Abstract
Disability remains a largely invisible component of diversity within the nursing profession due to a lack of comprehensive data collection and ongoing systemic ableism. This article explores the multifaceted experiences of nurses with disabilities through an intersectional lens, illustrating how disability intersects with other marginalized identities to create unique and compounded barriers. Drawing on the authors’ personal narratives, one with an apparent physical disability and the other with a nonapparent, dynamic disability, the paper highlights how disabled nurses navigate intersectional discrimination, exclusion, and invisibility in both educational and professional settings. Emphasizing that disability is a natural part of human diversity, this article calls for nurses and professional nursing organizations to reimagine equity, diversity, inclusivity, and belonging to include the experiences of people with disabilities and to ensure access in nursing.
Implications for Practice, Education, Research, or Policy
Limited research exists regarding the prevalence and experiences of nurses with disabilities. Due to the lack of data and awareness, nurses with disabilities are often left out of nursing initiatives designed to increase equity, diversity, inclusivity, and belonging. Disability often intersects with other minoritized identities in nursing and society; however, research about intersectionality among people who have disabilities is scant. In this article, the authors share their personal experiences as nurses with disabilities and intersecting marginalized identities.
Introduction
Disability remains an underrecognized yet significant area of underrepresentation within the nursing profession; however, it is hard to quantify how underrepresented nurses with disabilities are because these data are not included in most national diversity reports. For example, organizations such as the American Association of Colleges of Nursing (2019) and the Health Resources and Services Administration (2024) only report nursing diversity data based on gender (men and women), race, and ethnicity. This approach to understanding the current state of diversity within the workforce lacks critical information about other oppressed populations within the United States, including sexual and gender minorities and people with disabilities.
According to the Centers for Disease Control [CDC] Disability and Health Branch (2025), approximately 28.7% of adults in the United States live with a disability. While there are some data about the incidence of disability based on racialized identity, it is difficult to ascertain how other intersectional identities impact disability rates. For example, 25% of people who identify as Black and African American have a disability, compared to 20% of people who identify as white (CDC Health Branch, 2025). Findings from the 2020 Behavioral Risk Factor Surveillance System indicate that lesbian, gay, bisexual, transgender, and queer (LGBTQ) people have higher rates of disability, with 36% of LGBTQ adults self-reporting a disability compared to 24% of non-LGBTQ adults (Suryavanshi et al., 2025). Research that explores the intersection of other identities and disabilities is needed to fully understand the prevalence and impact of intersectionality on disability.
It is difficult to ascertain how many nurses in the health-care workforce have one or more disabilities. A study by Ly (2021) using United States census data indicates that 15% of nurses who are not in the workforce are disabled, but it is unclear whether they left nursing due to disability or became disabled after leaving the workforce. It is likely that nurses with disabilities, particularly physical disabilities, are significantly underrepresented based on the historical and ongoing exclusion of learners with disabilities from nursing programs (Marks & Sisirak, 2022).
Additionally, when accepted into nursing programs, students with disabilities face notable barriers, including rigid technical standards, limited accommodations, and bias from faculty and peers (Marks & Sisirak, 2022), which can lead to failure to progress through the nursing program. Many nursing programs historically framed disability as a limitation incompatible with “safe” clinical practice rather than recognizing that, with accommodations, nurses with disabilities can perform their roles effectively and bring valuable perspectives to patient care in all settings (Marks & Sisirak, 2022; Neal-Boylan & Miller, 2020).
A study by Jackson and colleagues (2025) found that 8.4% of a total of 6416 nursing students had a disclosed disability; most of the students included in the study reported psychological disabilities. Students who reported physical disabilities were significantly underrepresented compared to students who reported psychological disabilities (Jackson et al., 2025). Psychological disabilities involve “actual or perceived impairment due to a diversity of mental, emotional, or cognitive experiences” (Ebuenyi et al., 2023, p. 1). In contrast, physical disability is defined as “a limitation on a person's physical functioning, mobility, dexterity, or stamina” (United Spinal Association, 2025, para. 1). Jackson et al. (2025) found that students who disclosed disabilities that impact mobility only represented 0.1% of the total study population. Further, based on our experiences, nurses within the workforce often do not disclose disabilities or request accommodation due to fear of discrimination, stigma, and bias, which may limit the ability to collect accurate data. Ongoing issues with ableism and discrimination, and the failure to collect accurate data, have rendered nurses and students with disabilities largely invisible (Carroll & Shaw, 2024). As a result, this population is often left out of nursing initiatives designed to increase equity, diversity, inclusivity, and belonging.
