Inside/Outside: Descriptive Phenomenological Methods and the Macro/Micro Gap

Abstract

This paper was drawn from a qualitative study that sought to capture the experiences of a population group that are for the most part invisible within mainstream data and policy. Research involving LGBTQ+ people has historically privileged the experiences of White, gay men living in affluent areas with access to specialist services. Our study explored the health and social care pathways of marginalised LGBTQ+ people, for example those who had faced overlapping homelessness, substance use, domestic violence, or the criminal justice system. The setting was North East England, a region whose population experience significant health inequities and a lack of specialist services compared to other regions. A descriptive phenomenological approach was selected to privilege the lived experiences of participants. At the same time, the study was constructed around an intersectional, queer, critical feminist theoretical framework that sought to explore how social inequities – for example, linked to gender, race, or sexual orientation – interact to shape unique experiences of exclusion, stigma, and invisibility. This created a tension between a methodology which focused on individual subjective experience, and a theoretical framework that sought to recognise the influence of broader power structures. This is a familiar tension within qualitative health-related research, with established debates about the interaction of structure (social norms) and agency (individual actions). In this article, the authors document the adaptation and application of descriptive phenomenological methods that integrated the perspectives of others into participants’ descriptions of the phenomenon under study. In doing so, this approach also attended to intersectionality: acknowledging that people inhabit multiple social positions, which are impacted by power relations that shape their subjective experiences.

Keywords

phenomenology intersectionality health inequity marginalization LGBT

Background/Study Justification

Certain groups are known to experience health inequities, defined as the ‘unfair and avoidable differences in health across the population, and between different groups within society’ (NHS England, 2024). In the UK, the term severe and multiple disadvantage is commonly used to describe socially excluded groups who face compounded stigma, discrimination, and overlapping risk factors for poor health, such as poverty and trauma, and who are often missing from health data and records (Aspinall, 2014; Office for Health Improvement & Disparities, 2022). While income and healthcare access are major drivers of health disparities (Marmot, 2010), there is growing evidence of the health inequities experienced by minoritised groups (Bambra & Marmot, 2023). The Hard Edges report (Bramley et al., 2015), drawing from ‘key datasets’, defined severe and multiple disadvantage as overlapping experiences of homelessness, substance use, and offending. Within this report, men made up 78% of those experiencing all three domains. However, later analysis in the Gender Matters report (Bramley et al., 2020), which included definitions of poor mental health and experiences of violence and abuse, revealed a more balanced distribution across the sexes. This shift shone a light on two key points: first, that multiple disadvantage is gendered, and second, that how we define disadvantage shapes who is seen and thus receives additional support.

The concept of a ‘cycle of invisibility’ emerged in the 1980s to describe how a lack of data on women of colour led to their neglect in policy analysis and reform (Inuzuka, 1991). Chan (1996) adapted this concept for LGBTQ + people in education, showing how heteronormative environments where anti-discrimination practices were ignored created unsafe conditions and perpetuated invisibility. The cycle of invisibility has since been applied to other LGBTQ+ sectors such as care for older adults (Harrison, 2001; Sokolec & Dentato, 2014). Without explicit protections, some LGBTQ+ people hide or alter their identities to avoid discrimination. Service providers and commissioners may then assume they have no LGBTQ+ clients and fail to consider their needs in future service design and delivery.

Visibility is therefore central to LGBTQ+ experiences, with stigma – the unwanted mark of difference – varying depending on whether an identity is visible or concealable (Goffman, 1963). For instance, a gay man who conforms to ‘masculine’ social norms may face less discrimination than one perceived as ‘effeminate’ (Gerrard et al., 2023). For transgender people, ‘passing’ as their identified gender can reduce risk of violence. However, it can also expose them to being accused of deception (Kaur, 2017), and intra-group stigma may be enacted by peers for supposedly devaluing trans identities (Sycamore, 2006). Those who can conceal their identity often face the added stress of anticipated stigma, fearing negative treatment if discovered (Quinn & Earnshaw, 2013). Stigma and its enactment at individual and systemic levels is thus unevenly distributed across sexual and gender minority populations, whose experiences of being LGBTQ+ vary widely according to any number of social positions, identities, histories, or personal life experiences.

Essentialism suggests that there is an ‘essence’ to a person’s experience within a group that has a clear, constant meaning, for example that there is a universal experience shared by all women or all Black people (Grillo & Wildman, 1991). While the LGBTQ+ descriptor often implies a shared experience this risks masking important variations, erasing the complexity of sexual and gender identities and the impact of factors such as race, class, and income level (Monro, 2020). Despite raised awareness of the health inequities faced broadly by LGBTQ+ people (Ayhan et al., 2020; Dinos et al., 2021; Government Equalities Office, 2018; Henderson et al., 2022; McDermott et al., 2021), such research may reinforce the concept of an essentialised experience. LGBTQ+ research has historically privileged White, gay men, with recruitment taking place at visible events or networks such as Gay Pride, thereby rendering other groups invisible (Cochran, 2001; Eliason & Schope, 2007; Hall et al., 2021). Recent legal gains in some countries have allowed some LGBTQ+ people to assimilate into mainstream norms such as marriage and family life, contributing to a narrative that LGBTQ+ lives are ‘unproblematic’ and ‘getting better’ (Duggan, 2012; Lawrence & Taylor, 2019; Witeck, 2014). This erases the realities of those who cannot access these rights. For example, ‘coming out’ is celebrated as central to LGBTQ+ identity, but for sexual and gender minority Muslims coming out can put them at risk of harm (Beckett et al., 2014; Jaspal, 2012; Jaspal & Siraj, 2011; Yip, 2017). Additionally, not conforming to expectations of coming out can result in suspicion and further marginalisation from LGBTQ+ communities (Halberstam, 1998; Rahman, 2010).

