Exploring Intersectionality: How Disabled and Queer Identity Shape Mental Health Care According to Dr. Rachel Womack

Research has shown a strong connection between queer identity and disability—a connection Dr. Rachel Womack is deeply familiar with. 

“The research shows that folks with disabilities are significantly more likely to identify as queer, and vice versa,” Womack said. “That connection is particularly strong for individuals who are autistic, and with autistic people, we see that there is a significantly higher likelihood of identifying as trans or gender nonconforming.”

This is a fairly recent discovery that has seen little research. 

“What many don’t know is that this intersection exists all across the disability and the queer spectrum,” Womack said. “We see things like lesbians being significantly more likely to identify as having a physical disability, compared to heterosexual women.”

Likewise, Womack said a lot of people studying this connection focus primarily on why the correlation exists, but Womack’s greatest curiosities lie elsewhere.

“To me, that’s not the most important question we should be asking. As a social worker, and as someone who is queer herself and also works in the disability space,” she said, “I think the better questions are, how can we support these folks and how can we change social views, social norms and perceptions to create an environment that’s safer for people who are both disabled and queer?”

Womack has actively researched the way disability and queer identity interact in mental health services. 

Womack has actively researched the intersectionality of disability and queerness in mental health services. For her dissertation, she interviewed people who identified as queer and disabled and explored how those identities affect the therapist-client relationship, something she said was a new frontier in this field of research. 

“That can be a space that is, I think, particularly difficult for folks to navigate, especially when we think about providers and their knowledge of serving the queer and disabled population,” she said. “It’s something that needs a lot more attention than it gets.”

Womack’s Findings

Womack noted that understanding queer clients has come a long way in recent years, but providers’ understanding of disability has a long way to go in many cases. 

“What I found a lot is that there were quite a few providers who were queer and who were pretty well versed on the culture that comes with that and some of the issues that the queer community faces, but those people had no real knowledge or understanding of disability,” she said. “There is often a misunderstanding of where is the line? What are we actually looking to treat and what do we accept as part of who this person is?”

In addition, Womack noted that some queer identities, such as asexuality, are not as well-understood among providers and their misconceptions can alienate people who are seeking help. She believes training can help address these misconceptions. 

“As much as [social workers and other mental health professionals] may take a social model approach to other aspects of identity, we don’t really do that with disability a lot of the time,” she said. “I think, sometimes it gets lumped into conversations around mental illness. So maybe if there’s discussion of autism, it’s in a class on psychopathology…providers often become so deeply ingrained in this medical model of disability that it can be really hard for them to step out of that.”

She also thinks providers compartmentalize people’s identities and said, “They didn’t know how to take an intersectional perspective, where they’re looking at the experience of this person who is queer and disabled. They were only looking at these things in pieces.” 

Womack discussed the impact of providers who had marginalized identities themselves on service provision. Often, providers with any marginalized identity created a more comfortable space for queer clients with disabilities, even in cases where it wasn’t an identity clients shared. It was rare for providers to disclose whether or not they had a disability. Womack suspects that this, much like other patterns her research highlighted, is due to the more medical approach in the field’s education practices. 

Education is the easiest place to start fixing those problems. Womack noted that no educational program could teach providers everything, but they could still have a profound impact if they changed their approach. 

“They can teach folks to look at disability in a certain way and to consider disability in a certain way,” she said. “The most important thing that we can be teaching these future mental health providers is to learn from people who identify as disabled.”

Thompson Earns Universal Design Certificate

Elizabeth Thompson has been involved with HDI for a while, but she’s always ready for an opportunity to learn more. 

Thompson, who works with the RETAIN project in Administrative Support, recently received her certificate in Universal Design. 

“I started my journey with HDI350-Introduction to Universal Design in the fall of 2022, and then I finished it up this most recent semester in ’24,” Thompson said. 

The certification program teaches seven basic principles of universal design – Equitable Use, Flexibility in Use, Simple and Intuitive Use, Perceptible Information, Tolerance for Error, Low Physical Effort, and Size and Space for Approach and Use – then explains how to apply these ideas in multiple different spaces. 

Though Thompson was already acquainted with aspects of universal design, she came away with a much broader and wider perspective on the subject. 

“I was able to stretch my own thoughts and opinions about what universal design is,” she said. “Whatever you’re looking at, especially websites and…documents and things like that, that there is just so much that can be improved for people to increase the accessibility.”

