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Enduring in silence: understanding the intersecting challenges of women living with multiple sclerosis in the workplace

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Enduring in silence: understanding the intersecting challenges of women living with multiple sclerosis in the workplace

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Content Enduring in Silence: Understanding the Intersecting Challenges of Women Living With
Multiple Sclerosis in the Workplace
Meredith Anne Jaggard
Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education
May 2024

© Copyright by Meredith Anne Jaggard 2024
All Rights Reserved

The Committee for Meredith Anne Jaggard certifies the approval of this Dissertation
Theresa Haskins
Courtney Malloy
Patricia Tobey, Committee Chair
Rossier School of Education
University of Southern California
2024

iv
Abstract
This dissertation addresses the intersection of gender and disability, focusing on the challenges in
the workplace faced by women living with multiple sclerosis (MS). The study aimed to explore
the impact of the intersection of gender and disability on the participants’ employment
experiences. Utilizing an intersectionality framework, the study recognizes the
interconnectedness of identities and systems of oppression. The theoretical lens underscores the
unique experiences of women with MS, acknowledging the complex relationship between gender
and disability. The study employed a qualitative approach consisting of interviews. Preliminary
findings revealed that the participants faced significant challenges, including the need for
accommodations, belonging, and marginalization. The intersectionality of gender and disability
further complicates their experiences, with inequalities in treatment highlighted. Coping
strategies such as education, advocacy, and building support networks emerged in the findings.
The study highlights the participants’ resilience and determination, emphasizing the importance
of workplace inclusion, accommodations, and support systems. Future research suggestions
include exploring the intersectionality of women of color living with MS and examining their
challenges in belonging and career advancement. Overall, this research contributes to
understanding the distinct experiences of women living with MS in the workplace and informs
interventions to promote inclusivity and support their professional endeavors.
Keywords: Intersectionality, gender, disability, multiple sclerosis, workplace challenges,
disability rights, belonging, career advancement, disability critical race theory

v
Acknowledgments
A heartfelt expression of gratitude is extended to Dr. Patricia Tobey, my dissertation chair.
Your unwavering support and expertise have been the bedrock of this academic expedition, and I
deeply appreciate your commitment to navigating me through the intricacies of research.
I extend my sincere thanks to my esteemed committee members, Dr. Courtney Malloy
and Dr. Theresa Haskins. Your insightful feedback was transformative, elevating this dissertation
from a mere draft to a masterpiece.
To my pillar of support and my person, Jaggs, and my daughter, Ellie, your steadfast
encouragement transformed this academic journey into an adventure of a lifetime, making each
step less of a marathon and more of a shared triumph. I do not say this enough, but you both are
my everything. Your unwavering love, support for loving as is, and being my biggest champion
make our love and life our defined perfection. A lifetime of adventures will never be enough.
Being your wife and mama are two of my most cherished titles.
A special acknowledgment goes to my mentor from the outset, Dr. Tory Cox. Our
monthly meetings were highlights of this journey, and I am grateful for the time and space you
provided.
Dr. Jenny Kwon and Eric Dumbleton, your unwavering support and encouragement from
the inception to the conclusion of this process have left an indelible mark. You both are forever
woven into the fabric of my life.
A heartfelt shout-out to Cohort 22 for being a source of camaraderie and shared
experiences throughout this academic pursuit. Your collective support rendered challenges more
surmountable and successes more meaningful. Frances Yeo, thank you for meeting every

vi
Tuesday since the start of the program; you have been a constant rock. And to the best reading
group, Virginia, Swifty, and Melissa, you are stars.
Thank you to my editor, Dr. Guadalupe Montano; you are magic.
Thank you to my Jones/Jaggard/Joseph/Frame/Lines family, who believes in me so
fiercely.
To me, I stand today as a testament to self-belief. To the young woman who was told she
would not have children, that a doctorate was not meant for her, she would never be ready to go
somewhere in her career, or face life in a wheelchair with a supposed end to her dreams—you
defied it all. We have all encountered people who do not see the dreams that live inside us, and I
share my journey in the hope that it inspires someone to trust in their abilities and revel in their
accomplishments. Completing this dissertation is more than an academic triumph; it is a personal
victory, echoing the resilience of women who feel that burning fire within them. It is not about
“them esteem” or “us esteem;” it is simply “self-esteem”—something only you need to believe
in. Your dreams are valid. Cheers to me, to us, and the acknowledgment of our hard-earned
success.
Last but certainly not least, I dedicate a space in this acknowledgment to the incredible
women living with MS. Your resilience, courage, and determination in the face of adversity are
not only admirable but also serve as powerful inspiration. As you navigate the workplace,
advocating for equality and defying the odds, remember that your strength resonates far beyond
the confines of individual battles.
To everyone who played a role, whether big or small, in this chapter of life—thank you.
LFG.

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Table of Contents
Abstract.......................................................................................................................................... iv
Acknowledgments............................................................................................................................v
List of Tables ................................................................................................................................. ix
List of Figures..................................................................................................................................x
Chapter One: Introduction to the Study...........................................................................................1
Context and Background of the Problem.............................................................................2
Importance of the Study.......................................................................................................3
Overview of Theoretical Framework and Methodology .....................................................5
Definitions............................................................................................................................6
Organization of the Dissertation ..........................................................................................8
Chapter Two: Literature Review ...................................................................................................10
History of Disability in the Workplace..............................................................................10
Reasons Underlying the Problem of Practice ....................................................................11
Existing Strategies for Solving the Problem......................................................................13
Intersectionality Framework ..............................................................................................14
Challenges and Barriers.....................................................................................................16
Conceptual Framework......................................................................................................17
Stakeholder Group for Study .............................................................................................29
Summary............................................................................................................................31
Chapter Three: Methodology.........................................................................................................33
Research Questions............................................................................................................33
Overview of Design ...........................................................................................................33
Research Setting.................................................................................................................34
The Researcher...................................................................................................................34

viii
Data Sources ......................................................................................................................35
Validity and Reliability......................................................................................................38
Ethics..................................................................................................................................39
Limitations and Delimitations............................................................................................41
Chapter Four: Findings..................................................................................................................42
Framework for Research....................................................................................................43
Interviewees.......................................................................................................................43
Overview of Findings: Research Question 1 .....................................................................51
Overview of Findings: Research Question 2 .....................................................................61
Summary............................................................................................................................65
Chapter Five: Recommendations...................................................................................................66
Summary of Findings.........................................................................................................68
Recommendations for Practice ..........................................................................................72
Implementation of Recommendations...............................................................................74
Recommendations for Future Research .............................................................................80
Conclusion .........................................................................................................................80
References......................................................................................................................................82
Appendix A: Interview Protocol....................................................................................................99
Introduction to the Interview .............................................................................................99
Conclusion to the Interview.............................................................................................100
Research Questions..........................................................................................................101
Appendix B: Recruitment Email..................................................................................................103
Appendix C: University of Southern California Information Sheet ............................................105
Appendix D: Recommendation for Benchmarking Success........................................................107
Appendix E: A Priori Coding Template ......................................................................................108