While research identifies disproportionately higher rates of LGBTQ+ homelessness (McCarthy & Parr, 2022), substance use (Kidd et al., 2022), and representation within the criminal justice system (Harvey et al., 2022), much of this data is drawn from the US and Canada. In the UK, studies have explored how sexual minority identities intersect with single domains. For example, Smiles et al. (2023) identified how some English substance use services failed to meet the needs the needs of sexual minority men engaging in chemsex, Matthews and Poyner (2020) and England (2021) explored how heteronormativity is reinforced within homelessness settings in Scotland and Wales, and Dunn (2013) highlighted reasons behind LGBTQ+ invisibility within the English and Welsh prisons. However, there is limited research from the perspective of multiple disadvantage: how sexual orientation and/or gender identity intersect with axes of power and privilege within the UK’s political and commissioning framework.

To date, only one UK-based study has explored LGBTQ+ experiences of multiple disadvantage: a grey literature report from the LGBT Foundation (2020) for Lankelly Chase which highlighted that current definitions of multiple disadvantage are too narrow to capture this group’s experiences. Further underscoring the need for further studies in this area are recommendations to address the under-reporting of intersectional issues within LGBTQ+ healthcare research (Crowe et al., 2021; Dopp et al., 2024; Fraser et al., 2019).

We sought to address this gap in the literature by adopting an intersectional perspective on LGBTQ+ people’s experience of disadvantage. Thus, while sexual orientation and gender identity remained a central focus we carefully considered the impact of other social factors on people’s experiences. Bambra (2022, p. 6) argued that ‘place also needs to be considered as an aspect of intersectionality by the wider health inequalities research community’. Noting the lack of research about LGBTQ+ people living outside large, affluent cities and/or ‘gaybourhoods’ such as London, Brighton, and Manchester (Hess & Bitterman, 2021), our study focused on North East England. North East England is a region with significant health inequities (Goldblatt et al., 2024) and where cuts to public sector finances under government ‘austerity measures’ have been keenly felt by third sector organisations supporting marginalised populations (Clayton et al., 2016).

Our main aim was to explore the health and social care experiences of LGBTQ+ people with experience of disadvantage in North East England and, by identifying barriers and facilitators in these pathways, to use this knowledge to improve future services. We then set out to: (1) conduct qualitative interviews with LGBTQ+ individuals who had experienced disadvantage, (2) conduct qualitative interviews with health and social care professionals, (3) involve members of the public throughout the process to ensure their perspectives shaped the study’s design, analysis, and recommendations, and (4) integrate and interpret data from all components to make service recommendations for LGBTQ+ people facing disadvantage in the North East of England. Findings from this study have been published elsewhere (Adley et al., 2025a; 2025b); this paper however explores the pragmatic approach taken to descriptive phenomenological methods, and how the mutually reinforcing qualities of its methodology and theory helped to connect issues of structure and agency.

Theoretical Framework: An Intersectional, Queer, Feminism

Intersectionality explores how overlapping social positions create new, distinct forms of social exclusion and division (Collins & Bilge, 2020). Rather than ‘adding up’ disadvantages, intersectionality argues that these axes interact to produce unique lived experiences and health outcomes (Bowleg, 2012; Crenshaw, 1990). The concept of intersectionality, rooted in Black feminist thought such as the Combahee River Collective (1977), was introduced by Crenshaw (1989, 1990) in her analysis of three court cases in the United States. Crenshaw highlighted how the law’s single-axis frameworks failed to recognise discrimination against Black women in employment cases. Courts saw no racism because Black men were hired, and no sexism because White women were hired, thus rendering Black women’s exclusion invisible.

Collins (2015) notes how ‘race, class, gender, sexuality, ethnicity, nation, ability, and age operate not as unitary, mutually exclusive entities, but as reciprocally constructing phenomena that in turn shape complex social inequalities’ (p. 2). Within health and social care research, intersectionality has been used to identify how intertwined identities drive health inequities (Medina-Martinez et al., 2021), moving beyond individual-level determinants (Alvidrez, 2021) to map out hidden intersections of marginalisation (Carastathis, 2016). Highlighting the practical need for intersectional approaches in public health (Etherington, 2015), studies such as Demant et al. (2018) reveal disparities – for example in substance use – that were missed when ethnicity and sexual orientation had been considered separately. Agénor (2020) however, cautions that much intersectional quantitative health research measures identities rather than interrogating the power structures that produce inequities. Associating health inequities with social identities risks losing intersectionality’s axis around the questioning of power relations and the search for social justice (Collins & Bilge, 2020; Green et al., 2017).