And while learning about digital accessibility and the many tools that can be used both to enable it and to assess it. 

However, as much as she appreciated learning about those things, when they began to cover universal design in terms of physical space, Thompson got really excited. 

“That’s always been my thing,” she said. “I’ve remodeled several houses for my own living and one for my parents, so I really, really like that physical world of making sure that someone has full access and can go as many places as possible.”

Thompson also talked about how earning this certificate helped her learn about the ways in which universal design can help everyone, not just people with disabilities. 

“A ramp makes it accessible for someone who uses a wheelchair or power wheelchair,” Thompson said. “But the mother or father with a stroller, that ramp is very useful for them. Even somebody who’s walking their pet. Not all animals like to go up and down steps. It just broadens the access.”

All in all, Thompson said the entire process was an excellent learning experience that gave her a lot of new knowledge and tools that can help a lot of people. 

“There was no part that didn’t excite me,” she said. “Universal design helps the world to be more accessible for everybody.”

To learn more about the UDL Certificate, follow this link: https://hdi.uky.edu/undergraduate-certificate

Gayle Bartilow Staff Photo

Dr. Bartilow receives Cooter Social Justice Advocate Award and dissertation of the year

Dr. Gayle Bartilow was not prepared for how much of an effect her dissertation research would have on her. 

When she traveled to South Africa to do research on how apartheid had affected educational opportunities and how modern South Africans are working to decolonize education to build a better system, she expected that she would hear some difficult stories, but she had no idea exactly how intense it would get. 

“I was not prepared for the level of, hardship, violence, and the heart wrenching stories that came out,” she said. “I did not expect to hear that some of the people that I interviewed actually engaged in warfare. I didn’t know that it was that intense. I wasn’t prepared for the number of people that had died during that time. And I found out about how violent that period…the bloodshed, and the people that I interviewed were students. They were children when this happened.” 

Though the work may have been difficult, Bartilow feels it was important – and Bellarmine University, the school where she received her doctorate, agrees, given that it recognized Bartilow with its Dissertation of the Year and Robert and Kathleen Cooter Social Justice Advocate Award. Bartilow said she was honored and humbled to receive the award – and driven to honor the stories that her participants told her.

“The participants are really entrusted in me a lot when they shared those very personal stories,” she said. “I feel as if I have a responsibility to share that.”

Bartilow said that confronting such difficult subject matter had a profound effect on her. The stories were often difficult to hear. 

“I had to check my own mental health,” she said. “While I was interviewing the participants, I started to struggle. with my own mental health. I was having bad dreams, and I could feel the tension and the stress in my body, headaches and trouble sleeping. So I had to just be really mindful about caring for myself as well.”

But Bartilow’s work was ultimately focused on life beyond those difficult stories, on how the people who lived them changed the world in response. She specifically focused on educators who were in school during the apartheid era, and on what they had done to offer today’s students opportunities they had been denied. 

“One of the themes that came through was the need to build up others, support community,” she said. “My participants made the point of telling their students that they need to support others, they need to create a pathway for others to succeed as well.”

That’s ultimately what the Cooter Social Justice Advocate Award celebrates – a dissertation that works towards a more equitable world. Bartilow is joyous that she got the chance to do research that was found worthy of it – and to learn about people pushing past hardship to make the world a better place. 

“It’s about creating positive change,” she said. “Social change and social justice for people who have had extraordinary difficulties, circumstances that limited them and denied them opportunities.” 

wheelchair at the airport

HDI Collaborates with CVG to Promote Accessible Air Travel

Dr. Walt Bower has been involved in disability advocacy for a while but even he is continually learning about the difficulties of air travel for passengers with disabilities. 

Bower, HDI’s Pre-Service Training Coordinator recently teamed up with Dr. Julie Pfeiffer, a research assistant at HDI, to hold a panel on wheelchair accessibility during air travel in partnership with the Cincinnati/Northern Kentucky International Airport, known by the airport code CVG. 

“Airplanes are the only type of public transportation in the United States that do not have spaces for wheelchair users,” Bower said. “Without such a space, thinking about traveling by air for many individuals with disabilities continues to be challenging, frustrating, nearly impossible, and sometimes even life threatening.”

