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Intersectional Identity Stress & Resilience


You can use these links navigate to specific intersections:

Conflict in Allegiances (CIA) - Sexual Identity and Racial/Ethnic Identity Intersectionality Stress


LGBT people of color experience stigmatization of their sexual orientation within their ethnic or racial communities (Díaz, Ayala, Bein, Henne, & Marin, 2001; Díaz, Bein, & Ayala, 2006; Espín, 1993; Morales, 2013, Ryan et al., 2009), and macroaggressions and segregation based on their ethnic and racial background within the mainstream LGBTQ White communities (Balsam, et al., 2011; Espín, 1993; Morales, 1989). For LGBTQ people of color, this position may engender conflicts in allegiances (CIA) with their multiple social group status (Morales, 1989; Santos & VanDaalen, 2016; Sarno, Mohr, Jackson, & Fassinger, 2015), such that a strong connection to one group may increase an individual’s exposure to discrimination regarding the other group identity. This connection can pose greater challenges to the developmental task of integrating their multiple group identities. Experiences of conflict between one’s sexual minority group identity and one’s ethnic or racial group identity yield challenges for an individual’s ability to integrate his, her, eir, zir, or their multiple social group identities (Morales, 1989), a process that has shown to be stressful. 


Sarno and colleagues (2015) developed the 6-item CIA scale to capture conflict associated with LGB people of color’s perceived integration of ethnic or racial identity and LGB identity. Individuals rate statements such as “I feel as if my sense of cultural identity is at odds with my LGB identity” and “I have not yet found a way to integrate being LGB with being a member of my cultural group” on a 7-point Likert- type scale where 1 = Strongly Disagree to 7 = Strongly Agree. The responses are averaged and higher scores indicate greater conflict between ethnic or racial and LGB identities. Sarno et al. (2015) reported an alpha of .86, and Santos & VanDaalen (2016) reported an alpha of .80. In these investigations, LGB people of color with strong ethnic group orientation reported more CIA and less engagement in LGBTQ communities (Sarno et al., 2015) and high CIA was associated with having more depression symptoms (Santos & VanDaalen, 2016).  


A comparable measure for people of color who identify as transgender, queer, or another sexual minority has been identified (LGBT People of Color Microaggressions Scale; Balsam et al. 2011) and will be reviewed at a future time. We are also aware of research teams who have created or who are developing and evaluating new measures of intersectionality stress for LGBTQ people of color.  This page will be updated when such measures are published. 


Author(s) and Reviewer(s): Prepared by Luis Armando Parra, PhD and Paul D. Hastings, Ph.D. If you have questions or comments about this entry, please email Dr. Parra at


Version Date: December 2017 


Balsam, K. F., Molina, Y., Beadnell, B., Simoni, J., & Walters, K. (2011). Measuring multiple minority stress: the LGBT People of Color Microaggressions Scale. Cultural Diversity and Ethnic Minority Psychology, 17(2), 163-174. 

Cole, E. R. (2009). Intersectionality and research in psychology. American Psychologist, 64(3), 170-180. 

Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 139-167. 

Diaz, R. M., Ayala, G., Bein, E., Henne, J., & Marin, B. V. (2001). The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from 3 US cities. American Journal of Public Health, 91(6), 927-932. 

Diaz, R.M., Bein, E., & Ayala, G. (2006). Homophobia, poverty, and racism: Triple oppression and mental health outcomes in Latino gay men. In A. M. Omoto & H. S. Kurtzman (Eds.), Sexual orientation and mental health (pp. 207-224). Washington, DC: American Psychological Association.  

Espín, O. M. (1993). Issues of identity in the psychology of Latina lesbians. In L. D. Garnets & D. C. Kimmel (Eds.), Between men—between women: Lesbian and gay studies. Psychological perspectives on lesbian and gay male experiences (pp. 348-363). New York: Columbia University Press.  

Morales, E. S. (1989). Ethnic minority families and minority gays and lesbians. Marriage & Family Review, 14(3-4), 217-239. 