Intersectionality’s approach to identity is nuanced. While warning against ‘oppression Olympics’ – the competitive ranking of oppression (Hancock, 2012) – it also acknowledges that some identities, such as race, may have greater impact than others (Grillo & Wildman, 1991; Simien, 2007). It resists rejecting identity categories, as this could undermine the meaning of those categories to their members and their potential as sites of resistance (Crenshaw, 1990). Intersectional research thus occupies a middle ground: both recognising the importance of identities and contextualising them within systems of power and influence.

Queer theory reminds us that many of these discussions rest on socially constructed categories of identity. Foucault (1978) traced a history of Western homosexuality’s shift from a forbidden act of deviance (sodomy) to a pathologized psychiatric condition. This ‘aberrant sexuality’ (p. 44) emerged from social and medical discourse and was now incorporated into individuals as an identity. Defining this identity of homosexual ‘other’, by necessity defines a heterosexual ‘us’. This interplay of socially constructed identities was highlighted by queer theorists such as Britzman, who noted how ‘where something queer happens to the signified… something queer happens to the signifier’ (1995, p. 153). Gender constructs were famously troubled by Butler (1990) who queried the gender binary and the presumed link between sex and gender, arguing that gender categories are achieved and policed by compulsory heterosexuality, not inherent truths. Queer theory, drawing on post-structuralist thinkers such as Derrida (1967), seeks to deconstruct stable categories like ‘man’ and ‘woman’ and interrogate the process of ‘othering.’ Yet even queer theory relies on relational definitions, drawing boundaries between ‘queer’ and ‘non-queer’ in its conceptualization of heteronormativity (Browne et al., 2007; Müller, 2023).

Queer theory’s challenge to gender binaries and the primacy of biological sex at times clashes with some feminist thought; critics have argued that deconstructing gender can erase women’s material experiences (Stein, 1992; Walters, 1996). Yet, as Richardson et al. (2006) note, feminist and queer theories together question assumptions about gender and sexuality, challenge norms, and reveal how systems enforce conformity. Queer theory emphasizes the fluidity of margins between ‘in’ and ‘out’ groups instead of treating them as fixed.

Our study did not attempt to establish a unified ‘intersectional queer feminist’ theory, but instead combined these traditions into an intersectional, queer, and critical feminist dialogic framework. These three approaches have each critiqued the limitations of the others and enriched understandings of marginalisation (Dill & Kohlman, 2012; McLaughlin, 2003). Together, they encourage researchers to privilege the perspectives of marginalised groups and ‘learn from the “outsiders within”’ (Weber, 2006, p. 48). An intersectional, queer, feminism recentres the margins: it acknowledges multiple, dynamic axes of oppression and their interactions with wider systems (Goethals et al., 2015). All three approaches critique processes of power, broadening our understanding of privilege, oppression, and the regulatory function of normativity.

Philosophical Framework

Our study used a constructivist approach to explore marginalised people’s experiences of health and social care services. The aim of such an inquiry is to understand and reconstruct people’s constructions of reality (including those of the researcher), acknowledging that multiple realities can co-exist depending on social settings and positions (Guba & Lincoln, 2008). Meaning is constructed inductively, with success measured by increased understanding of the phenomenon (Creswell, 2017; Merriam, 2014).

Epistemologically, the study drew on descriptive phenomenology, a philosophical movement developed by Husserl (1913) in response to positivism’s view of reality as something that could be objectively measured. Phenomenological method focused on the essence of human experience: how people perceive and engage with the world around them, privileging participants’ lived experiences as the main source of knowledge (Creswell, 2009).

Husserl’s work has inspired many branches of phenomenology, which can pose challenges for researchers in distinguishing between different approaches. Broadly, two main strands exist: Husserl’s descriptive (or transcendental) phenomenology and Heidegger’s interpretive (or hermeneutic) phenomenology. Husserl’s phenomenology is epistemological, seeking to reveal the core structure of experiences while encouraging researchers to set aside (or ‘bracket’) their own assumptions (Given, 2008; Schwandt, 2007). Heidegger (1927) argued against Husserl’s bracketing: his position was that consciousness cannot be separated from its context. His interpretive approach is ontological, focusing on how we exist in the world rather than how we know it (Hofstadter, 1982). Over time, the gap between these two forms has perhaps narrowed, with Husserl himself later acknowledging the influence of social structures on experience (Oksala, 2022; Thonhauser, 2023). Despite the differences between its different strands Merleau-Ponty (1945) argued that at the core of all phenomenology is a shared ingredient: that it is within people’s lived experiences that greater meaning of phenomena can be found. This is aligned with constructivism, emphasising the processes of description and understanding that must take place to uncover the essential nature of phenomena.

While researchers do not necessarily have to know about the detailed history and evolution of phenomenology, when designing their research they should, as Creswell and Creswell (2022) advise: ‘start by understanding… the philosophical assumptions the researcher brings to a study’. The choice of descriptive phenomenology for our study was based on key factors outlined in Table 1.