Purpose
In this article, we will provide a brief description of disability and intersectionality, share our perspectives as minoritized nurses who live with apparent and nonapparent disabilities, and discuss how intersectionality impacts our lived experience as disabled women. Additionally, we will discuss the implications of disability intersectionality on nursing education, practice, research, and policy. In this paper, we will use a variety of terms to explain our experiences, some of which may be used interchangeably, such as invisible and nonapparent. We use both identity-first (disabled person) and person-first (person with a disability) language because people with disabilities have different experiences, and our preferences related to terminology are not the same. Absent knowledge of a person's preference, we recommend that nurses use person-first language because it prioritizes the person (Ladua, 2021) and is a commonly accepted best practice in nursing.
Background
Disability is a broad term that refers to physical, mental, sensory, or cognitive conditions that substantially limit one or more major life activities (Americans with Disabilities Act [ADA], n.d.). Disability is a natural variation of human experience, and most human beings will experience disability in their lifetime (Hendry et al., 2022). It is important to understand that disability is not a problem to be fixed, though within health care, people with disabilities are often viewed from a medical model lens (Brinkman et al., 2023), which considers disability “an individual-level deficit in need of correction” (Brinkman et al., 2023, p. 1). On the other hand, the social model of disability suggests that it is society's barriers, including physical, attitudinal, and systemic, that disable people rather than their bodies or minds (Ladua, 2021).
Apparent Versus Nonapparent Disabilities
To understand the challenges and benefits of having an apparent or nonapparent disability, we need to begin with some definitions and terminology. Apparent disabilities refer to disabilities that can be easily identified or detected by looking at the person. Often, people who have apparent disabilities use assistive aids that make their disabilities more obvious (Dakessian, 2022). For example, people who use wheelchairs are readily identified as having mobility limitations. Nonapparent disabilities may also be referred to as hidden, nonvisible, or invisible disability (Hendry et al., 2022). People with nonapparent disabilities often experience physical, mental, or neurological impairment that is not easily identified and adversely impacts their abilities and quality of life (Invisible Disabilities Association, 2025). An example of someone with a nonapparent disability is someone living with a disabling autoimmune disorder or mental health impairment.
Intersectionality and Disability
Disability affects people from all backgrounds and identities (Dorsey Holliman et al., 2023; Wickenden, 2023). For many disabled people, experiencing ableism and bias is compounded by the intersection of other forms of discrimination related to their identity, including but not limited to age, race, ethnicity, gender, sexuality, and class (Dorsey Holliman et al., 2023; Stergiopoulos & Rosenburg, 2020; Wickenden, 2023). The concept of intersectionality emerged from Black feminist theory in the early 1980s, notably by Kimberle Crenshaw in her paper titled “Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory, and Antiracist Politics” (Crenshaw, 1989). Focusing on the experiences of Black women, Crenshaw discussed that discrimination was not solely a gender or race issue because the cumulative effects of multiple forms of discrimination impact the daily lives of Black women. The concept of intersectionality has expanded beyond race and gender to explore the impact of multiple marginalized identities. In disability, it is critical to understand that all forms of oppression are linked; therefore, disabled people may be disadvantaged by multiple sources of oppression as a result of their unique identity (Horner-Johnson, 2021; Stergiopoulos & Rosenburg, 2020).
Andrea Dalzell's Story
I am an African American, cisgender woman who lives with a physical disability that is readily apparent because I use a wheelchair. Within my positionality and identities, I experience anti-Black racism, sexism, and ableism, which is amplified because of my obvious disability. The intersection of these historically oppressed identities increases the harm I experience as a disabled woman. In many spaces, I am read and responded to first through a lens of limitation, my wheelchair, my race, and my gender, each triggering implicit assumptions. The result is a compounded bias that shapes how I am seen whether I am in scrubs or seated in a leadership meeting. People make assumptions before I speak, question my expertise, and often look past my leadership because of how I show up in the world. These layers of discrimination are not abstract; they are structural and personal, embedded in the gatekeeping practices of health care and education.