Morales, E. (2013). Latino lesbian, gay, bisexual, and transgender immigrants in the United States. Journal of LGBT Issues in Counseling, 7(2), 172-184. 

Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123, 346–352 


Santos, C. E., & VanDaalen, R. A. (2016). The associations of sexual and ethnic–racial identity commitment, conflicts in allegiances, and mental health among lesbian, gay, and bisexual racial and ethnic minority adults. Journal of Counseling Psychology, 63(6), 668-676. 

Sarno, E. L., Mohr, J. J., Jackson, S. D., & Fassinger, R. E. (2015). When identities collide: Conflicts in allegiances among LGB people of color. Cultural Diversity and Ethnic Minority Psychology, 21(4), 550-559. 

Super Woman Schema – Experiences of stress and strength in African American Women

​African American women experience disproportionately high rates of psychological stress-related chronic health conditions, such as obesity, cardiovascular diseases, and diabetes. Research studies designed to understand and address stress-related chronic health conditions in African American women have been limited by the use of stress concepts and measures that have not incorporated a more comprehensive picture of the interpersonal, intrapersonal, and sociohistorical dynamics of African American women’s physical and emotional health.  

​The Superwoman Schema (SWS) Conceptual Framework and Superwoman Schema Questionnaire were developed through mixed-methods research with funding support from the American Psychological Association, the Substance Abuse and Mental Health Services Administration, and the National Institutes of Health (National Institute of Nursing Research and National Institute for Minority Health and Health Disparities) to understand how postures of resilience and self-efficacy, adaptively adopted as a means to survive life adversity, may also serve as potentially maladaptive contributors to chronic stress-related health conditions.1-3  A demographically-diverse sample of African American focus group participants described their lived experiences of experiencing and coping with stress, as well as the associated resilience, and risk factors including stress and delayed health-promoting behaviors.1 Analyses of these data resulted in the identification of five SWS characteristics: the obligation to project an image of strength, the obligation to suppress emotions, resistance to admitting vulnerability or accepting help from others, the motivation to succeed despite limited resources, and the prioritization of caregiving over self-care. 

​Perceived benefits of SWS were identified, including preservation of self, family, and community, as well as perceived liabilities such as stress embodiment and stress-related coping responses and health behaviors that may increase the risk for interpersonal strain and chronic health conditions. Based on the empirically grounded SWS Conceptual Framework, SWS characteristics are influenced by sociohistorical factors, such as racial and gender stereotyping and oppression, lessons from foremothers on how to survive, past experiences with mistreatment or abuse, dissatisfaction with unfulfilled promises of support, and spiritual values that may reinforce quiet endurance of life’s adversities.  

​In three quantitative and qualitative studies with demographically diverse African American women from various regions in the United States, items were developed from the original SWS focus group research and psychometrically evaluated (n=48; n=561; n=130).6 The five-factor structure of the Giscombe SWS Questionnaire was confirmed, consistent with the SWS conceptual framework. The Giscombe SWS Questionnaire,6 has strong psychometric properties (internal consistency and validity), with positive associations among SWS and subjectively reported race-related, gender-related, and generic stressors, the use of food to cope with stress, poor sleep quality, and physical inactivity, and obesity – all factors associated with increased CM risk.6 More recent investigations of SWS in African American women have revealed significant associations among SWS characteristics and indicators of cardiometabolic risk (e.g., allostatic load, biological aging).4-10 

​​Giscombe Superwoman Schema Questionnaire: The Giscombe Superwoman Schema Questionnaire (G-SWS-Q) includes 35 items and the following five subscales: an obligation to present an image of strength, an obligation to suppress emotions, resistance to vulnerability, intense motivation to succeed, an obligation to help others; Participants are instructed to use the following response options: this is not true for me, this is true for me rarely, this is true for me sometimes, and this is true for me all of the time. Participants also rate how much the situation bothers them: very much to not at all. The G-SWS-Q has exhibited excellent psychometric properties for African American women across educational backgrounds and age ranges (Cronbach’s alpha range for subscales 0.79-0.89), test-retest reliability (r = 0.89); and has been significantly associated with CM risk, depression, perceived stress, sedentary behavior, and sleep disturbance.6 

​Author(s) and Reviewer(s): Prepared by Cheryl L. Woods-Giscombé, PhD. For questions about the G-SWS-Q contact Cheryl at


Version Date: September 2023


Woods-Giscombé, C.L. (2010). Superwoman Schema: African American women’s views on stress, strength, and health. Qualitative Health Research, 20, 668-683.  