ix
List of Tables
Table 1: Taxonomy Diagram, Using Information from Formulated Meanings 22
Table 2: Participant Demographic Information 44
Table 3: Belonging in the Workplace 53
Table 4: Marginalization and Discrimination in the Workplace 58
Table 5: Accommodations in the Workplace 65
Table A1: Interview Protocol 101
Table D1: Timing for Recommendations From Components of the Inclusive Workplace
Transformation Model 107
Appendix E: A Priori Coding Template 108

x
List of Figures
Figure 1: Conceptual Framework Diagram 18
Figure 2: Model for the Career Development of Women with Physical and Sensory
Disabilities 30
Figure 3: Key Words From the Interviews 51
Figure 4: Burke-Litwin’s Model of Organizational Performance and Change 76
Figure 5: Inclusive Workplace Transformation Model Adapted From the Burke-Litwin
Model 77

1
Chapter One: Introduction to the Study
Over the past few decades, there has been a growing recognition of the importance of
inclusivity, equality, and accessibility in the workplace for people with disabilities. However,
much of the research in this area focuses on the experiences of men with disabilities, leaving
women with disabilities largely understudied (Chowdhury et al., 2022). Understanding what
obstacles women living with a disability face in the workplace, and how to address them, is
critical to their continued advancement (Noonan et al., 2004). According to the research, one of
the leading obstacles women living with a disability face is a sense of belongingness in the
workplace (Koch et al., 2021). Belonging is a cornerstone for human needs (Baumeister &
Leary, 1995), and acceptance by work members of one’s disability serves as a source of “identity
and feelings of normality” (Saunders & Nedelec, 2013, p. 100). Research has found that people
or employees who feel seen or like they belong, in turn, are more motivated in their environment
(Elliot et al., 2017). This paper outlines how the intersectionality and voices in the workplace of
women living with a disability need to be amplified, focusing on the research needed to
strengthen those voices and the theoretical frame to ground the study.
According to the World Health Organization (2022), women with disabilities are one of
the most marginalized and excluded groups in society. Marginalization in the workplace prevents
career progression (Bonaccio et al., 2020), affects well-being (Santuzzi & Waltz, 2016), and
causes a lack of motivation and belonging (Mejias et al., 2014). These challenges display the
need for further studies on how workplaces can create environments that support women living
with a disability, uphold the law according to the Americans with Disabilities Act (ADA), and
create an even playing field of equal rights for everyone in the workplace.

2
Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system
and typically affects more women than men. The most recent estimate is that approximately one
million adults live with MS, affecting their body functions and resulting in “a considerable
disruption to daily living and life roles including work” (Bebo et al., 2022, p. 1). Women living
with MS who are able to work find that modifications at the office, supportive managers and
colleagues, and supportive home environments boost their ability to work (Dyck & Jongbloed,
2000). Since women living with MS are a vulnerable marginalized population, work adjustments
and more inclusive policies are needed to embrace this population in the workforce (Vitturi et al.,
2022a). This dissertation explored the literature on women living with MS in the workplace and
studied their lived experiences to make recommendations based on the research.
Context and Background of the Problem
Addressing the issue of women living with a disability in the workplace and their lack of
belonging requires research on why they experience marginalization compared to their ablebodied peers. Currently, the research establishes that women living with a disability experience
less career progression and lack motivation in the workplace (Wilson-Kovacs et al., 2008).
However, there is a gap in the literature on the amplification of voices for the intersectionality of
women and those living with a disability. Few studies have addressed the experiences of women
with disabilities in the workplace to identify strategies to promote inclusivity, equality, and
accessibility. This research project contributes to the development of policies and practices that
support gender and disability equity in the workplace by examining the experiences of women

3
with disabilities in the workplace and identifying strategies to promote their inclusion and
success.1
Importance of the Study
Amplifying the voices of women living with a disability through academic research will
enable organizations to eliminate the barriers and challenges these women face. According to
Kwon and Archer (2022), little research has examined inequities in the workplace, instead
focusing on how people living with a disability can settle into a worksite’s structures and
policies. By understanding the challenges faced by women living with a disability and the
intersectionality of gender and disability, organizations can promote their inclusion and career
development (Suresh & Dyaram, 2020).
Women living with a disability are often overlooked, creating a feeling of not belonging
and marginalization in the workplace in part due to a lack of accommodations to support their
needs (Kwon & Archer, 2022). Studying this particular population allows workplaces to develop
programs and practices that are inclusive of all abilities, regardless of gender and disability status
(Roulstone & Williams, 2014). Ultimately, the study sought to contribute to more inclusive and
equitable workplaces for all employees for the world’s largest minority group, according to
Kwon and Archer (2022). Additionally, understanding the lived workplace experiences of
women living with a disability contributes to a deeper understanding of their intersectionality.
Gaining knowledge about this population will help their career advancement and retention in the
workplace (Kim et al., 2020).
1 The author generated this text in part with GPT-3, OpenAI’s large-scale language-generation
model. Upon generating draft language, the author reviewed, edited, and revised the language to
their own liking and takes ultimate responsibility for the content of this publication.

4
There is a large gap in the literature and research on the experiences of women living
with MS in the workplace. Women living with MS experience a wide range of marginalization
and ableism because of their invisible disability (Kattari et al., 2018). Multiple sclerosis
challenges, internal and external, bring to the forefront the need to legitimize how invisible
disabilities need to be recognized as a tier of disability (Vick, 2013). Although holding a job is
challenging due to fatigue, cognition, and impairment in mobility, employment is valuable in the
form of self-image, meaningful activity, and economic security (Johnson et al., 2004). Women
living with MS are a marginalized population due to their gender and visible or invisible
disability in the workplace.
The research about women living with MS and holding employment has a few studies in
the early 2000s, around the time when the American Disabilities Act was passed, and picks it up
again in 2021, but it is scarce. Studying women living with MS and the barriers they face to
belonging and advancement is essential for promoting equality, inclusivity, and support in the
workplace. By examining the intersection of gender and disability, it can drive positive change,
improve policies and practices, and create a more inclusive and empowering environment for
women living with MS.
Purpose of the Project and Research Questions
The intersection of gender and disability presents unique challenges for women with
disabilities in the workplace. Despite the growing attention to disability rights and inclusion in
the workforce, women with disabilities face significant barriers to employment and career
advancement. This study aimed to explore the extent to which the intersection of gender and
disability affects the employment experiences of women with disabilities. The following research
questions guided the study:

5
1. What are the lived experiences of women living with multiple sclerosis (MS) in the
workplace regarding belonging, opportunity, and oppression?
2. What are the perceived ways in which gender and disability intersect, affecting the
upward mobility of women with disabilities?
Based on the research questions, I used intersectionality as a framework to guide this research.
Overview of Theoretical Framework and Methodology
This study used intersectionality as the theoretical framework because it recognizes that
individuals have multiple identities that intersect to create unique experiences and helps to center
marginalized voices. Intersectionality reveals the lines of inquiry for dismantling interlocking
systems of oppression (Crenshaw, 1989). Introduced by Kimberlee Crenshaw in 1989, the theory
of intersectionality emphasizes that various social identities and systems of oppression intersect
and interact with each other, producing experiences of marginalization and privilege (Crenshaw,
2017). Using the intersectionality framework, I explored how the combination of gender and
disability affects women’s employment experiences and how these experiences may differ from
those of women without disabilities. In addition, the intersectionality framework highlights how
different forms of discrimination may interact and contribute to the marginalization of women
with disabilities in the workplace, preventing them from career advancement, affecting their
well-being, and decreasing their sense of belonging in the workplace.
Intersectionality is the lens that guided this study, which is an intersectional framework
that accounts for the ways that race, gender, and ableism are interconnected (Annamma et al.,
2013). Using intersectionality as a lens helped to show how women living with a disability and
patterns of oppression and marginalization are interconnected. Furthermore, it “recognizes the
shifting boundary between normal and abnormal, between ability and disability” (Annamma et

6
al., 2013, p. 10). Another key tenet is the social construction identity of disability as a deficit
“deviation from a white, middle-class, able-bodied ideology of normal” (Ball et al., 2022, p. 97).
Using intersectionality as an overarching framework supports the emphasis on how multiple
lenses intersect to impact women living with a disability.
For my study, I used a qualitative research design with a phenomenology approach,
focusing on interviews with women living with a disability who are currently employed across
industries living with MS. I recruited participants through disability organizations, online
forums, disability conferences in July 2023, and C-suite executives at the National Multiple
Sclerosis Society. Amplifying the lived experiences of women living with MS in the workplace
will highlight their unique perspectives to the forefront.
Definitions
Throughout the dissertation, keywords are used to provide an understanding of the
obstacles women living with a disability face in the workplace. The definitions are meant to
provide context and meaning for the study.
Able-bodied means having an able body, one free from physical disability and capable of
the physical exertions required in it (Davis, 1997).
Ableism is stereotyping, prejudice, discrimination, and social oppression toward people
with disabilities—the largest minority group in the United States (Bogart & Dunn, 2019).
Belonging: a subjective feeling of value and respect derived from a reciprocal
relationship with an external referent that is built on a foundation of shared experiences, beliefs,
or personal characteristics (Mahar et al., 2013).
Career advancement: career mobility and promotion prospects in a chosen workplace or
setting (Carmeli et al., 2007).

7
Disability is a difficulty in functioning at the body, person, or societal levels in one or
more life domains, as experienced by an individual with a health condition in interaction with
contextual factors (Leonardi et al., 2006).
Disability critical race theory (DisCrit) is a framework that theorizes about the ways in
which race, racism, dis/ability, and ableism are built into the interactions, procedures, and
discourses that affect people with dis/abilities qualitatively differently than people with
dis/abilities (Crenshaw, 1993; Solórzano & Yosso, 2001)
Disability identity is the concept of awareness and acceptance of corresponding
impairments from a physical or mental illness (Dunn & Burcaw, 2013).
Discrimination refers to organizational practices (e.g., hiring, firing, compensation) that
differentially treat or affect employees that belong to a protected class due to race, religion,
color, national origin, sex, age, or disability status (Colella & King, 2018).
Glass cliff: Women in the workplace who hold leadership positions tend to be more
precarious and associated with a greater risk of failure than their male counterparts (Ryan &
Haslam, 2007).
Intersectionality is a term coined to speak to the multiple social forces, social identities,
and ideological instruments through which power and disadvantage are expressed and
legitimized (Crenshaw, 2017).
Invisible disability refers to a disability that is not visible to the naked eye (Madaus,
2011; Oslund, 2013).
Marginalization refers to a multidimensional, dynamic, context-dependent, and diverse
web of processes rooted in power imbalance and systematically directed toward specific groups

8
and individuals, with probabilistic implications for development (Causadias & Umaña-Taylor,
2018).
Masking: used by workers with MS to hide their MS-related experiences even when they
have disclosed that they had MS at their place of work (Vickers, 2017).
Multiple sclerosis (MS) is a CNS disorder characterized by inflammation, demyelination,
and neurodegeneration that is the most common cause of acquired non-traumatic neurological
disability in young adults (Rush et al., 2015).
Self-efficacy refers to people’s beliefs about their capabilities to produce effects
(Bandura, 1994).
Social construction: the social history of disability and the social contexts that both
enable and disable individuals who negotiate these contexts (Shogan, 1998).
Woman/women: femininity is not merely a psychologically or biologically defined
attribute. Despite the significance of biological and psychological mechanisms in the formation
of gender, it is important to define it as a non-essentialist concept formed through socio-cultural
processes (Rahbari & Mahmudabadi, 2017). Being a woman is not based on your ability to bear
children but on something much deeper. Our gender experiences are more accurately found in
the small ways we interact with the world and how the world interacts with us (Preston, 2023).
Organization of the Dissertation
This dissertation is laid out in five chapters. Chapter One introduces the problem of
practice and gives a broad overview of the study’s theoretical framework, methodology, and
research question. Chapter Two reviews the literature surrounding the intersectionality of women
living with a disability and the barriers to belonging and advancement in the workplace. Chapter
Three reveals the study’s methodology, outlining the guiding research questions, how the study

9
was designed, and an unbound description of the researcher. Chapter Four reveals the research
findings. Finally, Chapter Five provides recommendations from the research findings and
suggests recommendations for future research.

