Intersectionality: A Deeper Look at Therapy and Well-Being

In therapeutic practice, the concept of intersectionality matters deeply not only as a theoretical lens but as a lived reality for many clients. When clients live at the intersection of multiple identities and multiple systems of power, trauma, resilience, and culture, each of our clinical frameworks needs to keep pace. This post explores four interrelated dimensions: layered identity and mental health, systemic stressors, cultural perceptions of strength, and how therapy can engage intersectionality without flattening or minimizing complex experience. 

Layered Identity and Mental Health 

When someone holds multiple identity markers such as race, gender, sexuality, class, ability, immigration status, or religion, these do not simply add up in a linear way. They interact, overlap, and shift across contexts. The term intersectionality, coined by Kimberlé Crenshaw, refers to how multiple social identities interlock and how systems of oppression and privilege entwine around them. 

From a mental health perspective, this means that emotional distress, trauma, resilience, and wellness may look different not only because of a single identity category but because of the specific combination of identities and the contexts in which they are lived. 

For example: 

● A Black queer woman may experience something different from a White queer woman and different again from a Black heterosexual woman not just because of race or sexuality alone, but the intersection of those identities along with class, ability, and other factors. 

● Research shows that mental health disparities are more visible when intersectional frameworks are used. One review found that studies still often examine only one identity axis such as race or gender instead of how they coexist. 

● People with overlapping marginalized identities may face higher burdens of stigma, invisibility in research and care, and systemic neglect. 

Clinical implications: 

● In intake and assessment, invite a richer understanding of identity by asking questions like, “How do you experience your race and gender together in the world?” 

● Recognize that coping strategies and wellness resources might need to be tailored to the unique combination of identities rather than using a one-size-fits-all model. 

● Be curious about how identity intersections affect self-narrative, including how clients experience belonging, othering, invisibility, power, and vulnerability. 

Systemic Stressors: Recognizing How Oppression Impacts Personal Narratives

Intersectionality is not just about identity categories in abstraction. It involves systems of oppression such as racism, sexism, ableism, classism, heteronormativity, xenophobia, and ageism. These shape the social determinants of mental health. 

For example: 

● Intersectionality is essential for understanding the lived reality of experiencing mental illness in societies shaped by social systems of power and oppression. 

● The concept of systemic stressors includes both external discrimination and internalized stigma or vigilance, as explained in minority stress theory. 

● One study with young women found that structural disadvantages such as race, gender, and age intersected to produce “chains of dismissal,” where mental health concerns were routinely delegitimized. 

What this means in therapy: 

● When sitting in the counseling room, it is insufficient to treat distress purely at the symptom level. We must also invite the narrative of systemic stress into the work. 

● Ask questions such as, “How have you experienced the world as someone with your set of identities?” and “What social or structural barriers are you up against?” 

● Be alert to cumulative effects. The more marginalized identities someone holds, the more likely they are to face layered stress. 

● Recognize that resilience in these contexts is often underacknowledged. Clients may be carrying an invisible emotional workload that deserves space in therapy. 

Cultural Perceptions of Strength: What Confidence Looks Like Across Communities 

Different communities hold different implicit and explicit models of strength, confidence, resilience, and wellbeing. What counts as “healthy” or “successful coping” varies across cultural contexts. 

Examples of various strengths: 

● In some communities, confidence might mean assertiveness or visible self-advocacy. In others, such as collectivist or immigrant cultures, it might mean quietly holding things together or maintaining harmony. 

● A Latinx client might value family, interdependence, and relational balance, viewing confidence as quiet steadiness rather than outspoken assertiveness. 

● A client from a working-class background might view confidence as being able to navigate hardship or ask for help without shame. 

Therapeutic considerations: 

● Invite reflection on how families and communities taught the meaning of strength and confidence.

● Collaborate on defining what confidence or well-being means for the client rather than relying on dominant cultural norms. 

● Explore how cultural expectations interact with safety and risk for clients navigating multiple marginalized identities. 

● Recognize that cultural narratives of strength sometimes mask emotional burden, such as overresponsibility or caretaking roles. 

Therapy and Intersectionality: Avoiding the Flattening of Experience 

One of the major pitfalls in therapy is flattening—treating identity as a checklist rather than as an interwoven and dynamic experience. Intersectionality calls us to move beyond tokenism or surface-level inclusion. 

Key strategies for clinicians: 

● Frame identity as dynamic, contextual, and relational. Ask, “When do you feel most yourself? When do you feel unseen?” 

● Explore power, privilege, and oppression openly. Invite nuanced reflection on how identity brings both power and constraint. 

● Adopt cultural humility. No therapist can master every cultural perspective. Use curiosity and ask clients to guide you through their lens. 

● Go beyond single-axis interventions. Work with clients’ experiences as women of color, queer immigrants, disabled professionals, and others whose intersections create unique needs.

● Embed structural awareness. Consider how access barriers, discrimination, or economic precarity shape wellbeing. 

● Tailor interventions flexibly. Offer identity-affirming therapies and community-based supports that align with the client’s lived context. 

● Avoid tokenizing. Intersectionality is about integrating identity into full personhood, not exoticizing difference. 

● Reflect on therapist positionality. Consider how your own privileges or biases shape interpretations of “normal” or “healthy.” 

Closing Thoughts 

Using an intersectional lens in therapy is essential for responsive and ethical care. When we invite layered identity, we honor the full richness of a person’s lived experience. When we recognize systemic stressors, we validate what many clients endure beyond the therapy room. When we explore cultural meanings of strength, we affirm diverse pathways to healing. And when we avoid flattening complexity, we practice true empathy. 

Holding these dimensions together—identity, system, culture, and therapeutic stance—creates deeper, more inclusive narratives of healing and resilience.

References 

Bowleg, L. (2017). Intersectionality: An Underutilized but Essential Theoretical Framework for Social Psychology. The Palgrave Handbook of Critical Social Psychology. 

Harari, L., & Lee, C. (2021). Intersectionality in Quantitative Health Disparities Research: A Systematic Review of Challenges and Limitations in Empirical Studies. Social Science & Medicine. 

Intersectionality and Discriminatory Practices within Mental Health Care. Philosophy, Ethics, and Humanities in Medicine, BMC, 2024. 

Intersectionality and Mental Health: How Diverse Identities Impact Wellbeing. Mental Health Partners Blog, 2024. 

Understanding Intersectionality in Behavioral Health. ICANotes, 2023. 

Intersectionality and Mental Health Among Emerging Adult Black Americans. American Journal of Community Psychology, 2023. 

Intersectional Approaches to Risk, Resilience, and Mental Health in Adolescence. Frontiers in Psychology, 2023.