Applying Intersectionality With Constructive Grounded Theory as an Innovative Research Approach for Studying Complex Populations: Demonstrating Congruency

One goal of qualitative health research is to fully capture and understand stories of people who experience inequities shaped by complex interlocking structural and social determinants. With this social justice–oriented goal in mind, it is critical to use a methodological approach that appreciates prevailing inequities and oppression. In this article, we propose an innovative approach that joins qualitative health research methodology with critical inquiry. Specifically, we propose advancing constructive grounded theory (CGT) through applying intersectionality as an emergent critical social theory and an analytical tool. With our proposed approach being novel, minimal attempts to conceptualize and operationalize CGT with intersectionality exist. This article focuses on initiating theoretical conceptualization through focusing on demonstrating congruency. We are guided by this focus to seek connectedness and fit through analyzing historical and philosophical assumptions of CGT and intersectionality. In our article, we demonstrate congruency within four units of analysis: reflexivity, complexity, variability, and social justice. Through these units, we offer implications to applying intersectionality within CGT methodology. These include a foundation that guides researchers toward further conceptualizing and operationalizing this novel research approach. Implications also include innovatively exploring complex population groups who face structural inequities that shape their lived vulnerabilities. Our proposed research approach supports critical reflection on the research process to consider what shapes the researcher–participant relationship. This includes reflecting on analysis of power dynamics, underlying ideologies, and intermingling social locations. Thus, our conceptual paper addresses the call for evolving social justice methodologies toward inquiring into complex populations and generating knowledge that challenges and resists inequity.

Keywords: constructivist GT; critical feminist theory; methods in qualitative inquiry; social justice; action research

It is well-documented that complexity among vulnerable populations is driven by broad structural forces where multiple disparities exist ([66]; [69]). For example, populations such as migrant groups, people with substance use challenges, and people with mental health issues are impacted by inequitable health experiences that are shaped by structural determinants such as gender, race, and class ([41]). Although the significance of understanding structural and social determinants shaping health experiences within vulnerable population groups has been validated, such inquiry remains superficial ([5]). Little attention has been given in qualitative methodologies to how complexities involving multilevel health determinants are addressed. [31] support this claim in their recent call for needing innovative ideas to evolve social justice methodologies toward understanding complex populations. Such populations can be understood as those experiencing health disparities that are socially and structurally constructed by determinants influenced by oppressive forces such as health and social policy ([75]; [79]).

In our commitment to enhance research inquiries into complex populations, we wonder how qualitative health researchers can enhance the understanding of multilayered experiences that are influenced by broader sociopolitical and economic structural forces. To address this question, we propose to innovatively advance constructive grounded theory (CGT) as a methodology with social justice intentions, through applying intersectionality as an emergent critical social theory within qualitative research. In doing so, we also aim for continuous evolvement of intersectionality through drawing on qualitative methodology as a conduit for generating knowledge that resists social injustice ([23]).

Our aim of this article is to conceptualize the application of CGT with intersectionality and lay foundations for researchers to authentically employ our proposed approach. These foundations are conveyed through demonstrating philosophical and theoretical connectedness. Such demonstration has been identified by qualitative health researchers as congruency ([78]). Through our conceptualizations, we pragmatically provide researchers with units of analysis to integrate within their inquiries into complex populations.

Within the landscape of qualitative methodologies, the intentions of CGT include broadening inquiries focused on understudied, complex human behavior ([10]; [36]; [70]). Awareness of power relations within the researcher–participant relationship is also central to CGT ([10]). These intentions fit well with our critical feminist situatedness. With multilayered and multilevel influences driving the complexities faced by vulnerable populations, we realized the need to build upon CGT intentions to appreciate feminist tenets focused on complexity. Intersectionality fits into this theoretical optic.

