As defined in Chapter 2 the concept of intersectionality provides a mechanism to recognize and describe the confluence of identity groupings present concurrently in a person’s life. The importance of understanding this confluence is the recognition of multiple dimensions acting simultaneously and the diversity within groups that the range of possible different intersectional positions creates. Recognition of mutually constitutive identities is a central principle of feminist thinking according to Shields (2008).
More contemporary uses of intersectionality in the literature do not specify the available social identities; therefore they allow a broader conception that emphasizes variation and fluidity of social locations and processes (Gopaldas, 2013; Hankivsky, 2012). The intersectional locations along multiple different combinations of social identities create different lived realities that can be recognized for research, policy or law (Trahan, 2011). Importantly, in the interwoven nature of these categories, the impact of one on another can be to either strengthen or weaken another characteristic at the point at which they intersect (Winker & Degele, 2011).
Bowleg (2012) asserts that most social identities are multiple and intersecting, yet much research dealing with health disparity considers the systems of privilege and
oppression, such as racism or sexism, independently. While we all have intersectional identities the focus is often on historically oppressed and marginalized groups such as racial and ethnic minorities and lesbian, gay, bisexual and transgender (LGBT) people, those who are financially disadvantaged and those with disabilities. Importantly, Bowleg (2012) adds that the intersectional position of people is recognized from their own context and through their view rather than “their deviation from the norms” of the position of the prevailing cultural group (Bowleg, 2012, p. 1269).
Intersectionality is not additive and does not suggest that the effects of one category can be calculated by summing the effect of another, such as race plus gender. Rather,
56 intersectionality attempts to interrogate the interaction and examine the different impacts that lead to control, exploitation or privilege (Grunenfelder & Schurr, 2015; Hankivsky, 2012; Koehn, Neysmith, Kobayashi, & Khamisa, 2013; Trahan, 2011). By understanding the effects of oppression and privilege, intersectionality as a theoretical framework adds value to this research. Considering issues of culture, ethnicity, language and migration mechanism in CALD SPs, for example, it would be superficial to treat all identity constructions as sources of oppression. This fails to capture the experience of a successful migrant retailer who simultaneously experiences discrimination and
disadvantage based on her ethnicity and English language ability while enjoying the advantages of successful business privilege (Trahan, 2011). The differences in power and the effects of those differences on the individual’s health thus become apparent (Davy, 2011). “Power imbalances and discrimination, as well as positive health care experiences, are understood as unique to each individual’s constellation of intersecting identities, social roles and the broader social and political contexts in which they exist” (Koehn et al., 2013, p. 446).
Carbado and Gulati (2013) echo the idea that intersectionality exposes both ends of the privileged-to-oppressed spectrum by reminding us that white heterosexual men have intersectional identities. By arguing for the differentiation of intersectionally
marginalized and privileged groups, they attempt to disrupt the perception that intersectionality is only concerned with marginalized categories (Carbado & Gulati, 2013). Bowleg (2012) echoes the idea that all intersectional positions are not equally disadvantaged. She uses the example of high socioeconomic people having better health outcomes, but demonstrating that this is not universal with the educated black women having higher infant mortality rates than less educated white women.
A criticism of intersectionality is the potential complexity that results from an infinite host of differences (McCall, 2005; Phoenix & Pattynama, 2006). This is certainly a struggle I understand, and yet any reductionist tendency would risk essentializing and homogenizing entire groups (Viruell-Fuentes, Miranda, & Abdulrahim, 2012), whereas my purpose is to gather multiple perspectives within the context of CALD SPs.
Intersectional research, Gopaldas (2013) says, instead, stresses the inclusion of all voices. While Grunenfelder and Schurr (2015) recommend owning the complexity and developing approaches to capture the identities and power relations that shape people’s lives.
57 Hankivsky (2012) cautions that intersectionality as a research paradigm is not
prescriptive, with no particular design or focus on method. She instead suggests a conceptual shift to the way a researcher understands and interacts with difference. This requires careful and reflexive thought about how my selections may influence the results and interpretations of the research and my intersectional position as the researcher. Which differences are examined is shaped by data availability, interest and emphasis of the research and researcher positionality (Dhamoon & Hankivsky, 2011). Bowleg (2012) suggests that the challenge of determining categories should be countered by conceptualizations that are broad enough to demonstrate positions of privilege and oppression simultaneously.
While recognizing that lack of a guideline for intersectional research is a challenge, as a theoretical framework Bowleg (2012) recommends that an intersectionality informed stance informs the commitment to understand how multiple identity categories work together to influence a person’s reality. Shields (2008) recommends a “both/and” strategy entailing the individual identities as well as the intersections and their
emergent properties, considering interpersonal, contextual and structural categories. It is through this lens that intersectionality informs the research of CALD people working as simulated patients.