10
Chapter Two: Literature Review
This literature review examines possible challenges for women in the workplace living
with a disability, specifically MS, and their barriers to belonging and obstacles to advancement
in their careers. The review begins with historical and contextual background on disability laws
and how these persist in the workplace, marginalizing women living with a disability and further
perpetuating barriers to belonging. This is followed by an overview of the intersectionality
framework used in the research. Next, the review will present challenges and barriers to women
living with a disability preventing them from advancement and proven strategies used to
overcome the issue. Finally, using the intersectionality framework, there is an exploration of key
conceptual frameworks that arise from the literature, including value as a currency in the
workplace, lack of career advancement, and margination because of a woman’s disability.
History of Disability in the Workplace
Historically, women living with a disability in the workplace have faced barriers to
belonging and advancement. Approximately 51.2 million Americans are disabled (Steinmetz,
2006), and according to the U.S. Bureau of Census, women who identify as living with a
disability have an employment rate of 45.7% (Randolph, 2005). Workplace discrimination
against women has not changed much over the past century (Samosh, 2021). Women, with or
without a disability, face challenges that their male counterparts do not (Heilman & Caleo,
2018). However, the intersectionality of gender and disability exacerbates these challenges, and
women struggle to overcome workplace barriers (Tompa et al., 2022).
Title 1 of The ADA of 1990 states that employers cannot discriminate against employees
with a disability. Still, there is a consistent and repetitive lack of compliance by employers to
follow the guidelines (Lindsay et al., 2018). Jones (1997) pointed out that one of the major

11
limitations of the ADA law is that it provides little guidance on how to go about providing equal
opportunities for persons with disabilities. However, contrary to reports of implementation of
laws, research suggests that hiring people living with a disability increases profit and retention
(Hartnett et al., 2011), making them just as valuable as their able-bodied peers. Nevertheless,
women in the workplace living with a disability experience mistreatment compared to their ablebodied peers (Koch et al., 2021). Examining the two, disability and gender, intersect to capture a
full range of identities that have been marginalized in the workplace (Hirschmann, 2012).
Reasons Underlying the Problem of Practice
Since the passage of the ADA, the literature and challenges facing those living with a
disability have persisted. This study of women living with a disability facing obstacles in the
workplace is grounded in the following statistics from Colella and King (2018):
• There is an official unemployment rate of 14.2% versus 9% for non-disabled people,
larger than any other protected class of citizens.
• The average duration of unemployment was 25 weeks versus 21 weeks for nondisabled people.
• There is a higher rate of underemployment, including 7.8% of involuntary part-time
workers living with a disability versus 5.5% for non-disabled people.
• There is an 11.5% reduction in wages (i.e., full-time earnings) for people living with a
disability.
Colella and King (2018) concluded that “these numbers represent a reversal of nearly all
the employment gains made since the enactment of ADA in 1990” (p. 135). Finally, according to
Steinmetz (2006), the majority of people with physical disabilities are female: 28.2 million, or

12
20% of all women in the United States, compared with 23 million men, or about 16 % of all men
in the United States.
Women Compared to Men Living With a Disability
Although protections and access to equal rights are meant for all genders, women still see
marginalization in the workplace due to disability. According to research from Mwachofi (2009),
who replicated a study conducted 30 years ago from 653,206 case management data about
gender differences in access and outcomes, “men with disabilities stand a better chance of
escaping poverty than do women” (p. 693) in regard to earrings and opportunity in the
workplace. Mwachofi concluded that 30 years later, there is still a need for change that “ensures
equity in quality of services which might translate into more equitable employment and earnings
outcomes” for women (p. 693). Another study, focusing specifically on the intersectionality of
gender and disability, also found evidence that women with disabilities are, on average, “more
psychologically affected by inequitable workplace conditions, partly because they earn less, are
exposed to more workplace stress, and are less likely to experience autonomous working
conditions” (Brown & Moloney, 2019, p. 112) compared to their male counterparts living with a
disability. Women living with a disability continue to see marginalization in the workplace,
affecting their sense of belonging and equality.
When it comes to women versus men living with MS, the discrepancies are stark. New
data shows that two to three times as many women as men live with MS (MS Trust, 2020). The
large percentage of women living with MS versus men is due to pregnancy, differing hormonal
states, and distinct social roles (i.e., primary caretaker; Jobin et al., 2010). In regard to work,
Roessler et al. (2007) found that of 3,082 allegations of employment discrimination by adults
living with MS, two thirds or 75% were filed by women living with MS. The study found that

13
women living with MS were more likely to not receive merit-based incentives and were more
likely to allege discrimination in the form of harassment and intimidation than men with MS.
Existing Strategies for Solving the Problem
Despite the growth of women’s career development literature over the past several
decades (Betz & Fitzgerald, 1993; Phillips & Imhoff, 1997) and the vast literature addressing the
employment issues of persons with disabilities, there has been very little research focused
specifically on the career development of women living with disabilities in the workplace.
However, Noonan et al. (2004) concluded that there are strategies that can be adopted for women
living with a disability that could improve the workplace experience. The strategies begin with
the attitude of women living with a disability toward actions they take in the workplace, both of
which can have a positive outcome. The authors also outlined external factors, those that the
employers could implement to create an environment of belonging and inclusivity: connecting
women living with a disability with mentors, creating a network of women supporting women
(inclusive of all abilities and disabilities), building rapport and engagement with colleagues in
the workplace, and encouraging a strong and supportive relationship with friends and family
outside of the workplace.
Noonan et al. (2004) suggested that throughout the employment of women living with a
disability, career interventions should happen regularly by employers to continue to develop their
skills in their particular roles and coping mechanisms. Specific coping mechanisms include
continuing education on prejudice, gender and ableism bias, and professional success. Finally,
Noonan et al. (2004) stated that employers must identify barriers in their policies and advocacy
work to help maintain and build self-efficacy (Lent et al., 2000; Swanson & Woitke, 1997).
Examples that have been used are “feminist therapy strategy” (Noonan et al., 2004, p. 78), which

14
encourages women to engage in proactive political activities related to disabilities and gender
equality. These strategies will help women living with a disability solve problems they may face
in the workplace.
Intersectionality Framework
Crenshaw’s (1989) intersectionality framework has been influential in feminist and
critical race scholarship. Intersectionality emerged as a response to the limitations of traditional
feminist and anti-racist theories that failed to adequately address the experiences of individuals
who face multiple forms of oppression. The word “intersection,” according to Knudsen (2006),
refers to a line that cuts through another line and can be used for streets crossing each other.
Although intersectionality did not reference disability and sexualities in its origin, these were
integrated into the theory of intersectionality in the early 2000s (Lykke, 2020; Meyer, 2002).
This dissertation uses the intersectionality framework in the context of women living with
a disability as a recognition that these individuals experience intersecting forms of oppression
and discrimination based on both their gender and their disability (Brown & Moloney, 2019).
Using intersectionality in this way aids in acknowledging that the experiences and challenges
disabled women face are influenced by multiple social, cultural, and structural factors
(Randolph, 2005). This approach recognizes that the discrimination and marginalization disabled
women face are not solely based on their disability or gender alone but are shaped by the
interaction of these multiple identities (Crenshaw, 1989). Those identities, which have been
proven to lead to margination, are showcased in the workplace, where, according to Chowdhury
et al. (2022), women with disabilities are expected to work in underpaid positions and earn much
less when compared with men with disabilities or women without disabilities which leads and
can have an impact on their success in their position (Pettinicchio & Maroto, 2017). Using the