My path into nursing was not shaped only by academic ambition but by lived experience. At age 5, I was diagnosed with transverse myelitis, an inflammation of the spinal cord that eventually resulted in paralysis. By age 12, I was using a wheelchair full time. From a young age, I knew how it felt to be in a hospital bed, misunderstood and overlooked. These early encounters with the health-care system planted the seed for a career in which I could offer care from a place of deep empathy and firsthand knowledge.
Though my early years were filled with spirited activities like singing in the gospel choir, the reality of daily pain, limited mobility, and increased medical needs shaped my understanding of life. It required me to prioritize self-care with an emphasis on health-care management at an early age. It became imperative that I find a balance among my social, academic, and professional lives.
College alone was an accomplishment. I started on a premedical school track and was immediately met with doubt and barriers in prerequisite classes such as chemistry, where vented hoods were not accessible. After applying to and being accepted by a nursing school, I entered the program with the same dreams and drive as my peers. Yet, during a mandatory orientation, two faculty members pulled me aside and questioned whether I could perform clinical duties and stated the hospital affiliations would refuse to accept a student with a physical disability into their facilities. My wheelchair, not my academic record, became their focus. The technical standards for nursing schools were not written with disabled students in mind. Although the Americans with Disabilities Act (ADA) has been law for years, many nursing schools, like mine, still operate as though accessibility is optional.
Despite the skepticism, I drew strength from Title II of the ADA and advocated for my right to be given a chance. Title II of the ADA requires state and local governments to provide people who have disabilities with equal opportunity to benefit from all their programs, services, and activities (ADA, n.d.). Knowing that I had some protection under the law gave me hope for a future as a nurse. I worked alongside the college's office of students with disabilities and insisted that my physical appearance did not determine my academic or professional abilities or capability. This did not come without pushbacks. Some instructors did not want to adjust clinical sites or modify assignments, citing “safety” or “fairness.” Others questioned whether a nurse in a wheelchair could respond in an emergency, ignoring the fact that emergency protocols rely on teamwork and not individual heroics. While my nondisabled peers were seen as teachable and full of potential, I was forced to prove over and over that I belonged.
After graduation, I faced another wall: employment. Despite a nursing shortage, I applied to over 1500 jobs in 4 states and had 76 clinical placement interviews. Frequently, hiring managers questioned whether a person in a wheelchair could deliver nursing care, with assumptions about increased infection risk and inability to perform CPR. What they did not say but often implied was that my appearance did not match their image of a nurse. I was not just disabled, I was Black, a woman, and unapologetically visible. These experiences emphasized how disability, particularly when visible, can overshadow qualifications and perpetuate bias within health care.
Against the backdrop of the COVID-19 pandemic, perceptions shifted. Suddenly, hospitals in crisis welcomed every health-care hand, and for the first time, need outpaced bias. This crisis-driven need became the opening I had long awaited. Hospitals, overwhelmed and short-staffed, finally welcomed my skills without question, allowing me to work at the bedside during the peak of the pandemic in New York City.
As a Black woman in a wheelchair, I navigate overlapping biases that often make me a double or triple target for discrimination. Intersectionality is not just a framework I read about but it is how I live. My race, gender, and disability are not separate layers. They form a reality where I am both hypervisible and ignored, praised for resilience but denied opportunity. My presence in a white-normative, ableist field has required me to interconnect coping strategies and advocacy in ways that monolithic approaches to diversity cannot (Crenshaw, 1989). A white nurse in a wheelchair might be seen as exceptional or inspirational, while a Black woman in a wheelchair is more likely to be viewed as incapable or burdensome. When I set boundaries or advocate for inclusion, I am labeled difficult or demanding—a stereotype many Black women in leadership know all too well (Blackstock, 2024; Buckles & Ives-Rublee, 2022).