We draw on [23]) interpretation of intersectionality as an emerging critical social theory. [23] explains how intersectionality is situated within the crossroads of critical analysis and social action. Being within this crossroad means employing intersectionality as a social theory while ensuring sustained reflection on its objectives and analytical aims ([23]). Although intersectionality has already been claimed and discovered by multiple disciplines, many have left philosophical assumptions and historical roots unexamined. As a result, intersectionality has matured and moved forward quickly without much reflection or critical exploration. Now emerging into a critical social theory, researchers engage with intersectionality to describe and challenge social inequities with intention to influence change. The notion of interconnectedness being a pillar of intersectionality ([24]; [28]) guides our focus toward the interplay of constructs including race, class, and gender as interdependent systems of power. In addition, production of social inequality through intersecting power relations and how these power relations drive health experiences are focal points of [23] insights. We also align with [39] and [43] uptake of intersectionality, which directs our attention toward unanswered questions and unconsidered issues. Our discussion of intersectionality is also situated pragmatically as an analytical tool guiding attention toward structurally embedded influencers and critiquing domineering knowledge ([20]; [24]; [28]). Intentions of this uptake include fostering contextualization of power relations and better understanding perpetuating inequities ([18]; [24]).

Importantly, we acknowledge intersectionality as situated within Black and Indigenous women's experiences of identity and the multilayered, influential forces that shape these identities. [23] provides examples of these broad forces as ideologies such as neoliberalism, capitalism, racism, and imperialism which drive complexity and influence inequities experienced within social life. With more recent development of intersectionality through seminal scholars such as [20], [22], [23]) and [28], we were collectively inspired by the capacity to shed light upon often ignored forces that shape identities and health experiences. Our resulting integration of intersectionality and CGT became a unique research approach expanding the critical feminist intentions of CGT. In exploring this approach, we are also responding to [65] claim that applying intersectionality within qualitative health research is an emergent critical trend. However, as [78] advice, methodological connectedness with a researcher's theoretical perspective is essential to rigorously ground inquiries. [23] supports this advice in her call to refine and evolve intersectionality through critical application with congruent methodologies. Although intersectionality has been explicitly applied to CGT methodology in one study ([53]), little has been done methodologically to critically analyze such connectedness. As a result, we focus this article on establishing congruency between CGT and intersectionality as an emergent critical social theory and an analytical tool ([24]; [40]; [44]). We argue the need for this congruency to foster philosophical and theoretical connectedness which form a rigorous pathway for researchers inquiring into complex population groups.

We begin this conceptual paper by describing the evolution of grounded theory (GT) into its current three strands. We then describe the roots of intersectionality and its philosophical underpinnings. To foster theoretical connectedness, we critically explore congruency between intersectionality and Charmaz's CGT. Through our exploration, we propose four units of analysis: reflexivity, complexity, social justice, and variability. We explore conceptualizing these units of analysis and offer pragmatic implications and exemplars for researchers adopting our proposed approach. In outlining exemplars, we showcase how researchers can capture stories of participant experiences using both CGT and intersectionality. Limitations of our approach are reviewed to stimulate questioning issues needing further thought on building on our perspectives.

In 1967, sociologists Barney Glaser and Anselm Strauss merged their diverse academic backgrounds and cofounded GT ([6]; [10]). Glaser was influenced by his academic work with Columbia University scholars Paul Lazarsfeld and Robert Merton. As a result, quantitative rigor and development of middle-range theory were central to Glaser's training and efforts to shaping GT ([10]). Strauss' mentors originated from the Chicago School of Sociology and included George Herbert Mead, John Dewey, and Martin Blumer. Through the teachings of these iconic social scientists, Strauss contributed key philosophical and theoretical foundations of pragmatism and symbolic interactionism to the development of GT ([10]; [71]). After meeting in the University of California, San Francisco through the School of Nursing, Glaser and Strauss combined these perspectives toward their common goal of developing sociological theory. The intention of GT was to generate theory that described social phenomena through focus on patterns of human behavior ([35]; [36]; [72]). Although GT has advanced since its inception into three unique stances, Glaserian, Straussian, and Charmaz's CGT, the original intention of exploring complex human interactions remains central ([55]). The notion of complexity enmeshed in human behavior is valued within GT where social interactions are explored over time and varying contexts.