Table 1.

Reasons for Selecting Descriptive Phenomenology Within the Current Study

Research topic	This was a relatively unexplored topic area, and as such was well-suited for descriptive phenomenology, which can help to uncover the essences of phenomena that have not yet been conceptualised in previous research (Al-Sheikh Hassan, 2025; Lopez & Willis, 2004).
Researcher positionality and bracketing	The lead author (MA) had historical experience as an ‘insider’ of the population group under study and had extensive professional experience with marginalised groups within health and social care settings. Aware of the potential impact of his personal and professional history, the concept of bracketing – in which the researcher’s prior experiences are identified, and analysis redirected towards the world as directly experienced by participants – was an attractive one.
Philosophy	Having been drawn towards Husserl’s work by Ahmed (2006), and intrigued by concepts such as intentionality and orientation in space, MA wanted to take advantage of the scope offered by doctoral study to explore the philosophy of descriptive phenomenology and its application as a research methodology.

Caelli (2001) questioned whether engaging with phenomenology is more of a challenge than it needs to be. While she acknowledged that some of this challenge – particularly around developing understanding of its complex philosophy – is perhaps unavoidable, she recommended a more open and clear discussion of methods that are more user friendly and less daunting for researchers. The following section seeks to address this within its presentation of the methods used within the current study.

Method

Study Design

A qualitative study design was selected, underpinned by an ethos of community involvement which infused all aspects of the study. Thus a co-design approach was intrinsic throughout the study, with knowledge co-created by the author alongside community members (Vargas et al., 2022). Aiming to explore the landscape of local health and social care services as a bounded locality, data were collected both with LGBTQ+ participants with experience of disadvantage, and the health and social care professionals involved in their service provision.

Recruitment and Sampling

There were 13 months of recruitment from August 2022-August 2023. Participants aged 18+ were initially purposively recruited via gatekeepers from the study’s steering group and from previously established networks of professional contacts. Eligibility criteria consisted of participants who had accessed health and social care services in the North East, and who self-defined either as:

• An LGBTQ+ person who has experienced multiple exclusion or disadvantage¹

• A professional who works with LGBTQ+ people who experience multiple exclusion, discrimination, or disadvantage.

Snowball sampling developed naturally as a recruitment method. The study was promoted through leaflets, a newsletter, and social media, offering contact by phone, text, WhatsApp, and social media messaging. Leaflets were available in multiple languages, the website addressed neurodivergence, literacy, and learning styles, with short, subtitled videos summarising study and participant information. Study materials were piloted with the steering group and Public Advisors. A total of 72 people took part in the study: 39 LGBTQ+ participants, and 33 professionals (average interview length 55.4 min).

Ethics

Ethics approval was obtained from the host university on 29/07/2022, with subsequent revisions granted on 12/08/2022, 25/05/2023, and 12/06/2023. Informed consent was obtained from study participants, with adaptations made to account for learning styles and literacy levels. For example, where it was unclear whether a participant had understood an interview question, this was rephrased, with participants gently asked to reflect back their understanding.

Data Collection

Data were collected in semi-structured interviews conducted by MA, within which demographic data were also captured. Demographic data were mainly used to guide recruitment and sampling and were checked regularly to monitor the study’s reach into the margins of this population. Demographic data tables can be found on the project’s data storage repository (OSF, 2025b). Participants chose their interview location, date, and time, including evenings and weekends. Interviews took place in person, at community sites, university venues, or, for rural participants at their locations, or online via Zoom or Teams. This flexible approach fit the constructivist paradigm, which values understanding experiences within social and cultural contexts (Creswell & Creswell, 2022). Interviews were informal and relaxed, with refreshments offered where available, to help capture participants’ ‘natural attitude’ (Schutz, 1967). The interview schedules can be found in Supplemental File 1 and Supplemental File 2, with additional study materials and demographic data available online (OSF, 2025b).

Community Involvement

The study adopted a co-operative, reciprocal, and participative approach to community involvement, following NIHR guidelines (NIHR RDS, 2022). Greenhalgh et al. (2019) highlight that public involvement is essential: it upholds participants’ rights, improves research quality, and addresses power imbalances between community members and academics. Diverse LGBTQ+ individuals, groups, and specialist services were involved throughout the study, ensuring the research stayed relevant and accessible for those who had experienced exclusion. This approach enhanced recruitment from marginalised groups, aligned with the emphasis on tackling health inequalities and embedding inclusion within research (NIHR, 2022).

Branded as Joined Up North East, the study was promoted through Facebook, Twitter, and a dedicated website (www.joinedupnortheast.co.uk). The steering group contributed to study design, materials, and recruitment, and highlighted priority groups locally such as transgender people at risk of homelessness, and LGBTQ+ people of colour.

