Operationalizing Intersectionality: Methodological Reflections on Challenges, Possibilities, and Pathways Forward

Introduction: Intersectionality offers a powerful way to capture how privilege and oppression intersect in shaping health and well-being. While widely invoked in qualitative health research, intersectionality is not always critically engaged, often used in a tokenistic manner rather than integrated across design and analysis. 

Goals and Methods: The authors reflect on applying intersectionality as paradigm within a qualitative dissertation study. Drawing on fieldwork, coding, reflexive notes, and positionality work, we critically examine how intersectionality can be operationalized in practice and the conceptual labour involved in doing so. In this study, we employed a narrative methodology with demographic reflections, semi-structured interviews, and member-reflection focus groups analyzed through reflexive thematic analysis guided by intersectionality at every stage. 

Results: We address the gap between invoking intersectionality and methodologically applying it by outlining four strategies developed throughout the research process. First, treating privilege and oppression as co-constitutive ensured analytic choices avoided over-emphasizing marginalization at the expense of relational power and resiliency. Second, resisting single-axis framings required flexibility—providing space for participants to self-identify in meaningful ways rather than imposing standardized categories. Third, managing analytic and ethical complexity involved balancing intersecting identities with necessary de-identification, foregrounding reflexive decisions about what could and could not be represented. Finally, recognizing intersectionality as elucidated—though not explicitly named—in participants’ accounts prompted reflection on intersectionality not only as a research paradigm, but also as a framework through which participants envision their lived-experiences of wellness. 

Conclusions: We aim to advance methodological discussions on how to do intersectionality in practice and to illuminate the tensions, challenges, and insights that arise in the process. By offering concrete strategies alongside these tensions, we contribute to developing rigorous, reflexive practices in qualitative health research—practices that uphold, rather than flatten, the complexities of positioning intersectionality both as a research paradigm and as a lived reality voiced by participants.