The initial GT work Glaser and Strauss published in the 1960s was underpinned by a realist ontology and objectivist epistemology that combined factor analysis, pragmatism, and symbolic interactionism ([1]; [56]). This collaborative effort reflects Glaser and Strauss' academic backgrounds and also potentially creates philosophical tension. Can a realist ontology align with constructionist beliefs where multiple truths exist? This conundrum was addressed in the 1990s where scholars started deconstructing GTs foundational underpinnings. For example, Strauss and postdoctoral student, Juliet Corbin, reconceptualized GT toward a relativist ontology and subjectivist epistemology ([2]; [3]; [16]; [60]). While a distinct bifurcation into two strands of GT resulted from Strauss and Corbin's reconceptualization, symbolic interactionism and pragmatism continued on as fundamental to the methodology. These philosophical pillars are also foundational within the third strand, Charmaz's CGT.

Although Charmaz was a student of both Glaser and Strauss, her interests leaned on Strauss and Corbin's conceptualizations. In developing the third strand of GT commonly known as Charmaz's CGT, she assumed a relativist ontology with a subjective epistemology emphasizing social construction of knowledge. Distinctly, Charmaz emphasized researchers' influences and contributions to social construction ([60]). The concept of researchers as coproducers of knowledge is central to critical feminist methodologies where awareness of inclusivity and power differential are present throughout the research process ([10]; [19]). Charmaz's CGT guides researchers to reveal, examine, and scrutinize their assumptions and decision-making ([10]; [64]). Thus, researchers are informed by the feminist concept of reflexivity and mindful of superimposing on the experiences of research participants. As a result, although researchers are coproducers of knowledge, intentions of highlighting the voices of research participants within this knowledge are prioritized. [8], [9]) ensures researchers are self-aware of their role within GT inquiries by encouraging application of theoretical lenses that concentrate on social justice and societal issues. It is well understood in current health research, that societal issues are fraught with multilevel complexity and inequity ([17]; [63]; [66]). Thus, implications of embracing versatility within Charmaz's CGT include having freedom to explore differing theoretical lenses that appreciate such complexity. The use of a critical theory that captures complexity through magnifying intersections of social concepts can benefit researchers in generating theory that reveals overlooked health needs ([74]). One such emergent critical theory that centers on complexity is intersectionality.

Throughout the research process, researchers are informed by overarching critical feminist tenets. However, [64] argues researchers assuming a critical feminist stance need to be clear on how they are approaching GT. In addition, [10]) calls for understanding the potential for advancing critical inquiry within GT. The critical feminist landscape includes multiple paradigms that provide unique lenses to approaching methodology. In our aim to address complexity within populations experiencing multilayered, interlocking forces of inequity, intersectionality became the feminist stance that aligned with our situatedness. As an emerging critical social theory and an analytical tool ([23]; [24]), we employ intersectionality to specifically and pragmatically address the interplay of multiple social locations among complex populations.

Viewing intersectionality as an analytical tool allows identification of unchallenged knowledge that perpetuates inequity among populations living in the margins ([24]; [40]). Our approach also guides the research process. For example, how questions are structured, how a study can be conducted, and how results are interpreted are influenced by the premises a researcher assumes ([37]; [39]; [44]). To gain more insight into intersectionality, we turn to the historical roots of feminism where social justice and human rights activism shed light on inequities going unnoticed.

The 1960s and 1970s comprised of second wave feminism and activism where the notion of "woman" was voiced unilaterally. This focus on sex and gender created discord as dimensions of race were being overlooked ([24]). This discord gave rise to key tenets of intersectionality including acknowledging voices going unheard and multiplicity of truth. Although central tenets of intersectionality were initially developed in the form of texts and social activism, uptake within research and praxis was delayed until the 1990s ([24]). Continuous evolution of intersectionality over several decades and beyond is a distinct feature that enables influence of societal thinking to shape its application.

A historical analysis of intersectionality reveals another distinct feature where appreciating voices of ignored populations including Black activists, feminist thinkers, Latina, lesbian, gay, bisexual, transgender, queer, and Indigenous scholars is foundational ([24]; [43]). Although there are many voices that have contributed to shaping discourse into a formal critical theory, introduction of intersectionality discourse originated in 1989 through [28] who continues to advocate for disrupting status quo and perpetual neglecting of racialization and sexism ([25]; [43]; [45]).