Recognising research fatigue in local LGBTQ-specific organisations, MA adopted a reciprocal approach to community involvement, helping at meetings and support groups, and volunteering at events such as Pride and Mela festivals. The study’s four Public Advisors were selected carefully over several months for their lived experiences of stigma and discrimination. They received training in qualitative analysis and in emotional safety, and met as a group in informal settings. A concerted, ongoing effort was made to identify and level the power imbalance between researcher and public contributors. As psychological safety developed, the Advisors became increasingly comfortable calling out unintended bias within the study design and (albeit unconscious) researcher bias, with their increased voice greatly enriching the study.

An online community dissemination event was co-hosted with local partner organisations in September 2024. During this event attendees were invited to share feedback on the study findings and recommendations. The event drew on examples of ‘gold-standard’ work already in place to support a hopeful and solution-focused approach (Marmot, 2024). Feedback from attendees was collated into plain language report which, along with the Public Advisors’ report and other plain language output, is publicly available (OSF, 2025a).

Quality/Trustworthiness/Rigour

Tracy’s (2010) ‘big-tent’ criteria guided the current study’s quality assessment.

Worthy Topic

While conducting this research, the cultural climate was one in which politicians and celebrities referred to Pride flags as oppressive (Iftikhar & Sabrina Barr, 2024), and government buildings flying flags described ‘as if they were occupied territory’ (Devlin & Mitchell, 2024). Prior research highlights persistent under-reporting of intersectional issues and calls for studies acknowledging the impact of intersectionality within health and other settings (Crowe et al., 2021; Dopp et al., 2024).

Rich Rigour

Guided by its intersectional, queer, and critical feminist theoretical framework, thirteen months were spent recruiting and interviewing ‘in the field’ with prolonged engagement at sites, for example taking part in local trans support groups from April 2022 to March 2023. A persistent, collaborative approach to engagement with marginalised groups resulted in recruitment of a diverse participant cohort – including those with conservative views – to ensure breadth, context, and counterbalance.

Sincerity

Rigorous reflection and reflexivity, and the questioning of researcher privilege explored methodological and personal biases and embraced cultural humility: the ‘self-awareness of personal and cultural biases as well as awareness and sensitivity to significant cultural issues of others’ (Yeager & Bauer-Wu, 2013, p. 256).

Credibility

Data triangulation incorporated peer debriefings and multiple participant perspectives within single sites. Phenomenological analysis supported a deeper synthesis of data, and findings that turned towards systems of power and privilege.

Resonance

Data were disseminated via the website in pdf reports, videos, blogs and interviews, with community members checking the relevance and representation of findings at the study’s dissemination event.

Significant Contribution

The research adds depth to discourse around multiple disadvantage, highlighting intersectionality within LGBTQ+ groups and prompting further inquiry into health and social care access for those on the margins.

Meaningful Coherence

The analysis of participants’ interviews was broadly aligned with the study’s scoping review findings (Adley et al., 2025a), and the study met its stated aims by generating pragmatic recommendations for services and researchers working with LGBTQ+ people facing additional marginalisation.

Ethical Reflexivity

Reflexivity was embedded throughout the study. Close attention was paid to personal and methodological ‘blind spots’, and attempts were made to address these where possible. For example, keeping a close eye on the demographic makeup of participants helped to balance out the early predominance of White, cisgendered, gay male participants, particularly as this reflected the lead researcher’s own demographic characteristics. Awareness of this group’s majority status both in LGBTQ+ structures and research (Hale & Ojeda, 2018; Logie & Rwigema, 2014) led to concerns that the study might also reinforce these existing societal privileges. Recruitment was accordingly halted on two occasions for more in-depth consultations with LGBTQ+ women and people of colour (described in more detail in a recent edited collection (Adley, 2026)). These consultations were successful in increasing recruitment of groups who have historically been marginalised within LGBTQ+ research.

Data Analysis

Descriptive phenomenology has been widely criticised for its lack of standardised methodological approaches (e.g.Paley, 2016; Zahavi, 2019). However, this flexibility is central to phenomenology’s nature and is also one of its core strengths, allowing researchers to tailor methods to their specific needs.

A decision was made to integrate processes of imaginative variation into the study’s methods, incorporating others’ perspectives into the analysis using approaches proposed by Moustakas (1994), Giorgi (1997), Giorgi and Giorgi (2003), and Todres (2005). Processes of imaginative variation explore possible alternative meanings of people’s experiences; using imagination to examine the phenomenon from different perspectives, to seek the most invariant meanings for a context, and to develop structural descriptions of an experience which identify the underlying factors and circumstances that shape what is being experienced (Giorgi, 1997; Moustakas, 1994; Todres, 2005). Imaginative variation draws the analytical approach away from Husserl’s original descriptive phenomenology towards his later work around inter-subjectivity (Husserl, 1936): how one’s reality cannot truly be separated from historical and cultural factors. However, a deliberate shift to include imaginative variation needs to be justified in order to support a study’s methodological coherence (Shorey & Ng, 2022).

For the current study, our methods followed Giorgi’s (1997) position that if the essence of a phenomenon is that which makes up its fundamental component, then a greater number and variety of its descriptions would more readily lead to its universal essence being revealed. Including imaginative variation still presents a description of the structure rather than an interpretation of a participant’s experience, however it is a description that acknowledges the relationships within it (Giorgi & Giorgi, 2003; Moustakas, 1994). Imaginative variation is a reflective phase, whose goal is not to interpret the participant’s experiences, but rather to enrich descriptions of its essential structures.

