More Than One Story: How Overlapping Identities Shape Our Mental Health
Author: Kathryn Lodwick-Jones
Mental health is more than just an individual experience, it is deeply influenced by social, cultural, and political factors. One key framework that helps explain these layered influences is intersectionality, a term coined by legal scholar Kimberlé Crenshaw. Intersectionality refers to how different aspects of a person’s identity, such as race, gender, sexuality, class, and ability, intersect to create unique modes of discrimination and privilege. When applied to mental health, this lens reveals how people’s overlapping identities can compound stress, limit access to care, and shape their overall wellbeing. This article explores the intersectional nature of mental health, focusing on how systemic inequalities impact individuals differently based on their identities, and how communities are navigating these challenges.
Why Does Intersectionality Matter in Mental Health Care?
Effective mental health care is far from a one-size-fits-all approach. While many of us are familiar with terms like anxiety or depression, the way individuals may experience symptoms and challenges, and how people get support, often depends on who they are and what they have access to. Facets of identity and how someone navigates the world directly and indirectly impact their access to care. For example, a white woman, a transgender man, and a Black immigrant mother might all struggle with depression, but the factors contributing to their challenges and experiences, the way their symptoms are treated, and how they are viewed and supported by their community and society as a whole may differ drastically. Intersectionality acknowledges the unique experiences of overlapping identities while also highlighting the impacts of oppression and privilege on access to support. Without considering these overlaps, we miss the full picture and the whole person.
The Impact of Overlapping Identities on Mental Health Risks
People who belong to multiple marginalized groups often face a complex web of challenges that increase their risk for mental health struggles. Individuals from the BIPOC and LGBTQIA+ community might experience racial discrimination, sexism, and homophobia, all of which can contribute to chronic stress, anxiety, and depression. According to NAMI, adults who are part of the LGBTQIA+ community are twice as likely as heterosexual adults to experience a mental health condition. The data remains consistent for youth as well, noting “LGB youth also experience greater risk for mental health conditions and suicidality. LGB youth are more than twice as likely to report experiencing persistent feelings of sadness or hopelessness than their heterosexual peers. Transgender youth face further disparities as they are twice as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to cisgender lesbian, gay, bisexual, queer and questioning youth”. According to the National Alliance on Mental Illness (NAMI), over 60% of LGBTQIA+ youth report symptoms of depression, and the rates are even higher for queer youth of color.
During the COVID-19 pandemic, the prevalence of mental health challenges increased while access to care declined, especially in communities of color. Research has demonstrated that for many BIPOC individuals, there was a significant increase in rates of anxiety and depression compared to white people. BIPOC individuals are also more likely to experience acts of racism and discrimination, associated with worsened mental health and well-being. Similarly, immigrants with disabilities may endure cultural isolation and systemic ableism simultaneously. These intersecting pressures often go unnoticed in mental health research, which tends to treat identity factors in isolation. Why does this happen? Because living with multiple layers of discrimination like racism, sexism, homophobia, or poverty can create what researchers call “minority stress.” These are the everyday pressures and traumas that come with being marginalized, and over time, wear people down emotionally and mentally.
Barriers to Mental Health Access and Treatment
Even when mental health services are available, they are not equally accessible to everyone. Language barriers, lack of insurance, and transportation issues are often the most common barriers to mental health care. Many people from marginalized communities also face stigma around seeking mental health care, especially when cultural norms discourage open discussion of emotional distress. Moreover, the mental health system itself is not immune to bias. Studies show that Black patients are more likely to be misdiagnosed with schizophrenia, while their depression is underdiagnosed. Similarly, transgender individuals often report being misunderstood or even mistreated by clinicians unfamiliar with their lived experiences. Even when people are ready to seek help, the mental health system isn’t always prepared to help them. These gaps highlight the urgent need for culturally responsive care. For example, fewer than 6% of U.S. psychologists are Black, and less than 8% are Hispanic, according to the American Psychological Association. That lack of representation can lead to miscommunication, mistrust, and even misdiagnosis.
Community Resilience and Coping Strategies
Despite these challenges, marginalized communities have long created their own networks of care and healing. From informal support networks, to culturally specific practices like talking circles in Indigenous communities or community-led therapy collectives, resilience takes many forms. Peer-led mental health groups, particularly within LGBTQIA+ and disability communities, offer accepting spaces where people feel supported and affirmed. Religious or spiritual traditions also provide coping mechanisms for many. These collective strategies underscore that healing is not just an individual act, but that community is necessary. Mutual aid groups, peer support networks, and culturally specific mental health programs are growing rapidly. Organizations like Therapy for Black Girls or Asian Mental Health Collective provide therapists who understand the cultural context of their clients’ experiences. These efforts show that healing doesn’t just happen in a therapist’s office, it can also happen in communities, families, and shared stories.
Policy, Advocacy, and the Path Forward
To address mental health inequities through an intersectional lens, change is needed at multiple levels. Policymakers must invest in mental health programs that are accessible, affordable, and culturally informed. Educational institutions should prioritize educating mental health professionals to understand and respect the complexities of identity and focus on ongoing cultural humility. Research funding must prioritize intersectional approaches rather than siloed demographic categories. At the grassroots level, continued support for peer-led and community-based initiatives can help fill the gaps left by mainstream systems. Ultimately, recognizing intersectionality in mental health isn’t just about better treatment, it’s about justice, equity, and the dignity of every person’s experience. To truly improve mental health outcomes, we need to bring intersectionality into the center of mental health policy, research, and care. That means:
- Training more therapists from diverse backgrounds and making therapy as a profession more accessible
- Including intersectional data in mental health research
- Funding community-based and culturally informed mental health services
- Fighting stigma in all communities not just around mental illness, but around race, gender, sexuality, and class too
We can’t fix what we don’t fully see. Understanding how overlapping identities shape mental health isn’t just about being inclusive, it’s about being accurate, fair, and effective. Everyone deserves mental health care that understands their whole story!
Equilibria is a group of licensed mental health professionals in Pennsylvania and New Jersey with multiple specialties to serve all aspects of our diverse community’s mental, emotional, and behavioral needs. We provide in person and telehealth services to individuals of all ages, families, and those in relationships. Click here to schedule an appointment today.