Ontologically, humans are viewed as complex and cannot be reduced ([20]; [28]; [77]). This complexity extends to the human experience where social locations are positioned. However, these social locations cannot be understood in isolation ([22]; [74]). Consequently, truth can be ascertained through understanding how social locations interconnect and thereby shape experience. A constructive epistemology resonates within intersectionality where social locations are viewed as socially constructed ([24]; [43]). Therefore, human experiences are unique and influenced by context. Understanding that these contexts are laden with power imbalance is an elemental assumption within intersectionality ([23]). Notably, intersectionality is predominantly described as what it does rather than what it is ([15]) which denotes pragmatism as an underlying epistemic. Ethically, intersectionality can be taken up as a worldview that aims at disrupting inequity and revealing processes of power, privilege, and disadvantage among complex populations.

The original intent of intersectionality stemmed from analyzing inequities within axes of racism and sexism to shed light on Black and Indigenous women's experiences that were overlooked and oppressed. Collins built on original intentions through describing societal oppressions as influenced by intersecting patterns of social locations ([20]; [24]; [59]). Examples of social locations include "age, culture, (dis) ability, ethnicity, gender, immigrant status, race, sexual orientation, social class, and spirituality" ([59], p. 61). Although these examples have significant philosophical and historical roots, we embrace social locations as constructs shaping identity ([24]).

Keeping close to central philosophical assumptions, [44] moved intentions of intersectionality forward through their conceptualizations of health inequities. The authors drew on original interpretations of feminism including Black feminism, Indigenous feminism, Latin feminism, and postcolonialism ([20]; [28]) and consider the interplay of varying social identities with broad structural processes of oppression and context to shape mental health experiences. [24] articulate how such interplays need to be considered within policy and practice domains. Answering this call include collaborative works addressing how intersectionality has moved beyond a field of study and into an innovative approach to analyzing inequity ([46]).

Implications of intersectionality being applied to disrupt inequity among underresearched populations can be seen within current literature. For example, within the nursing discipline, [38] apply the concept of "intersectionalities of influence" (p. 37) as an approach inquiring into how race, gender, class, education, citizenship, and geographical locations interplay to shape health experiences among immigrant and refugee women. From a social work disciplinary standpoint, [76] take up intersectionality as a perspective and a research framework to value diversity, empowerment, and historical oppression of refugee mothers. More recently, [53] attempted using intersectionality as a framework within their CGT exploring social processes influencing young adults using sports clubs. The authors used intersectionality as an idea where multiple intersecting identities and conditions converge to create a whole. Although findings included identifying a core social process within the context of complex social and power dynamics, demonstrating how intersectionality influenced findings was not explicated. These examples demonstrate the utility of intersectionality by researchers of various disciplinary backgrounds and applied on a diverse array of populations that have historically been neglected in research. Although decades of evolution and shifts in societal thinking have shaped intersectionality, there is a need for innovation in applying intersectionality toward addressing persistent social injustices affecting vulnerable populations. [23] supports this claim stating intersectionality is an ever-evolving body of knowledge that is ready for practitioners to investigate for diverse conceptualizations. Thus, we move forward to explore congruency in our aim to refine intersectionality as an emergent critical social theory and advance CGT methodology toward a novel social justice methodology.

Proposing application of intersectionality as an analytical tool on Charmaz's CGT to understand complex populations requires understanding congruency and limitations. We draw on [78]) guiding principles for developing rigorous qualitative research where congruency is identified as a benchmark of quality. The authors describe congruency as philosophical and theoretical connectedness within the methodology and throughout the research process. We explore congruency through four specific units of analysis. Drawing from Long's (2011) social science lens, units of analysis are descriptors for generalizable elements within research endeavors. This terminology fosters appreciating the unobservable domains embedded within our exploration ([54]). The following units of analysis emerged as foundational domains within our search for philosophical and theoretical connectedness: reflexivity, complexity, social justice, and variability.

These domains were developed through a process of comparing and contrasting assumptions, methods, and intentions within conceptual and research inquiries engaging with Charmaz's CGT and intersectionality. Through this process, theoretical connections emerged as units of analysis. In highlighting scholarship including seminal work and exemplars, we describe how each unit resonates within Charmaz's CGT and intersectionality (see Table 1). Through this visual, we aim to demonstrate congruency and facilitate conceptualizing how intersectionality as an analytical tool can be applied to Charmaz's CGT.