Woods-Giscombé, C. L., & Black, A. R. (2010). Mind-body interventions to reduce risk for health disparities related to stress and “strength” among African American women: The potential of mindfulness-based stress reduction, loving kindness, and the NTU therapeutic framework. Complementary Health Practice Review, 15, 15-31.  

Black, A. R. & Woods-Giscombé, C. L. (2012) Applying the Stress and “Strength” Hypothesis to Black women’s breast cancers delays. Stress and Health: Journal of the International Society for the Investigation of Stress, 28, 389-396.  

Woods-Giscombe, C. L., Carthron, D., Robinson, M., & Devane-Johnson, S. & Corbie-Smith, G. (2016). Superwoman Schema, stigma, spirituality, and (culturally) sensitive providers: Factors influencing mental health service utilization in African American women. Journal of Best Practices in Health Professions Diversity: Research, Education, and Policy, 9, 1124-1144. 

Woods-Giscombe, C. L. (2018). Reflections on the development of the Superwoman Schema Conceptual Framework: An intersectional approach guided by African American womanist perspectives. Meridians, 16(2), 333-342. DOI: 10.2979/meridians.16.2.14.  

Woods-Giscombe, C. L., Steed, T. C., Allen, A., Li, Y., Lackey, C., & Black, A. R. (2019). The Giscombe Superwoman Schema Questionnaire: Psychometric properties and associations with mental health and health behaviors in African American women. Issues in Mental Health Nursing, 40, 8, 672-681, DOI: 10.1080/01612840.2019.1584654  

Allen, A. M., Wang, Y., Chae, D. H., Price, M. M., Powell, W., Steed, T., Black, A., Dhabhar, F. S., Marquez-Magana, L., & Woods-Giscombe, C. L.  (2019). Racial discrimination, the superwoman schema, and allostatic load: exploring an integrative stress-coping model among African American women. Annals of the New York Academy of Sciences, (1457), 104-127. doi: 10.1111/nyas.14188  

Sheffield-Abdullah, K. A., & Woods-Giscombe, C. L. (2021). Perceptions of the superwoman role and distress among African American women with pre-diabetes. Archives of Psychiatric Nursing – Social Determinants of Health Special Issue.


Perez, A.D., Dufault, S.M., Spears, E.C., Chae, D.H., Woods‑Giscombe, C., & Allen, A.M. (2022). Coping with Racism: ’Is Superwoman Schema the female version of John Henryism?’ Social Science & Medicine. 


Thomas, M. D., Mendez, R. M., Zhang, Y., Wang, Y., Sohail, S., Chae, D. H., Márquez-Magaña, L., Sellers, R., Woods-Giscombe, C. L., & Allen, A. M. (2022). Superwoman Schema, racial identity, and cellular aging among African American women. The Gerontologist, gnac005. Advance online publication.  

Intersectionality theory provides a comprehensive lens by which the lived experiences of individuals belonging to multiple stigmatized or oppressed social groups (e.g., people of color, women, and lesbian, gay, bisexual, transgender, and queer [LGBTQ]) can be examined (Crenshaw, 1989). Predominant models of minority stress have not examined the unique stressful experiences linked to oppression associated with sexual orientation, ethnicity, or race identities in conjunction with one another (Cole, 2009). With this entry, we are beginning to catalogue measures that consider two or more aspects of identity in relation to the specific stressors (and strengths) that can manifest at these intersections.

Sexual&Ethnic Identity
SStress&Strength in African American Women
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