The panel started with an introduction by HDI’s Jason Jones, who is also a wheelchair user, followed by a panel of wheelchair users which included Dr. Kara Ayres, David Allgood and Paul Erway, who talked about challenges they’ve faced in the past when flying.

“They described their experiences with air travel, some of the anxieties and concerns that they have related to their wheelchair when traveling,” Bower said. “They also talked about, what they wished airports, airlines, TSA agents and others knew about passengers traveling in wheelchairs, or with other disabilities. And they also explained what their wheelchair means to them and their daily life.”

Often, Bower and Pfeiffer said, this includes accessibility on the plane itself, where a narrow central aisle makes it challenging to navigate, and small bathrooms with few accessibility features cause additional issues. 

“Although the bathrooms are deemed accessible under the Air Carrier Access Act, they’re typically not accessible to wheelchair users, because they don’t follow the same requirements of accessibility as we would find in the ADA,” Pfeiffer said. 

These problems, she added, can be difficult to fix. 

“It’s such a large problem because you have to reimagine what an airplane looks like and reimagine the size of things like aisles, doors, and seats,” Pfeiffer said. 

However, there are areas cited as major problems by people with disabilities where airlines and airports can make changes far more easily, such as providing additional training on how to prevent loss of and damage to wheelchairs. For example, approximately 32 wheelchairs or scooters were lost, damaged or delayed each day in the American air travel industry during 2023. 

“When it comes to other issues that wheelchair users face in air travel, like having their wheelchair damaged when it’s stowed under the plane or difficulty with safety when transferring from their wheelchair to the airplane seat, I think the most impactful thing we can do in those areas is improve training, education and awareness among airline personnel, which is why we held this panel,” Pfeiffer said.

The panel was also recorded so not only CVG, but other airports can continue to use it as training material to ensure that people with disabilities are treated with respect as they travel. 

“Through that event, we hope that the conversation and panel moves us forward to bridge the gap between accessibility and airline travel for greater inclusion for all people with disabilities,” Bower said.

Dr. Rachel Womack represents HDI at Disability Policy Seminar

Dr. Rachel Womack represents HDI at Disability Policy Seminar

When Dr. Rachel Womack attended the Disability Policy Seminar, she wasn’t entirely sure what was in store for her.

Womack, who serves as HDI’s Training Director, had been to academic conferences before, but policy seminars were a new experience – and one she enjoyed. 

“It wasn’t just sharing information, it was sharing, ‘Hey, here’s the relevant information and here’s what you can do with it,’” she said. “It was learning the valuable skill of how do we affect change at a policy level through education.”

The seminar was geared towards not only professionals, but also self-advocates and family members. 

The first couple days were dedicated to identifying the biggest issues in the disability community right now, which Womack said included employment, home and community-based services, Medicaid waiver programs, housing inclusive education, and the Autism CARES Act. They also learned how to advocate and educate without directly lobbying. 

“What we’re doing when we lobby is we are telling a lawmaker whether they should be in favor of or against a specific policy,” Womack said. “When we educate…what we can do is we can talk about just broadly, the importance of policies.”

She used the Autism CARES Act as an example, stating that, while she could not advocate for or against its reauthorization, she could talk about the importance of funding for autism research and training efforts in general. 

On the third day, attendees took to Capitol Hill to meet with their local lawmakers and put all the skills they’d learned to use. Womack traveled with LEND trainee Hannah Keene and teamed up with other members of Kentucky’s disability community to speak with lawmakers about the issues of the day and how they could affect Kentuckians with disabilities. 

“There was no discussion at all of a specific policy, but what we explained is that people with disabilities in Kentucky and across the nation want to work,” Womack said. “They can work. They can contribute very valuable things to the workforce. We talked about the difference between, things like sheltered workshops and, integrated competitive employment settings and kind of the impact that being in one of those environments versus the other can have on someone’s life.”

It was Womack’s first time attending the Disability Policy Seminar. But she doubts it’ll be the last.

“There are not enough spaces where professionals, students, self-advocates and family members can come together for one cause,” Womack said. “The tools that folks gain at events like the Disability Policy Seminar are so important because they’re so useful. It’s not something where we just go home and we say, ‘Hey, I learned this really interesting thing today.’ It’s, ‘Oh, I go home and now I know how to affect change, in the political arena because I’ve learned how to do that appropriately.”