Graph

Table 1. Summary of Congruencies Between Charmaz's Constructive Grounded Theory (CGT) and Intersectionality.

1 Note. GT = grounded theory; CGT = constructive grounded theory.

Through these four shared units of analysis, we offer a rigorous pathway that guides researchers toward operationalizing CGT and intersectionality to explore complex population groups. To further conceptualize these four units of analysis, we discuss how reflexivity, complexity, variability, and social justice reflect within CGT and intersectionality. Throughout our discussion, interconnectedness of the four units of analysis will be apparent. Although we focus our discussion on relating these domains to our proposed approach, we appreciate the significant histories underpinning each unit. With this article being focused on methodological conceptualization, we pragmatically hone in on how each unit of analysis could potentially reflect within a researcher's uptake of our proposed approach.

Reflexivity within CGT is described as an insightful capacity to self-reflect and acknowledge preconceptions and assumptions ([12]; [62]). Rooted in symbolic interactionism, [19] and [10] emphasize the epistemology that both participants and researchers cocreate meaning to develop a social process theory. It is therefore critical to recognize how researchers are positioned to influence this process through their values and assumptions. In doing so, researchers are driven to realizing power relations within the researcher–participant dyad. Strategies employed within CGT that ensure researchers address preconceptions and assumptions include memo-writing, theoretical sensitivity, and the notion of methodological rigor ([11]; [62]). Consequently, reflexivity is pragmatically integrated into the research process to encourage continuous awareness of power relations. [12] deepens emphasis on reflexivity by urging critical scrutiny of one's language and underlying influential ideologies. Calling this critical reflection "methodological self-consciousness," [12] explicates the need for constructive grounded theorists to assume reflexive stances throughout the research process. Taking a reflexive stance is a critical approach to revealing embedded power relations and ideologies which stems from critical feminist underpinnings of CGT ([51]).

Intersectionality shares this underpinning of magnifying power relations within relationships ([15]; [23]). In fact, reflexivity seems to stem from the reason why intersectionality is framed as an emergent critical social theory addressing oppression. This innate use of reflexivity is embedded within the era of feminist activism where self-reflection on race and gender as influencing one's identity led to stark realization of persistent inequitable treatment and broader hegemonic forces. A more explicit definition of reflexivity within intersectionality is made through [43] work where reflexivity is positioned as a strategy that acknowledges multiple truths and attends to voices unheard. [43] broadens application of reflexivity through emphasis on attending to structural hegemony and appreciating the need for diverse perspectives within research and policy-making. Thus, [43] exemplifies how reflexivity within intersectionality can be taken up at micro-, meso-, and macro-levels with intention to magnify power and scrutinize tacit knowledge. In critically honing in on one's biases and positionality, reflexivity can be used to unpack embedded interlocking forms of power differentials and social differences that have influence on decision-making ([27]; [46]). As a result, intersectionality assists researchers to identify with power and privileges and explicates views on who benefits from the inquiry being conducted. These views trickle into how knowledge is disseminated and taken up within education, policy-making, future research projects, and health-care delivery.

With reflexivity as a shared unit of analysis, applying intersectionality to CGT holds promise of honing in on power relations and broader processes embedded within researcher assumptions and ideas. Drawing on the exemplars provided in Table 1, memoing is a method within CGT that captures researcher ideas throughout the research process ([10]). These memos are considered as data to be integrated into analysis. Intersectionality and CGT share the need to continuously critique this data; however, intersectionality pushes this critique toward analysis of social locations and broad processes shaping these locations. Examples of questions that can emerge during this critique include: What social locations are present within researcher ideas? How are the researcher's own social locations reflecting within memos? What broader processes are influencing the interactions of the researcher with the data? Such questioning encourages researchers to articulate their own assumptions and privileges that are perpetuating power imbalances and oppressive processes.