As this was the lead author’s first attempt at phenomenological analysis, a clear, systematic, step-by-step analytic process was called for. The resulting seven-step method (Table 2), based on the approach adapted by Moustakas (1994), formed the basis of the analytical template designed for this study. It is of note that the definitions and descriptions of these steps should not be taken as definitive, as phenomenological concepts and methods are interpreted differently across the phenomenological literature.

Table 2.

The Authors’ Seven-step Method Amended From Moustakas (1994), Integrating Work by Keen (1975), Todres (2005), Giorgi (1997) and Pilarska (2021)

	STEP ONE	STEP TWO	STEP THREE	STEP FOUR	STEP FIVE	STEP SIX	STEP SEVEN
Process	Bracketing	Horizonalization	Textural description	Structural description	Integration	Synthesis	Presentation
Purpose	To identify, be mindful of, and reflect on researcher assumptions, bias, positionality, and judgements.	Identify units of meaning, being receptive to every statement.	To cluster invariant meaning units into themes and summarise experience.	Vary possible meanings and perspectives of descriptions of the phenomenon.	Clustering and integration: Moving from the ‘what appears’ to the ‘how it appears’.	A universal description of the phenomenon representing the group as a whole.	To express the general structure in a narrative form appropriate for its target audience.
Actions	An ongoing process, complemented by completing two reflective pieces of writing: i. after completing an interview ii. at the start of the analysis of an interview.	Consider each statement with respect to its significance to the phenomenon. Highlight/extract all nonrepetitive, non- overlapping statements relevant to the phenomenon (invariant meaning units).	Using processes of reduction, construct a textural description, summarising for each participant ‘the feel and shape of experience as it is experienced, naively and immediately’ (Keen, 1975, p. 18).	Add perspectives from different vantage points. Using processes of reduction, construct a structural description (the phenomenon, as experienced in terms of the setting and context).	Using processes of reduction, construct an individual textural-structural description (the meanings and essence) of each interview.	An intuitive-reflective integration of the textural-structural descriptions into a universal description. Construct a composite textural-structural description representing the essence of the experience.	Write a description of the phenomenon in a manner that relates to its structure. Describe how the elements contained with the phenomenon combine to form its essence.

Perhaps of particular relevance for qualitative researchers is how the process of bracketing, as applied within the current study, can complement reflective and reflexive practice. Bracketing is a rich and complex concept that has been reinterpreted and has evolved (Gearing, 2004). Our approach to bracketing moved away from Husserl’s transcendental concept and instead followed LeVasseur (2003) who described bracketing as ‘a reflective move that cultivates persistent curiosity and allows progress toward the things themselves’ (p. 418). Although bracketing is presented here as a discrete methodological step, it complements practices such as journaling, memos, and discussions with colleagues. Bracketing is not the same as reflectivity, however. Described as ‘reduction action’ (Fink, 1995), bracketing refers to an ongoing process of self-awareness and comprehension on the part of the researcher: both in the setting aside of researcher assumptions and the development of an evolving understanding of the phenomenon under study (Fischer, 2009; Tufford & Newman, 2010).

In addition to this ongoing process of bracketing and the reflective notes takes after an interview, MA also completed a written reflection at the start of analysing each interview. The value of this is illustrated in the following example:

Two consecutive interviews had been carried out in the same service: the first with a manager and the second with a frontline worker. The service’s approach towards diversity was reported very differently in these two interviews, with the manager painting a rosy picture of their organisation’s diversity credentials and the frontline worker being more critical. During the process of written reflection prior to analysing the manager’s interview, MA had noticed that he was holding onto judgements about her interview. He had – without consciously being aware of it – dismissed her interview as managerial ‘spin’. Noticing this bias and the assumptions he had made allowed him to set these aside and attend more closely to the interview, which turned out to contain rich descriptions of the phenomenon under study. Without this second round of bracketing, this valuable information might have been lost.

Figure 1 illustrates some of these methodological steps and examples of (a) bracketing, (b) horizonalization, with invariant meaning units (handwritten in black) and ‘the eyes of others’ (handwritten in blue), (c) textural description (handwritten in black) and structural description (handwritten in blue), and (d) an individual textural-structural description.

Figure 1.

An example of the analytical template used within the current study

Table 3 below illustrates two examples of the use of imaginative variation that integrated other perspectives into the analysis via structural descriptions. The columns show (from left to right): (i) participant statement, (ii) the textural description of the statement, (iii) the structural description of the statement, and (iv) the integration of the two descriptions into a textural-structural description.

Table 3.