What keeps me going is the belief that my presence matters. Not because I want to be the exception, but because I want to challenge the rule. I have become an outspoken advocate for disability rights and respectful language in health care. On podcasts and interviews, I have critiqued phrases in health-care documentation such as “wheelchair bound,” explaining how such terminology portrays unnecessary limitation and unintentional confinement. Language shapes perceptions, which in turn influence care, whether clinical or institutional. Nurses with disabilities offer creative problem-solving, emotional intelligence, and unique patient perspectives. Disability is a part of human experience. Black nurses bring cultural fluency and trust to marginalized communities. When these identities intersect, they reveal where the system fails and how it can be reimagined.
I push for change in nursing education, updated technical standards, providing inclusive faculty training, and a curriculum that treats disability as a part of human diversity and not pathology. In hiring practice, I advocate for meaningful accommodations, bias training, and equitable career pathways for disabled nurses, especially those who are Black, Indigenous, or people of color.
Today, I teach, speak, mentor, and lead. I do not hide my wheelchair. I do not hide my Blackness, and I do not hide my frustration with the slow pace of change. I also do not hide my pride, my power, or my purpose. I have learned that my visibility, while often uncomfortable, is necessary. My story is not just about overcoming but it is about restructuring the very system that tries to exclude me. Because I exist, another Black girl in a wheelchair will believe she can be a nurse. This time, she will not have to explain why; she will just get to be.
Anna Valdez's Story
I am a multiracial, cisgender woman who lives with mostly nonapparent and dynamic physical disabilities. While I am multiracial and ethnically Latina, I am phenotypically white, which contributes to the privileges I experience as a disabled woman. Within my positionality and identities, I experience racism, sexism, and ableism, but the amount of oppression I experience is minimized by my skin tone. I also experience the challenges and benefits of having nonapparent or “invisible” disabilities. I can walk and often do so without assistive devices; however, it is always painful and exhausting for me. In the 25 years that I have been disabled, I have learned how to mask symptoms and hide my disabilities. The ability to hide severe pain, fake wellness, and walk without mobility aids allows me to navigate spaces and affords me opportunities that might not exist if my illness and disability were readily apparent. This practice of hiding disabilities is common for people with nonapparent disabilities (Markou & Papakonstantinou, 2025).
I acquired my disabilities after becoming a nurse. This was critical for me because at the time I was admitted to nursing school, no accommodation was provided for people with disabilities. The Americans with Disabilities Act of 1990 was not fully enacted until 1991 (ADA, n.d.), when I was in my second year of nursing school. If I had acquired disabilities prior to nursing school, I would not have been able to become a nurse. When I enrolled in nursing school, I was required to physically demonstrate that I could walk 15 feet carrying 25 pounds, without difficulty. If I failed the test, I would have been disqualified for admission to nursing school.
It is important to note that prior to the ADA being enacted, nursing schools were not required to admit disabled people or make any accommodations. Currently, learners with disabilities have some legal protections for being able to enter and complete nursing school; however, the reality is that learners with disabilities, especially physical disabilities, continue to experience ableism in nursing school (Neal-Boylan & Miller, 2020). Many nursing faculty and program administrators still have a poor understanding of their responsibilities under the ADA and the requirements for access and reasonable accommodations (Neal-Boylan & Miller, 2020). The ADA and subsequent Americans with Disabilities Act Amendments Act of 2008 (ADAAA) have resulted in more protection and rights to accessing an education and career in nursing, but the pervasive attitude that people with disabilities cannot be nurses, and lack of knowledge about legal requirements for schools of nursing, continues to hamper the ability of learners with disabilities to enroll in nursing school and complete the education required to become a licensed or registered nurse.
My journey as a disabled person began 25 years ago, when I acquired systemic lupus erythematosus (SLE) and subsequently became worse as I was diagnosed with additional rare and incurable autoimmune diseases. At the time that I acquired SLE, I was working full time as a registered nurse in the emergency department and was enrolled in a post-licensure Bachelor of Science in Nursing program. I had been a nurse for eight years and had two young children who depended on me. While the ADA and ADAAA existed when I became disabled, there was a pervasive belief that people with disabilities could not be registered nurses. I could not imagine the hospital I worked in allowing me to continue working in the ED if I disclosed my disabilities. I would have been viewed as a risk to the hospital and a burden to my peers.
