(Re)centering Black Feminism Into Intersectionality Research

The current national awakening and acknowledgment that White supremacy, patriarchy, and capitalism are responsible for the disproportionate effect of coronavirus disease 2019 and of police brutality on Black or Indigenous people and other people of color, people with disabilities, and sexual and gender minorities have ignited a call to action for public health leaders. As public health researchers, we must go beyond merely acknowledging the presence of structural racism and explicitly assess the effect of interconnected systems of oppression on health outcomes. Intersectionality is an analytic framework that can be used to describe how people marginalized by structural inequities interact with these oppressive systems but only if implemented in the way it was envisioned by Black and Black lesbian feminists.^1,2

INTERSECTIONALITY ORIGINS

In recent years, many researchers have limited their implementation of intersectionality solely to the examination of multiple intersecting social identities without being attentive to intersectionality’s core emphasis on theory and praxis.¹ Intersectionality was designed to analyze interlocking systems of privilege and oppression and to develop strategies that challenge those systems, with an emphasis on racism, sexism, heterosexism, and classism.^1–3 The distinction that intersectionality focuses on intersecting systems of privilege and oppression rather than on intersecting social identities is key; everyone has intersecting social identities, but not everyone belongs to historically marginalized groups or experiences intersecting systemic oppression.

SOCIAL IDENTITIES LIMITATIONS

Possessing multiple social identities of groups historically marginalized by structural inequities does not automatically mean that a person will experience oppression at all or all the time. What makes people vulnerable to oppression is how others perceive them based on one’s societal norms, political realities, and legal landscapes. For instance, I am a multiracial Latinx, queer, nonbinary, able-bodied immigrant who has lived in two countries, both of which uphold anti-Indigenous, anti-Black, classist, heterosexist, and colonial thinking. My positionality makes me vulnerable to experiencing oppression under the aforementioned systems; however, simply knowing my intersecting identities does not inform whether and to what extent I experienced oppression. That is the main limitation of using social identities as markers of oppression and power in intersectionality research.⁴ For instance, race is often presented as a determinant of health when, in reality, racism is.

SOCIAL PROCESSES

Researchers must shift their practices and analyze social processes when conducting intersectional research. Social processes, such as experiences of discrimination, allow us to assess the effect of intersecting systems of privilege and oppression at the individual level and also to advance our understanding at the population level (e.g., structural discrimination).¹ Selecting the systems and the number of systems to be included should be dictated by the methodology and research question; however, anchoring the analysis through one main axis can facilitate the process. Most intersectionality scholarship has examined racism and sexism. We must expand the complexity of intersectional analysis to include classism and heterosexism as initially envisioned² and other often-neglected oppression systems that also critically affect health outcomes, such as ableism, cisgenderism, colorism, ethnocentrism, colonialism, and nationalism.

APPLYING INTERSECTIONALITY

Although not a traditional testable theory,³ findings from emerging quantitative intersectional research^4,5 indicate that identifying multiple intersecting systems of privilege and oppression is not necessarily associated with worse health outcomes and in some cases can be associated with protective outcomes. For instance, I conducted a study on transgender women of color and HIV testing patterns, looking at the intersections of transmisogyny, racism, and classism.⁴ The results showed that the transgender women of color who reported intersecting experiences of transmisogyny, racism, and classism had higher probabilities of being tested for HIV within the last year, indicating an association between experiencing intersectional discrimination and engaging in resilient behaviors such as HIV testing. However, the transgender women of color who reported only experiences of racism had a disproportionately higher probability of never having been tested for HIV than others in the study. If I had focused on only one axis, such as transmisogyny, I would not have identified the nuances of how racism negatively affected HIV testing behaviors but—when intersecting with other oppressions—was associated with an increase in HIV testing.

Applying intersectionality allows researchers to identify more accurately how intersecting processes result in both detrimental and protective health outcomes. As a result, clinicians can prioritize the most vulnerable when allocating prevention and treatment services that are commensurate with the needs of the communities of interest.

SOCIOCULTURAL CONTEXT

Assessing the structural-level effect of intersecting systems of privilege and oppression is central to intersectionality but more difficult to capture by assessing individual experiences. Although individuals can identify social processes, they might not necessarily identify the structures and institutions upholding those processes. For that reason, the analysis and discussion of individual-level results must address the structural level by providing the sociocultural context (laws, policies, norms, and interpersonal practices) of structural inequality on the research population.^3,6,7 Understanding the historic and geopolitical context in which the experiences of discrimination are taking place is essential. In taking an interdisciplinary approach, researchers can gain an in-depth understanding of how multiple intersecting systems of privilege and oppression operate.⁶ Researchers must explicitly connect findings to the current sociocultural context, even if it is a complex and intricate task in quantitative research and easier to achieve with qualitative or mixed-methods approaches.

CENTERING MARGINALIZED PEOPLE

Shifting the focus to social processes does not mean that researchers completely ignore social identities and the critical roles they play. Another key aspect of intersectionality is that the analysis should be centered on those with intersecting marginalized identities and not on those belonging to only dominant groups. This does not mean that the participants involved should have only marginalized social identities; it means that the discussions should prioritize the systems of oppression affecting them. Intersectionality calls on researchers to ensure that they are working with historically marginalized people from start to finish in the development, implementation, analysis, and dissemination of research. Thus, researchers must move away from the practice of using dominant groups as a reference point so that research truly focuses on the experiences of populations living at the margins.⁴ Ideally, beyond being just research participants, the community of interest should be part of the research process by using methodologies, such as participatory action research, an approach aligned with intersectionality’s emphasis on praxis. Furthermore, the literature review must not only cite but also critically engage with the contributions of authors belonging to the marginalized groups of interest as well as the Black and queer feminist scholars who developed and continue to expand intersectionality theory and praxis.^1–3,6,7 Similarly, research teams should ideally include members who share marginalized identities with the research population because those members also bring lived experience to every aspect of the research process. When team members do not reflect the marginalized identities of the research population, researchers should acknowledge and examine their positionality to assess the strengths and limitations of understanding the communities of interest.

CONCLUSIONS

When we design and implement research around social processes rather than social identities and ensure that every aspect of our research is focused on people marginalized by structural inequities, the spirit of intersectionality is alive and well in our work. Public health researchers have the responsibility to use research to advance the theory and to inform praxis by contributing to larger social justice efforts that promote health equity.