(From Left to Right) Excerpts From Two Participants’ Interviews, With Textural, Structural, and Integrated Textural-Structural Descriptions

Participant statements relevant to the phenomenon	Textural description: Attention redirected towards the world as directly experienced	Structural description: Incorporating the ‘voices of others’ allows for imaginative variation of these experiences	Textural-structural description: Using reduction processes (e.g. bracketing, intuition, and description)
LG13 I’ve had like some like [health] issues for like half a year now that I’ve had—my friends have been like, “Oh, you need to go to a doctor”. I’m like, “But I don’t want to.” [inhales] MA Is that anything you care to talk about? LG13 I think it’s just—because like I haven’t actually started my transition yet, but I’m down on their system as a male so inevitably I’m going to have to go and be like, “Look… I’m a woman,” and they’re going to be like, “What?” And I’m like, “Ugh”. MA That’s an interesting statement, as opposed to, “Oh, I’m a trans male.” LG13 Yeah. Yeah. I don’t know. I mean I probably would say I’m a trans man, but it’s just like in my head it kind of translates to “I’m a woman”. That’s just the internalised transphobia. Yeah. It’s like…. [inhales].. Especially because like, what I’m going in for is like chest problems and I’m, like, they can’t really examine that if I’m binding [wearing a tight-fitting piece of material to provide a flat chest contour].	I avoid going to my GP practice when I have health issues because I have experienced being ‘othered’ by staff in the past due to my identity as a trans man. Having parts of my ‘female-identifying’ body exposed reinforces my feelings of gender dysphoria.	LG13’s past experiences, and anticipation of stigma and othering contribute to what is preventing him from addressing his health issues. He describes a cisheteronormative data system that is not responsive to his specific cultural needs and which reinforces this othering. He describes a complexity within his response to healthcare staff’s surprise at finding out that he is a trans man. On the one hand he is binding, and earlier mentioned enjoying passing as male, yet here he appears to describe not deriving pleasure from having passed as male, possibly as he now has to explain himself (?yet again?)	Going to the GP brings my stigma – my unwanted mark of difference – to the fore. Normative frameworks within the GP practice makes this an unsafe place for me, and I avoid treatment. While this may put me at risk of more serious health problems, any fear is outweighed by the negative emotions I have felt, and anticipate feeling, when examined.
PR31 (Substance use practitioner) So I have the statistics of everybody in service, their substances, their gender, etc. We actually only have male and female options… And gender identity and/or sexual orientation is not something that we ask. So we don’t have statistics on that… That doesn’t mean that we’re not open to members of the LGBTQ plus community, we certainly have a no exclusion policy… But we’ve already sort of acknowledged the barriers that are in place… we have, there’s a real lack of people who are in service who are, for example, Muslim, and a lot of that has to do with cultural barriers of speaking out about substance misuse and mental health… We have funding pressures which we have to respond to. We’re good at collecting data around risk and type of drug used, as this is what we receive funds for. This is why our client group is mostly cisgendered White males. We respond to nationwide agendas… [The funding element] is quite broad and quite vague in the sense that it doesn’t necessarily require you to narrow down on any sort of demographic. And therefore, I think that we very much operate on a ‘who comes’ basis. And I think that there’s not enough, there’s not enough in place for us to go, “right, let’s target every minority community there is. Let’s target every demographic that isn’t White men”. Like there’s just not enough resources available.	We are a commissioned service who collect the data we are asked to do. We are a fair service, we have an open door policy and don’t exclude people. We’ve been looking at diversity with the service – for example the cultural barriers within Muslim communities that prevent them accessing our service. As a commissioned service, our funding depends on our response to government policies. Although the government don’t ask us to focus on specific groups, their focus on risk and specific drugs means that most of our clients are White males. We don’t have the resources to target minority groups.	PR31 describes a service that appears to be unaware of the existing guidance on how commissioned substance use services can adapt to make them more welcoming for marginalised groups. She describes Muslim communities themselves as being ‘a lot of’ the problem of non-engagement, and also highlights how her service is too stretched to target this community. She also describes a service whose funding is determined by government policy, with reference to drugs that are highlighted in government and criminal justice documents for their links to acquisitive crime and reoffending.	I believe that my service’s open door policy means that everyone has equitable access. I have not considered how risk is operationalised within the service, or reasons behind why this results in cisgendered White males as our main client group. I am not aware of the guidance that exists around service provision for minority groups. Funding pressures mean that populations other than our main client group are not part of our funding, and therefore less of a priority.

The process of generating an essence of the phenomenon from the raw qualitative data is shown in the diagram below (Figure 2). By applying processes of phenomenological reduction, a textural description is generated from each participant’s experiences, and a structural description generated from others’ descriptions of these experiences. These are further reduced into a textural-structural description. This process is then repeated for each interview, with the textural-structural descriptions integrated, and then synthesised as a whole. Through processes of reduction and ongoing bracketing, moving between intuition and description, and turning towards to the world as directly experienced by participants, the essence of the phenomenon can then be generated (Giorgi, 1997; Husserl, 1913, 1936; Moustakas, 1994; Todres, 2005).

Figure 2.

Process diagram

An extra step was added, specifically for the current study, as the quantity of interview data was abnormally large for a phenomenological study (Bevan, 2014). Each textural-structural description was further reduced into a textural-structural essence. These were then printed out and laid on the floor (Figure 3), after which they were formed into a linear narrative. Within this narrative, a phenomenological essence of the interviews was identified: the majority is the priority.