I never imagined myself as someone who could be disabled one day, and certainly not at the age of 30. When I developed severe pain and profound fatigue resulting in mobility issues, I was terrified. I had worked so hard to become an emergency nurse, and I did not want to lose my ability to work or to be perceived as broken by my colleagues. My family depended on my income, and I was afraid I would not be allowed to continue in my position in the ED, so I hide my disability. I pretended to be well and did my best to push through 12-h shifts until I could find a position that was more realistic. I worked with one close friend who knew I was sick, and she carried me through the last couple of hours each shift. She would find ways to put me in a chair, like moving me to triage.
I chose not to disclose my disabilities because I was afraid that my opportunities in nursing would be limited and that I would likely not be hired or retained in any clinical role if I disclosed my disability. Being able to mask or hide disability is a privilege for those of us who have nonapparent disabilities and have the ability to walk without assistive devices, but it comes at a cost. Before I became public about being disabled, I routinely hid my disability from employers and waited until I was hired by new employers to disclose that I am disabled and request accommodations. Essentially, I am usually able to pass as an “able-bodied” person for limited periods of time.
There are several benefits to having a nonapparent disability, including the ability to mask or hide limitations, not having to disclose my disability until I am hired, and being able to pass as nondisabled in settings where I want to look and feel like I belong. Most of the time, I am afforded the opportunity to decide whether I want to share that I am disabled. While these may seem like significant advantages, having to decide when and if I am going to disclose my disabilities is stressful. Markou and Papakonstantinou (2025) described many of the concerns I have experienced when deciding whether to disclose, including fear that I will experience bias, discrimination, stigma, and risk of losing my job. Those fears are well-founded in the ableism and harm I have experienced from nurses and other health-care professionals in the past 25 years.
While having a nonapparent disability comes with some perceived advantages, it also comes with challenges. Over time, I have learned that forcing myself to appear well and function without accommodations has resulted in further damage to my body and often leads to people, including health-care professionals and colleagues, not believing me, labeling me as a faker or “drug seeker,” and questioning my need for assistive devices and other accommodations. The experience of not being believed and taken seriously has roots in gender discrimination and has an additive impact on the experiences and outcomes of disabled women (Olkin et al., 2019).
Like many disabled nurses, I needed a plan for how I would be able to continue working as a nurse. Being a nurse has always been rewarding for me, and I did not want to give up everything I worked so hard to accomplish. To facilitate being able to continue to work, I focused on advancing my education to open doors to roles that were less physically demanding. I intentionally chose jobs that allowed me to contribute to the profession without further damaging my body, such as being a county trauma coordinator, critical care educator, researcher, editor, and my current role as a professor of nursing. Advancing my education while working full time was very difficult, but I saw it as my only option for continuing as a registered nurse. I never disclosed my disabilities to any employer before I finished my PhD and moved into teaching roles. The decision not to disclose is common among people who have nonapparent disabilities due to fear of workplace discrimination, stigma, and job insecurity (Markou & Papakonstantinou, 2025).
I thought that when I moved to academia, life would be much easier for me as a nurse, in part because many nursing faculty are older adults who may also experience mobility limitations. I was wrong. Ableism runs deep in academic settings, too. I face the same issues with not being believed and being viewed as a burden by some but not all of my colleagues. One of the things that is rarely discussed is the guilt, grief, and fear that people with disabilities experience when asking for accommodation or needing to take time off. I always feel like I have to work harder and be better than other people in order to be valued and seen as someone who belongs in nursing. Being a tenured professor affords me the privilege of job security. While it does not protect me from ableism, it allows me the freedom to publicly disclose and talk about disabilities, engage in research to further disability justice, and educate current and future nurses. I am empowered because of job security to show up as my authentic self, not mask symptoms, and lean into my identity as a disabled nurse. This is why I use identity-first language. I choose to embrace being disabled and recognize that I am not broken or flawed. I am a human being with unique abilities and limitations, like every other human being.
Implications
In considering the implications of this paper for research, policy, education, and practice, addressing barriers in nursing through an intersectional lens is critical for creating truly inclusive and accessible environments. Barriers related to disability, race, gender, and socioeconomic status do not exist independently as they interact and compound, leading to deeply entrenched inequities (Crenshaw, 1989). The following are some foundational recommendations for promoting disability justice and access in nursing.