15
intersectionality framework showcases how gender and disabilities intersect in the workplace,
resulting in marginalization and oppression.
Considering the intersectionality of disability and gender allows employers to better
understand and create policies in the workplace that address the specific needs and rights of
women living with disabilities. This framework emphasizes inclusive policies, accessibility,
equal opportunities, and empowerment for disabled women while recognizing and challenging
the intersecting systems of oppression they face (Bend & Priola, 2018). Furthering the
marginalization and barriers that people living with a disability face, women have been described
as an invisible marginalized group because they have been socially excluded and are often not
visible in society (Neal, 2019). Furthermore, this marginalization and intersection of gender and
ability make it more challenging to succeed in the workplace, producing a low sense of
belonging, which is key to motivation (Baumeister & Leary, 1995).2 By acknowledging and
addressing the challenges women with disabilities face in the workplace, workplaces can work
toward a more inclusive and equitable society for everyone.
The intersectionality of women living with a disability in regard to belonging and
advancement happens at all levels of employment. Women with advanced degrees and those who
are highly skilled in their fields are excluded from conversations because of their intersecting
gender and ability (Chowdhury et al., 2022). In Chowdhury et al.’s (2022) research, women
participants stated that they experienced significant barriers in their workplace due to their
gender and disability. The research themes that arose from the study included “isolation and
hopelessness, a sense of tokenism or de-legitimization, limitations of provided accommodations
2 The author generated this text in part with GPT-3, OpenAI’s large-scale language- generation
model. Upon generating draft language, the author reviewed, edited, and revised the language to
their own liking and takes ultimate responsibility for the content of this publication.

16
… and how multiple layers of identity fuel marginalization.” (Chowdhury et al., 2022, p. 28).
Excluding women living with disabilities in the workplace contributes to their feelings of not
belonging and exclusion.
Challenges and Barriers
Women living with a disability face multiple challenges in the workplace, specifically
with a sense of belonging and career advancement. Although there are safeguards for people
living with a disability in the workplace, the representation of people who fit the category is low
and even lower in top leadership positions. Despite laws and attention to inclusivity, barriers
persist, which was the focus of Wilson-Kovacs et al. (2008) quantitative research. They noted
problems associated with a lack of opportunity, resources, and support (Wilson-Kovacs et al.,
2008). The latter, lack of support, is one of the most detrimental because the support an
employee receives is a key factor in addressing barriers to dynamic employment (Jetha et al.,
2021). Living with a disability is challenging for everyday tasks, but not receiving support in the
workplace due to a disability leaves women feeling unmotivated in their careers.
If someone is living with a disability and able to work, the research suggests they tend to
experience less career success than their counterparts without a disability (Kulkarni &
Gopakumar, 2014). Strategies to continue advancement in careers include having a positive
attitude, giving a voice to a person’s disability and telling coworkers what they can do while also
voicing limitations, ensuring the feedback loop is open, and participating in disability advocacy
work “to remove performance myths; and building, leveraging, and contributing to disability
networks” (Kulkarni & Gopakumar, 2014, p. 445). To overcome the challenges to career
advancement, Samosh (2021) suggested a three-pronged approach to navigate the barriers.
Leaders who live with a disability benefit from the following facilitators, according to the

17
research: career self-management strategies, social networks, and organizational and societal
factors.
Strategies exist for leaders who live with a disability, but that percentage is small
compared to women who live with a disability and do not hold a leadership position. Jones
(1997) outlined workplace strategies to ensure women will thrive, including programs for ablebodied colleagues: diversity training for all staff, training for persons with disabilities, aiding
with coworker resentment, providing accommodations according to needs, and hosting and
supporting mentoring/sponsorship programs. It is important to note that these strategies are over
20 years old, yet they have not changed as ways to promote inclusivity and congruency (Ivey &
Dupré, 2022; Kulkarni et al., 2018; Mejias et al., 2014; Noonan et al., 2004). In order to identify
strategies and recommend new ones, identifying a conceptual framework for the research project
to ground the study is important.
Conceptual Framework
Using Crenshaw’s (1989) intersectionality framework to evaluate and understand the
challenges women living with a disability face in the workplace to belonging and advancement,
key concepts emerged from the literature as the conceptual framework. The following section
will highlight the key concepts emerging from the current literature:
• A person’s abilities in the workplace are viewed as a currency (meaning their work
holds value), and women living with a disability are viewed to have less value or
currency in their workplace (Klein, 2022).
• Women living with a disability feel marginalized in the workplace, resulting in a lack
of belongingness and motivation (Koch et al., 2021).

18
• Working and holding a job allows women with a disability to have a positive identity
and meaning (Saunders & Nedelec, 2013).
• Women living with a disability continue to experience constraints on career
advancement and inclusion (Brown & Moloney, 2019).
• There is an overwhelming lack of support for women living with a disability in the
workplace, and advancement is challenging (Wilson-Kovacs et al., 2008).
Figure 1 represents the relationship between key concepts in the theoretical and conceptual
frameworks.
Figure 1
Conceptual Framework Diagram

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Currency and Value
The notion that living with a disability and being a woman makes someone’s value or
status in the workplace less than their able-bodied peers comes from The Ezra Klein (2022)
podcast with guest Cecilia Ridgeway. Ridgeway argued that when women with a disability work,
it plays into the societal stereotype, and in turn, their status and value are lower because of it
(Klein, 2022). Klein (2022) described this as an employee’s currency in the workplace and found
that women living with a disability do not hold as much value or currency due simply to their
disability. Klien stated that no matter how hard a woman living with a disability tries or succeeds
in the workplace, she will never be considered as valuable as their able-bodied peers.
Historically, value is placed on gender in the workplace. Placing value on people creates
societal hierarchy, reinforcing long-standing inequities (Ridgeway, 2011). So, placing value on a
marginalized group has detrimental effects, specifically in the workplace with belongingness and
career aspirations (Koch et al., 2021). Alternatively, Heera and Devi (2016) noted that
“employing people with disabilities contributes immensely to the culture and the success of an
organization, which shows that their value can be seen in the workplace” (p. 56). Excepting the
value that employees bring to the workplace, regardless of gender, will make companies more
equitable and stronger.
Identity in the Workplace
Women living with a disability in the workplace hold themselves in a positive identity,
thus improving their value and well-being. For women living with a disability, working and
holding a job allows them to have a positive identity and meaning (Saunders & Nedelec, 2013).
Saunders and Nedelec’s (2013) research suggested that since people spend most of their time
working, it is key to proving personal meaning in their lives. The researchers concluded that

