Appreciating differences

Researchers have long studied the effects of race, ethnicity, gender, social class and sexuality on health and well-being, but few have looked at how all of these social categories work together to affect an individual’s life experience, or what social scientists now call “intersectionality,” a term borrowed from legal theorist Kimberle Crenshaw, JD.

It’s a gap speakers at APA’s Annual Convention attempted to address at a session sponsored by the APA Board for the Advancement of Psychology in the Public Interest and chaired by Kristin Hancock, PhD, psychology professor at John F. Kennedy University.

Despite the importance of ethnicity, age, gender presentation, disability and other key aspects of identity, psychologists and other health-care providers too often regard people as more alike than they really are, said Beverly Greene, PhD. “That can obscure other important aspects of their person and their experience,” said Greene, a psychology professor at St. John’s University and a private practitioner in New York.

For example, research suggests that white and Asian-American women tend to report similar levels of body dissatisfaction, which scientists often interpret to indicate that these groups have similar ideals of thinness, said Elizabeth Cole, PhD, a professor of psychology and women’s studies at the University of Michigan. Yet in a study that takes a more nuanced view of Asian-American women’s attitudes, researchers found that, unlike white women, Asian-American women generally do not want or seek plastic surgery to enhance their breasts (International Journal of Eating Disorders, Vol. 23, No. 2), Cole said. Instead, some Asian-American women wanted surgery to create a crease in their eyelid, making their eyes appear wider and more similar to Europeans’. Qualitative research indicates this desire stems from the fact that some Asian-American women believe their facial features are associated with negative stereotypes of Asians, including a passive and unsociable personality and narrow-minded outlook (Medical Anthropology Quarterly, Vol. 7, No. 1).

Scales that measure body image by focusing on weight alone would not reveal this concern, Cole said.

“Isn’t it time to rethink the assumption that these measures are equivalent and valid across all of these groups?” she asked.

Researchers can study intersectionality by using national public health data sets to examine social inequalities and tease out differences among groups, said psychologist Susan Cochran, PhD, MS, a professor of epidemiology at the UCLA School of Public Health. By pooling data from the California Quality of Life surveys on the one-year prevalence of drug dependency by gender and sexual orientation, for example, Cochran showed that bisexual women meet criteria for drug dependence at more than double the rates of heterosexual, lesbian and homosexually experienced women. Among men, however, sexual orientation did not play much of a role in drug dependence prevalence.

“This is another way of summarizing effects and finding a somewhat different sense of what’s going on with drug dependency in the gay community than I think most people outwardly observe,” she said.

Clinicians must also approach their work looking at intersectionality, as well, said Greene. Taking time to examine the interactive effects of each aspect of a client’s identity — be it his or her gender, sexual orientation, social class or race — will help practitioners understand how each client’s experience has shaped his or her behaviors, said Laura Brown, PhD, a clinical and forensic psychologist in independent practice in Seattle.

“It’s no longer as simple as looking at two streets crossing because if we do that, we miss the other streets coming in, and that’s where the car or bus is coming from that’s going to knock a person down,” said Brown, who with Douglas Haldeman, PhD, a Seattle counseling psychologist, served as a discussant for the symposium. “Intersectionality is a complicated but universally human phenomenon, and one that I’d invite all of you to consider as a lens for the work that you do.”

Amy Novotney is a writer in Chicago.