Research
There is a dearth of research about nurses with disabilities. Further research is needed to explore the prevalence and experiences of nurses and nursing students with disabilities. Additionally, research into why nurses with disabilities leave practice is necessary to guide decision-making about how to improve access, equity, and belonging in the nursing profession. Organizations that collect and report data about diversity in nursing must expand their focus beyond gender, race, and ethnicity to include disability and other marginalized identities. In addition to being able to evaluate how accurately nurses with disabilities are represented in the nursing workforce, it is critical to understand how intersectional identities impact experiences of bias, discrimination, and the ability to join and stay in the workforce. Nurse scientists must include disability, and disabled nurses, when conducting research intended to inform diversity, equity, inclusion, and belonging initiatives.
Policy
Policy change is equally important. Nursing schools and health-care institutions must critically appraise their policies and practices to ensure that people with disabilities are able to become nurses and remain in practice. Many nursing programs continue to confuse essential functions in workplace settings with technical standards (Neal-Boylan & Miller, 2020). Technical standards for nursing programs should focus on the outcomes required of nursing students rather than descriptions of how to accomplish tasks (Meeks et al., 2020). Practice settings need to evaluate their approach to accommodation and consider innovative accommodations for retaining nurses with disabilities. Policies guiding the nursing profession must address not only disability discrimination but also the intersecting impact of other marginalized identities. Policies should be informed by nurses and students with lived experience and ensure that efforts to address inclusion are not simply aspirational but operationalized in daily practice.
Education
Every nurse should read and understand their obligations under the ADA and ADAAA. This is especially true for nurse educators, who make decisions about admissions and completion of nursing school, and nurse leaders who make hiring and retention decisions. There are several important resources to guide health-care professionals about legal requirements and best practices in access and equity on the Docs With Disabilities Initiatives (2025) website, which includes a nursing section and advisory group named Access in Nursing. Resources include webinars, a terminology guide, and a technical standards toolkit. Meeks et al. (2020) published a book titled Equal Access for Students with Disabilities: The Guide for Health Science and Professional Education that is free to download at https://www.docswithdisabilities.org/equal-access-guide/. Nurse educators must be well informed about disability rights and justice.
Practice
Nurses need to increase their knowledge about the experiences and rights of disabled people so they can better support their patients and disabled colleagues. It is important to learn appropriate terminology, how to ensure access to equitable and dignified care, and how ableism shows up and causes harm in nursing practice. The American Nurses Association's (ANA) Code of Ethics for Nurses with Interpretative Statements (ANA, 2025) has several provisions to guide nurses and professional nursing organizations in their approach to disabled people, including an obligation “condemn all forms of oppression and demonstrate intentional efforts to reflect and act upon social justice issues that influence health outcomes and health equity” (ANA, 2025, para. 2). When working with a disabled nurse or patient, do not question the validity of the person's disability or the veracity of their health concerns. The symptoms, concerns, and needs of people who live with nonapparent disabilities are often dismissed because they are not believed or are viewed as too broken to fix.
Conclusion
Disability is an often-overlooked dimension of diversity within nursing, and the continued exclusion of nurses and nursing students with disabilities reflects deep-rooted systemic ableism. Our stories underscore the persistent barriers, discrimination, and institutional biases that marginalize disabled people, and the urgent need for change. While federal legislation such as the ADA and ADAAA provides a framework for access and inclusion, meaningful progress requires a cultural shift within nursing that centers disability justice and examines the impact of intersectionality on the experiences of disabled people. This includes collecting accurate data, evaluating technical standards, expanding accommodations, addressing issues of access, and ensuring that nurses with disabilities are visible and included in efforts to shape policy and practice. Nurses with disabilities bring unique perspectives that enrich the profession and improve patient care. Recognizing disability as a natural part of human diversity is essential for cultivating truly inclusive, equitable, and accessible environments in health-care and education. Nurses and nursing organizations must examine and dismantle barriers that prevent disabled people from thriving in nursing and society writ large.
Footnotes
Authors’ Note
Anna Maria Valdez and Andrea Dalzell contributed to conceptualization, writing, and final editing.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Author Biographies