20
working is a source of meaning and importance for those living with a disability and results in a
foundation of identity, feelings of normality, financial support, and socialization (Saunders &
Nedelec, 2013). However, despite feelings of normalcy and financial support, women living with
a disability face challenges to career progression and constraints on career advancement and
inclusion (Brown & Moloney, 2019). Identity in the workplace continues to elude women living
with a disability because, while it is related to self-worth and a stronger identity, it can also be
detrimental in their quest to define their disability identity, particularly for those who live with
MS (Henry, 2016).
Living with MS is a constant battle against and with one’s physical body. Women who
live with MS and hold employment gain a sense of worth and self in a body that declines over
time (Crossley, 2004). The threat to a woman’s identity in the workplace and ability to hold a
job, being treated differently, is one of the main themes women living with MS fear (Crossley,
2004). women also commonly mask MS-related symptoms in the workplace, even when their
diagnosis is known to the employer and colleagues, so they appear to be able-bodied (Vickers,
2017). To maintain a strong identity in the workplace, Crooks et al. (2009) found that adopting
flexible schedules and building strong social networks were central to maintaining employment
for those living with MS. The researchers concluded that maintaining paid work after the onset
of MS is important and beneficial to identity (Crooks et al., 2009). Despite the constant battle
against their declining physical bodies, women living with MS who maintain employment find a
sense of worth, self, and a strengthened identity in the workplace, emphasizing the importance
and benefits of holding a job in the face of this challenging condition.

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Discrimination
Experiencing discrimination due to ability, or lack of ability, intersecting with gender is
common in the workplace. In a survey of 1,038 adults with disabilities and 988 adults without
disabilities conducted by the National Organization on Disability, one in five employed
individuals with disabilities reported that they experienced discrimination during their
employment (Schmeling et al., 2006). Wage inequities also persist for women living with a
disability versus males living with a disability, as women with disabilities with full-time
employment were paid 65% of what men with disabilities earned despite higher educational
attainment (Randolph, 2005). In Randolph’s (2005) qualitative study, women living with a
disability categorized the discrimination they experienced into buckets of preconceived notions,
attitudes, accommodations, access, and exploitation. Table 1 groups discrimination and
nondiscrimination themes from the study based on these buckets.

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Table 1
Taxonomy Diagram, Using Information From Formulated Meanings
Type Category Example
Discrimination Assumptions Employee skills
Interview questions
Attitudes Mistrust
Cruelty
Overprotection
Patronizing attitude
Accommodations Barriers not addressed.
Lack of desire or knowledge to make
accommodations.
Resentment of accommodations
Need for self-advocacy
Access Lack of access to physical, social, and
political environments
Exploitation Quotas
Token disabled employee
Being taken advantage of
Low pay
Low position
Nondiscrimination Assumptions Focus on job, not disability
Attitude Respect for skills and talents
Accommodations Flexible scheduling
Workplace accommodations Adaptive
equipment provided by employer
Access Full access to employment
environments
Exploitation Salary based on objective criteria such
as tenure
Note. Adapted from “The Meaning of Workplace Discrimination for Women With Disabilities”
by D. S. Randolph, 2005, Work, 24(4), p. 377.
Women living with a disability experience discrimination in the workplace; however, it is
increased for those living with MS. In a comprehensive review of 26 studies regarding 9,571
workers living with MS, Vitturi et al. (2022b) found that 79.2% of participants experienced

23
stigma related to their disease in their workplace. The feeling of fear about disclosing their MS
diagnosis stemmed from not wanting to be discriminated against because of it (Vitturi et al.,
2022b). Also, 96.5% of participants indicated that they would like to be educated on dealing with
discrimination at work (Rumrill et al., 2015). While areas of intersectionality are prevalent for
women in regard to career advancement, belonging, and identity living with MS in the
workplace, Roessler et al. (2007) found that women and men living with MS are more alike than
different in terms of their employment discrimination experiences. However, the authors noted
that women with MS differed from men in the types of discrimination, as women are more likely
to file allegations related to harassment, and men are more likely to file allegations related to
hiring (Rumrill et al., 2015). Understanding and addressing these challenges is crucial in creating
a more inclusive and equitable work environment for individuals living with MS.
Career Advancement
Women living with a disability experience constraints to career advancement and
inclusion. Generally, the research shows that anyone living with a disability is over-represented
in lower-level and paid service jobs yet is largely under-represented in higher-level, managerial,
and professional roles (Barnes & Mercer, 2005; Goldstone & Meager, 2002). According to
Wilson-Kovacs et al. (2008), women living with a disability in management positions battle the
glass cliff theory, as they have insufficient time to carry out their responsibilities, and those who
lived with a disability were often not given the extra time they needed to perform tasks. Overall,
the research found that expectations, unnecessary pressures, and stress lead to marginalization
(Wilson-Kovacs et al., 2008). The women in the study stated that their workplace was not
equipped to accommodate their advancement (Wilson-Kovacs et al., 2008). Workplaces need to

24
prioritize creating an environment that accommodates and supports the advancement of women
living with disabilities, enabling them to fully contribute their talents and expertise.
Advancement in the workplace is important for women living with a disability, but living
with MS adds another barrier, as it predominantly affects women, particularly those of
childbearing age (Julian et al., 2008), at a rate of 3:4 women compared to men. Additionally, not
much has changed over time, and studies have reported that women are at greater risk for work
loss than their male counterparts (Julian et al., 2008; LaRocca et al., 1985; Edgley et al., 1991).
While living with MS is challenging in itself, Moore et al. (2013) found that of 221 participants
who identified as living with MS, 43.3% left their workplace due to disease symptoms of fatigue,
pain, and memory problems. Thus, almost half of the sample did not have an opportunity for
career advancement. In a longitudinal study of 8,122 participants with MS, 75% of whom
identified as female, 56% to 58% reported not being employed due to disease condition (Julian et
al., 2008). While career advancement for women living with MS continues to be a barrier, the
focus here is on employment instead of advancement.
Lack of Support
There is a lack of support, including emotional and programmatic support, for women
living with a disability. Assisting employees who live with a disability requires understanding
the disability and how to effectively show support through human resources programming
(Beatty et al., 2019; Wilson-Kovacs et al., 2008). Support and programs indicate a commitment
by the workplace to employees’ career advancement as a pillar of their culture (Wilson-Kovacs
et al., 2008). Support is one of the cornerstones for a sense of belonging and can affect the
employment outcomes of women living with a disability, and Mejias et al. (2014) recommended
support groups in the workplace. Ensuring support for women living with a disability in the