In exploring this second unit of analysis, [55] highlights the critical perspective GT provides through drawing out the "essence of complex interactional processes" (p. 121). Moreover, [1] articulate these complex processes as including human interaction, "organizational functioning, social movements, cultural phenomena and interactions between nations" (p. 1075). The authors philosophically identify truth as being located within the complexities of interaction. [10]) exemplifies complexity in her actualization of [26] conditional matrix. This analytical tool provides a visual interlinking display that appreciates broad, structural influences, and facilitates action–interaction within these linkages ([55]). This interaction negates linear thinking and contributes to the process-orientated foundations of GT. [26] conditional matrix allows consideration of power relations that are contextual and embedded within interrelationships between micro- and macro-social structures ([10]; [55]). [48] exemplifies how using the conditional matrix fostered consideration of relating political socioeconomic issues with national policies to understand institutional problems and experiences of collective groups and individuals. The notion of a visual display as an analytical tool to map complexity is present in most GT studies where conceptual relationships linked to a core social phenomenon are made explicit visually.

The valuing of complexity within Charmaz's CGT methodology is also evident within intersectionality where humans are considered as multidimensional beings ([20]; [28]; [77]). [23] argues that complexity is central to the interactive and interactional process of intersectionality. Analyses of intermingling social locations being lived, understood, and influenced by broader forces are examples of such processes. Researchers employing intersectionality can thus engage with complexity as an ever-present and nonstatic phenomenon.

With the complexities of interaction reflecting as central within both CGT and intersectionality, researchers can focus on how interactions within the CGT process reflect multiple interlocking social locations. For example, interview questions can reflect inquiry into what influences participants in their interactions with a phenomenon. Data generated through interviews can be analyzed for broader structural forces embedded within these influences. Power relations and consequential inequities located within interactions can be prioritized within data collection and analysis.

In order to understand depth of human behavior, the concept of change and variability needs consideration. The philosophical underpinnings of CGT are deeply rooted by symbolic interactionism where knowledge is considered as ever-changing ([1]; [3]). As a result, human behavior is considered variable and dynamic. This understanding extends into the critical feminist roots of CGT where contextual influences are closely explored for diversity ([13]; [80]). As in [33], the flexible nature of CGT enabled the authors to employ various data collection methods and empower participants in order to embrace diversity and variability in behavior (see Table 1).

Scholars who harness intersectionality share this domain of variability in their worldviews of human identity. [44] theorizing is notable in arguing how effective intersectionality is in revealing identity shifts over time and context. For example, [17] critical ethnography with Karen refugee women was informed by intersectionality and postcolonial theory. Her work revealed the complex intersection of gender, health literacy, and education impacts on how gender roles are reinforced across migration contexts between men and women. The author's findings exemplifies migration and gender roles as varying contextual influences determined by both social and power structures including culture, geography, political conditions, and economic circumstances.

Appreciating variability within our proposed approach can take many forms. For example, data collection can include questions that appreciate how participants moving from one country to another have changed over time in their roles as mothers. Recruiting mothers from wide ranges of socioeconomic, age, geographical, and cultural backgrounds can capture complex variations and nuanced understandings in experience, which can inform critically oriented praxis toward social change. Through collecting such data, researchers are guided by CGT's theoretical sensitivity ([11]; [35]) to theorize and question what is happening within the data. Using intersectionality as an analytical tool, researchers can pay attention to structural and contextual forces influencing patient experience within the data. Theoretical sensitivity also provides researchers with seeing and making connections regarding social locations participants are living with and how oppressive processes are influencing these lived realities.

Aside from [8], [9]) encouragement for grounded theorists to address social justice by assuming differing theoretical lenses, [51] emphasize potential for attending to oppression through the GT research process. [57], in her study of the recovery processes of women with young children, found that use of a CGT methodology underpinned by critical feminism facilitated drawing attention to injustices embedded within broader sociopolitical influences. As a result, pragmatic systemic recommendations were made. Attending to such systemic injustices has been documented as a sustainable approach to disrupting social inequity ([66]).

Researchers using intersectionality as an analytical tool can share this intention of disrupting perpetual health inequity. The historical roots are an indication of how inextricably linked social justice is to intersectionality ([23]). Social justice as an ethical imperative of intersectionality is brought forward by [23] with intentions of disrupting binary terms within theory and praxis. Moreover, researchers using intersectionality can disturb reductionist views of health experiences ([77]). This disruption of understanding social locations as linear and simple opens ways of approaching human behavior and identity that are continually overlooked and viewed unilaterally. For example, [18] examine upstream structural and political processes influencing settlement of immigrant and refugee women. Through their analysis, the authors examine the structural and political processes of social exclusion among minority women at the intersection of gender, healthy literacy, and education. Recommendations are made that foster social inclusion within policy-making and disrupt perpetuating inequity.

