Intersectionality: How discrimination against race, gender reassignment, religion and other factors can combine to create an even more serious problem – Rosie Baruah

Intersectionality was developed as a concept in the US after Black women denied promotion in a firm were told they could not challenge hiring practices because Black men and white women had been promoted

It’s arguably a great time to be a woman in medicine: we have had a majority female medical school population for the best part of 30 years, increasing numbers of specialist societies and Royal Colleges have women at the helm, and finally a light has been shone on the NHS gender pay gap.

I don't think this is enough. It’s not enough just to have more women in the profession, and in leadership positions. We need to think about whether all women are being supported and benefitting from increased equity in medicine. The Equality Act provides protection against discrimination due to possession of certain named protected characteristics, of which sex is one, but one of many.

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There is a whole host of other protected characteristics in the Act including age, disability, gender reassignment, marital status, pregnancy and maternity, race, religion and sexual orientation. This is because people may be discriminated against because of more than one of their protected characteristics, and sometimes because of a specific combination of them, which leads to a discussion around ‘intersectionality’.

The medical community needs to make sure that all women are able to achieve their true potential (Picture: Christopher Furlong/Getty Images)The medical community needs to make sure that all women are able to achieve their true potential (Picture: Christopher Furlong/Getty Images)
The medical community needs to make sure that all women are able to achieve their true potential (Picture: Christopher Furlong/Getty Images)

This concept was first described by US law professor Kimberlé Crenshaw. She described a situation in which a group of Black women were unable to raise an action against their employer for discrimination, as no Black women had been promoted in their company. Because Black men were in promoted positions, and white women were also in promoted positions, there were no grounds to legally challenge hiring practices.

The women’s intersecting identities as Black people and as women were the reason they faced discrimination, but as there was no recognition, legal or otherwise, of the ways these identities combined, intersected and become a sum greater than their parts, they could not seek a legal remedy for the discrimination they faced.

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Examining the effect of gender on its own provides only a distorting ‘single-axis’ analysis that does not account for the multidimensional, transformational effect of the intersections of other identities such as race, ethnicity, social class and sexual orientation on a person’s social experience. The effects of possessing multiple characteristics cannot be separated out and are more than additive; they intersect to create an effect greater than the sum of their parts; this intersectionality can result in people facing multiple forms of exclusion. An excellent talk by Professor Crenshaw on “the urgency of intersectionality” can be found on the TED Talks website.

The theme of this year’s International Women’s Day in March was “inspire inclusion”. I would ask you to think about not just how women that you know may be lifted up, be included, be supported to reach their potential; I want you to think in an intersectional way. How much of a win is it if we have a committee that is now 50 per cent women, but none of them are working class, and/or Black, and/or Muslim and/or...!

There are so many ways in which a person’s characteristics can have acted as barriers to them, greater than the sum of their parts. We absolutely should cheer on the amazing women who are trailblazers in leadership, research and clinical medicine – and we owe it to all women in medicine to raise all of us up to achieve our true potential.

Rosie Baruah is a consultant in critical Care and anaesthesia in Edinburgh



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