25
workplace does take extra work, yet the research indicates that the benefits are retention and
loyalty (Wentling & Palma-Rivas, 1998). The implementation of support groups and tailored
human resources programming can greatly impact the employment outcomes of women living
with a disability.
Employment is typically a determinant that a person is in good health. Yet, up to 80% of
people living with MS stop working within 15 years of their initial diagnosis (Railton et al.,
2002). Strober and Arnett (2016) and Jongbloed (1996) surveyed over 800 women living with
MS and found that supportive work and home environments were the main factors contributing
to their ability to continue employment. Once women have come to terms with their MS
diagnosis, the most common concern they had, according to Railton et al. (2002), was what their
employer would think of them and their ability to do their job. Furthermore, the lack of employer
support had a long-lasting impact on the woman’s motivation for future employment and worth
(Railton et al., 2002). The lack of support from employers and colleagues can have a direct
impact on women living with a disability in the workplace and beyond.
Ableism
The experience of ableism among people living with a disability continues to be a
common theme in the workplace. Working in the United States, those living with a disability
describe themselves as an “invisible marginalized group, because they have been socially
excluded to the point where they often are literally not visible” (Neal, 2019, p. 5). The ableist
narrative around workers living with a disability, compared to their able-bodied peers, includes
themes of unworthiness, lower productivity, and subordination (Lundberg, 2022). In a 2021
study by Kwon, participants revealed they were seen as deficient and unproductive in the
workplace simply because they were classified as disabled. The seven participants in the study

26
revealed two ways they countered their disability stereotype (Kwon, 2021). They resisted
ableism by openly communicating the scope of their ability and by stepping outside the category
of people with disabilities.
Women living with a disability experience ableism, even when their disability is
invisible. A study by Kattari et al. (2018) involving 14 participants who had invisible disabilities
and experienced ableism found they had challenges from colleagues when they felt the need to
educate them on their disability, accommodations, and needs. Research from Vick (2013)
identified women living with MS as experiencing ableism because they do not look disabled, and
their symptoms (challenges) are internal. This highlights the importance of raising awareness and
promoting inclusivity to combat ableism, particularly for women living with MS, where
symptoms and limitations may not be immediately visible.
Advocacy
Advocacy about disability in the workplace empowers and educates colleagues about the
needs of those living with a disability. Living with a disability, visible or invisible, can make it
harder to identify barriers in the workplace. However, Santuzzi et al. (2014) noted that the
allyship of other colleagues is a key way to improve accommodations and belonging. Advocacy
for colleagues living with a disability includes education of others, action to change
accommodations to meet the needs of colleagues living with a disability, and speaking up when
they see wrong in policies and actions (Sabat et al., 2014). When allies take on the responsibility
of educating others on behalf of a colleague with a disability, the research shows that it can lead
to a more favorable outlook on those living with a disability, in turn creating a stronger sense of
belonging (de Boer et al., 2012). Allyship in the workplace is one of the most productive ways to
make change for people living with a disability.

27
Women living with MS face multiple barriers and obstacles in the workplace, making
self-advocacy challenging to meet their needs. Bachari et al.’s (2021) study of women living
with MS concluded that feelings of judgment, social isolation, job security, and stigma in the
workplace were the primary reasons women do not advocate for themselves. The study also
revealed that MS creates uncertainty because it prevents self-care and limits independence and
the ability to participate in family and society, limiting advocacy even more (Bachari et al.,
2021). Self-advocacy training for women living with MS through human resources or patient
care doctor’s office is proven to be beneficial in helping to vocalize specific needs and
accommodations needed by the women (Rumrill et al., 2016). Fostering an environment that
encourages self-advocacy and allyship can significantly improve inclusivity and ensure women
living with MS are not just accommodated but are actively supported in the workplace.
Disclosure
Disclosure about a health-related issue can be very personal and a challenge for women
in the workplace. Historically, women are part of a marginalized group, making the disclosure of
any illness complex due to factors of stigma, support, and power structures (Werth et al., 2018).
Werth et al. (2018) found that disclosing illness empowers women to obtain accommodations
needed for workplace success with their illness. Werth (2010) grouped the factors of disclosure
concern for women into the following categories: expected management and peer support,
stigma associated with illness, severity or variability of illness, individual labor market power,
institutionalized contingent flexibilities, institutionalized non-contingent flexibilities, and outside
influences such as caring responsibilities. Adding invisible disabilities makes health disclosure at
work even more complicated because the lack of visible symptoms means that the impacts on

28
worklife are not obvious to others, making the disclosure decision particularly challenging
(Ganesh & Lazar, 2021).
Living with MS means a variety of symptoms are not visible, including cognitive
function, loss of feeling in extremities, and fatigue, making disclosure at work particularly
difficult. In a study of 9571 participants who live with MS and work, Vitturi et al. (2022) found
that the main reason people did not disclose their diagnosis was fear of discrimination. The study
also found that up to 79.2% of people living with MS experience some form of stigma. However,
when women do disclose their diagnosis, Kirk-Brown (2014) found in their survey study of 1438
people, it can positively affect their employment and prolong their job. The decision to disclose
an MS diagnosis is multifaceted, including personal, systematic, and social factors (Gill &
Hynes, 2021). Making the decision to disclose an MS diagnosis in the workplace continues to be
a challenge.
Accommodations
The ADA ensured that individuals could not be discriminated against because of a
disability, including in the workplace, and required reasonable accommodations, such as remote
work. In a survey of 2,282 non-employed people living with a disability, one-third confirmed
that barriers they face in the workplace could be resolved by accommodations (Anand & Sevak,
2017). After the COVID-19 pandemic, people working and living with a disability increased by
60% due to the option of remote or virtual work (U.S. Department of Labor, 2021).
Accommodations in the workplace have been beneficial to attracting, retaining, and promoting
employees (Padkapayeva et al., 2017). Accommodations allow people living with a disability
more options to thrive in the workplace.

