sessions highlighted a need for empathy-driven communication within public health and social work. In substance misuse, a shift from “abuse” to “misuse” represents a move toward harm reduction—a concept that prioritizes reducing negative impacts over moralizing behavior. For SRHR, especially topics related to menstruation and contraception, focusing on health over hygiene can help dismantle deep-rooted stigmas and enable more constructive dialogues around health equity and rights.
Language as a Tool for Social Change
The politics of language is more than just semantics. In public health, it plays a fundamental role in shaping policies, practices, and perceptions. If we want to build a society that embraces empathy and inclusivity, we must start by refining our words. During this visit, I saw firsthand how language can either empower or inhibit individuals’ access to the support they need, depending on its framing.
By being mindful of the language choices one makes and advocate for terms that respect, include, and support those we aim to serve can we foster a truly inclusive environment that addresses not only health challenges but the social inequities and stigmas that often compound them.
References:
- National Alliance of Advocates for Buprenorphine Treatment. The Words We Use Matter: Reducing Stigma Through Language. Farmington, CT: NAABT, Inc., 2008. https://www.naabt.org
- World Bank. Menstrual Health and Hygiene. Last modified May 25, 2022. https://www.worldbank.org/en/topic/water/brief/menstrual-health-and-hygiene
