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Understanding cultural intersectionality

This is an excerpt from Patient-Centered Care in Sports Medicine by Rene R Shingles,Lorin A Cartwright.

Repacking the Luggage

One cannot always separate pieces of one’s cultural luggage (see figure 3.2). For example, during the 2008 U.S. presidential campaign season, many pundits argued that African Americans would support Barack Obama, whereas women, particularly those older than age 35, would support Hillary Clinton. If this were so, then one of the authors of this text, who happens to be an African American woman over the age of 35, would, if voting for a Democrat, be left in an impossible quandary! It raises the question, “Which part of me do they want—my African American half or my woman half?” In reality, of course, the two cannot be separated.

Similarly, Jane’s identity as a woman or as a straight White person cannot be torn apart from her conservative Christian upbringing in a farming community. Her “class and race privilege may blind her to issues of race and class, or her experience of gender inequality may foster the illusion that this automatically prepares her to know everything she needs to know about other forms of privilege and oppression” (Johnson, 2001, p. 52). Thus, fragmentation ignores the complexities, social realities, and experiences of people at different social locations and identities that intersect race, ethnicity, class, gender, sexuality, and religion. Fragmentation also presupposes social categories are dichotomous or dualistic—which hinges on “either/or” thinking (Andersen and Collins, 1995; Collins, 1991), where gender means either woman or man and sexuality means either straight or gay. When forced into a dichotomy, social locations become dependent on their polar opposites. The assumption is that one side of the dichotomy is superior to the other, which does not recognize the interlocking dimensions of social inequality (Baca Zinn and Dill, 2016).

For example, Connell (1992), although not denying male authority is evident and socially constructed, argues there is a “gender order” within masculinities—which is to say, masculinity is not fixed, but rather, expressed differently depending on one’s social location. Men may be both privileged and disempowered simultaneously, rather than either privileged or disempowered. Working-class White men, gay Chicano men, and middle-class African men may all enjoy gender privilege, but the privileges may or may not be fully realized, experienced, or perceived when they intersect with class, sexuality, ethnicity, and race (Messner and Sabo, 1990). For example, race and gender privilege did not prevent Lindsy McLean—the longtime head athletic trainer for the San Francisco 49ers football team—from being abused because of his sexuality. McLean is a member of the National Athletic Trainers’ Association Hall of Fame, yet he was victimized because he is gay, “starting in the early ’90s, when a 350-pound lineman would chase him around, grab him from behind, push him against a locker and simulate rape” (Bull, 2004, p. 93).

In health care, social locations and identities may also intersect in such a way that an athletic trainer believes racialized stereotypes, thus causing them to respond inappropriately and treat the patient ineffectively. For example, Retha Powers (1989), an overweight Black woman, struggled with compulsive overeating and dieting. When she divulged her struggles to a White female high school counselor, the counselor said, “You don’t have to worry about feeling attractive or sexy because Black women aren’t seen as sex objects, but as women. . . . Also, fat is more acceptable in the Black community—that’s another reason you don’t have to worry about it [battle with compulsive overeating]” (Powers, 1989, pp. 78, 134). The counselor’s “presumption of Black women’s strength and physical deviance completely overshadows and rejects Powers’ reality of having an eating problem” (Beauboeuf-Lafontant, 2005, p. 87), missing the intersection of race, gender, and sexuality.

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