Social justice is a core intention within CGT and intersectionality. [10]) emphasizes CGT researchers to avoid importing theoretical frameworks with embedded hegemonic concepts. Staying close to participant words throughout the research process privileges their views and interpretations. In fact, researchers are encouraged to consider race, class, and gender as among a variety of social constructions that need to be defined by participants rather than defined by researchers ([10]). Applying intersectionality as an analytical tool further encourages researchers to inquire into how social locations interplay and interact with broader processes such as racism, classism, and/or neoliberalism. As a result, researchers adopting our proposed approach need to ensure gender and race are among social locations clearly acknowledged and explored for what lies within the intersections. How power relations are situated within these intersections and thereby shape experience is also central to applying intersectionality with CGT.

With intersectionality being an ever-evolving body of knowledge ([23]), we are faced with continuous uptake, conceptualizations, and evolutions that can further expand our proposed approach. Thus, we are limited by the current state of what is understood about intersectionality. In addition, although we have described congruency between CGT and intersectionality, our exploration consists of identifying limitations within our proposed approach. These limitations reflect what could surface within a research inquiry applying an intersectionality as an emergent critical social theory and analytical tool to Charmaz's CGT. Each limitation we discuss in this section reflects the units of analysis explored in this article.

A limitation of qualitative research identified within the literature concerns reflexivity as a method glossed over by researchers ([34]). Although reflexivity has been a part of the qualitative family of research methodologies including CGT, articulating how researchers have embraced this domain can be shallowly addressed. Additionally, [62] confirm how researchers' worldviews can limit the reflexive process. Thus, neglecting explicit description of a researcher's situatedness and how reflexivity was addressed can further perpetuate muting of participant voices. This limitation needs further understanding when considering applying intersectionality as an emergent critical social theory and analytical tool to Charmaz's constructive GT.

Although social justice goals include revealing power imbalance and appreciating multiplicity of human identities, a limitation of attending to complexity is locating the various intersections involved. Highlighting certain social locations over others creates privileging and oppression. For example, [61] identifies trending prioritization of the race–class–gender trinity thereby oppressing other social locations. This exclusionary consequence is further politicized by [39] who points out how political priorities drive privileging certain social locations over others. As a result, although researchers apply an intersectionality lens with focus on social justice and policy change, further subjugation may occur unwittingly by limiting categorical analysis to race, class, and gender only. [32] centers this privileging of social locations such as the race–class–gender trinity on researcher choice. Disrupting such reified intersectional groupings has been recommended. This aligns with critical feminist tenets of challenging domineering knowledge. Hankivsky (2012) weighs into this limitation of reified knowledge within the growing body of intersectionality research and encourages researchers to acknowledge embedded privileges.

Although critical feminism is threaded throughout the CGT research process, more clarity on a researcher's feminist stance is necessary ([10]; [64]). We propose a novel approach to advancing CGT and evolving intersectionality toward refinement thereby enhancing social justice intentions ([23]). Our proposal brings together CGT with intersectionality as an emergent critical social theory that guides researchers toward the interplay of social locations and broader driving forces affecting complex populations. To foster philosophical and theoretical connectedness, we demonstrated congruence within our paper between CGT and intersectionality through four units of analysis. These shared units provide a rigorous foundation for researchers to build upon, analyze, and integrate into inquiries using our proposed approach. We offer this new perspective to researchers inquiring into complex phenomena particularly with vulnerable populations facing inequities shaped by hegemonic structural forces and processes. Although we have demonstrated congruency, we acknowledge the ever-evolving nature of intersectionality and qualitative methodology. Thus, we encourage further conceptual thinking about our proposed approach to continue moving our intentions of social justice inquiry forward. Actualizing our approach to further understand inequities faced by vulnerable populations is also necessary to further tease out how intersectionality contributes to advancing CGT. We urge researchers to continue building on our proposed approach to promote research endeavors with social justice intentions.