Figure 3.

The textural-structural essences of interviews, formed into a linear narrative

This essence, in its simplicity, resonated with key themes running through this study, such as the unquestioned privileging of White, (apparently) cisgendered heterosexual males within services designed to support those on the margins. Discovering the phenomenological essence is not the final destination however – far from it. Instead, it provided an axis point for further analysis that helped to bridge the micro/macro gap.

Figure 4 illustrates this process. It presents short illustrative quotes, condensed from statements made by study participants. Following phenomenological analysis, statements are then juxtaposed against the essence of the majority is the priority, and what the statements mean relative to the speakers’ own majority/minority positions and beliefs about which groups should be prioritised. The final column in Figure 4 provides analysis that connects the world of the subjective experience to wider social structures.

Figure 4.

Illustrative Quotes to Demonstrate How the Phenomenological Essence Provided an Axis for Further Analysis

Discussion

At first glance, descriptive phenomenology’s focus on subjective experience contrasts with that of intersectionality, which looks to the influence of societal power and privilege on people’s experiences of – for example – sexism, racism, or homophobia. This tension between acknowledging both the individual subjective experience and broader social influence is a familiar one in qualitative research, with established debates about the interaction of structure (social norms) and agency (individual actions) (Giddens, 1984).

Husserl’s descriptive phenomenological approach indeed centres on understanding the meanings of people’s subjective experiences, and his work has been criticised on the grounds that its overly subjective focus failed to consider wider social influences. Leboeuf (2023) for example suggested that, despite recent orientations towards issues such as gender and race, phenomenological studies have often rendered invisible those at the intersection of gender and race. A ‘critical phenomenology’ has been proposed that focuses on both the individual and the societal, and considers the practices of social change and political activism that are central to intersectionality (Guenther, 2020). Against this, others have questioned whether a redefined critical phenomenology is necessary. Oksala (2022) writes of the ‘intersubjective transformation’ of Husserl’s later work that establishes ‘a historical and political constitution of reality’. In this work, Husserl explored in depth the concept of intersubjectivity: the mutual understanding or knowledge that exists between people or ‘this “all of us”— from my point of view, indeed “in” me’ (Husserl, 1936, p. 182).

For Rodemeyer (2022, p. 96) the phenomenological method, with its in-depth descriptions of lived experience, is inherently critical and leads to ‘the identification of those structures that must necessarily be in play for those experiences to take place’. In a similar manner, intersectional research can also occupy a middle ground. While intersectionality is at its heart a critical enterprise: a questioning of power relations and structures of oppression (Collins & Bilge, 2020), it is also rooted in an experience-based epistemology (Simien, 2007) that recognises the importance both of subjective experiences and their context within wider systems of power and influence.

Within the current study, methodology and theory complemented each other and were mutually reinforcing (Crotty, 1998; Urcia, 2021). For example, aligned with intersectionality, and queer and critical feminist theories, value was placed on the perspective of the outsider. Ongoing reflexivity about which groups were not being included during recruitment led to areas of (albeit unintentional) bias within the study’s original design being addressed. The subsequent adjustments made to the study increased the participation of people historically marginalised within LGBTQ+ research. This in turn led to a richer, more comprehensive set of interview data, from which could be drawn a more broadly applicable phenomenological essence.

This essence – generated from the phenomenological reduction of individual experience and imaginative variation – formed a bridge between the micro level of individual, subjective experience and the macro, system level. Applying the majority is the priority as an axis for further analysis supported a critique of wider systems of power. In doing so, the study’s phenomenological methods attended to intersectionality: that people inhabit multiple social positions, impacted by power relations that shape their subjective experiences.

Supplemental Material

Supplemental Material - Inside/Outside: Descriptive Phenomenological Methods and the Macro/Micro Gap

Supplemental Material for Inside/Outside: Descriptive Phenomenological Methods and the Macro/Micro Gap by Mark Adley, Maurice Yolles, Amy O’Donnell, Stephanie Scott in International Journal of Qualitative Methods

Supplemental Material

Supplemental Material - Inside/Outside: Descriptive Phenomenological Methods and the Macro/Micro Gap

Footnotes

Acknowledgements

The authors would like to thank the journal’s editor and the reviewers for their considered comments which greatly helped to improve this article.

ORCID iD

Mark Adley

Ethical Considerations

No ethical approval was required for this methodological paper that does not directly involve humans or animals, and uses completely anonymized data which does not contain personal information.

Author Contribution

MA: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Visualization, Writing – original draft, Writing – review & editing. AOD/SS: Conceptualization, Formal analysis, Methodology, Supervision, Validation, Writing – review & editing. MY: Methodology, Writing – review & editing.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This is a component of a study that is funded by the National Institute of Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NIHR200173). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

There are no datasets associated with this paper. Data sharing is therefore not applicable to this article as no new data were created or analysed in this study.*

Other Identifying Information

One of the co-authors (Prof. Yolles) is a proponent of the bounded relativist ontology discussed within the paper.

Supplemental Material

Supplemental material for this article is available online.

Note

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