29
Women living with MS may require additional accommodations in the workplace.
Seventy percent of people diagnosed with MS are women (Dogan, 2018), making the disease
female dominate, with symptoms peaking between the ages of 20 and 40. Since it is a femaledominated disease, it is imperative that accommodations be tailored to each request, which will
empower women to succeed in the workplace (De Dios Pérez et al., 2023). In a comprehensive
review of 26 published papers totaling 32,507 participants, the main symptoms reported from
MS were fatigue, mobility challenges, and cognitive impairments (Schiavolin et al., 2013),
which impacted their employment experience, and accommodations were needed. Given the
significant impact of MS symptoms on women living with MS in the workplace, tailored
accommodations are imperative to their management and success.
Stakeholder Group for Study
Several stakeholders are involved in creating an inclusive environment and advancing
women living with a disability, including employers, colleagues, and family members.
Employers should be tasked with recruiting, hiring, and training women living with a disability
(Hartnett et al., 2011). Additionally, employers should collaborate with human resources to
ensure the workplace creates a culture of inclusion and acceptance through anti-bias training and
mentoring programs (Kulkarni et al., 2018). A second stakeholder group involves workplace
colleagues who offer social support and well-being (Holland & Collins, 2022). A third
stakeholder group is the support systems outside of the workplace, which provide a foundation of
support before, during, and after employment. Family influence plays a role in the success or
hardship of women living with a disability in the workplace (Noonan et al., 2004). All of these
stakeholders play a key role in the continued success of women living with a disability in the
workplace.

30
To better understand the stakeholder groups’ role in the employment success of women
with disability, Figure 2 represents an emergent model for the career development of women
with physical and sensory disabilities presented by Noonan et al. (2004).
Figure 2
Model for the Career Development of Women With Physical and Sensory Disabilities
Note. From Challenge and Success: A Qualitative Study of the Career Development of Highly
Achieving Women with Physical and Sensory Disabilities by B. M. Noonan, S. M. Gallor, N. F.
Hensler-McGinnis, R. E. Fassinger, S. Wang, & J. Goodman, 2004, Journal of Counseling
Psychology, 51(1), p. 71. (https://doi.org/10.1037/0022-0167.51.1.68)

31
In Figure 2, the double arrows represent the contextual inputs of the core dynamic self,
which flow into the core, interact with it in mutual impact, and flow out again as actions and
consequences. According to the researchers,
[The] emergent model represents a dynamic system, organized around the core category
of the dynamic self, which contains interconnected identity constructs (disability, gender,
and racial/ethnic/cultural identities), personality characteristics, and belief in self; the
encircling of the core category is perforated to indicate ongoing developmental change
and growth. (Noonan et al., 2004, p. 71)
Although a thorough analytic undertaking would necessarily involve all stakeholder
groups, due to time and resource restrictions, the stakeholder groups for my study are employers
and women living with a disability in the workplace. Employers are one of the primary
stakeholders for this study because their attitudes and perceptions are the foundation for creating
a culture of belonging and pathways for advancement and inclusion for employees living with a
disability (Bengisu & Balta, 2011; Échevin, 2013). Employers can play a crucial role in shaping
the attitudes, perceptions, and supportive environment necessary to foster a culture of belonging
and facilitate opportunities for advancement and inclusion for employees with disabilities.
Summary
Chapter Two overviews the intersectionality of women living with disabilities in the
workplace and the barriers they face to belonging and advancement, according to the literature.
The specific focus of Chapter Two is on the literature on women living with MS. The review
touches on the historical context of workplace discrimination against women with disabilities
and highlights the persistent challenges they encounter. Despite evidence suggesting that
organizations can benefit from employing people with disabilities, women with disabilities still

32
experience marginalization and lack of belonging compared to their able-bodied peers and their
male peers. The literature points to higher unemployment rates, longer durations of
unemployment, higher levels of underemployment, and reduced wages compared to non-disabled
individuals. These statistics indicate a reversal of employment gains since the enactment of the
ADA.
Strategies for addressing the problem include connecting women with disabilities to
mentors, building supportive networks, fostering rapport and engagement in the workplace, and
promoting external relationships for support. Regular career interventions and coping
mechanisms are also important strategies for employers. Crenshaw’s (1989) intersectionality
theoretical framework helps to frame the challenges disabled women face in the workplace. The
framework acknowledges the multiple forms of oppression and discrimination that intersect in
these women’s experiences in the workplace. Their marginalization and invisibility make it
difficult for them to succeed in the workplace, decreasing their sense of belonging and harming
their careers and advancement. Strategies such as a positive attitude, voicing one’s disability and
abilities, and participating in disability advocacy work are ways to overcome these challenges.
Finally, based on the theoretical framework of intersectionality, key conceptual
frameworks emerge from the literature: the devaluation of abilities, marginalization, lack of
belongingness, the positive identity associated with work, constraints on career advancement,
and the lack of support for women with disabilities in the workplace. Overall, Chapter Two
provides a foundation for understanding the historical context, challenges, and strategies related
to the intersectionality of women living with disabilities in the workplace to help implement best
practices.

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Chapter Three: Methodology
This study aimed to amplify the voices of women living with MS about workplace
obstacles regarding belonging and career progression. Highlighting their lived experiences and
interviewing them helped address workplace challenges to provide updated accommodations and
timely practices. Utilizing Crenshaw’s (1997) intersectionality framework and addressing the
marginalization of women living with a disability, the study employed a qualitative design to
examine value, belonging, discrimination, margination, and career advancement. Based on the
literature, those topics align with the current research. Chapter Three details the research design
and methodology utilized to conduct interviews guided by the research questions. This chapter
begins with an overview of the methodological design and methodology, specifically the
inclusion criteria and rationale. Next, a detailed account of the data collection methods and data
analysis is provided, highlighting the connection to the research questions. Finally, a discussion
on ethics concludes the chapter.
Research Questions
The following research questions guide this study:
1. What are the lived experiences of women living with MS in the workplace regarding
belonging, opportunity, and oppression?
2. What are the perceived ways in which gender and disability intersect, affecting the
upward mobility of women with disabilities?
Overview of Design
The interviews consisted of verbal open-ended questions and explored the intersectional
experiences of women living with a disability, focusing on perceptions of discrimination,
stereotypes, and microaggressions related to gender and disability. It also covered belongingness

34
in the workplace, specifically the sense of fitting in, social connectedness, and identification with
the workplace. Lastly, the interviews addressed workplace advancement, specifically
opportunities for training and development, barriers to career advancement, and strategies for
success.
Research Setting
One-on-one interviews with women living with MS took place on Zoom. It was
important to ensure that all participants knew that accessibility was at the forefront of the
interviews, so they were all held virtually unless the interviewee requested otherwise. I also
selected Zoom because there were discussions about difficult experiences living with MS in the
workplace, and it was important that the participants feel secure discussing those experiences. I
transcribed the interviews using Otter AI, which is an artificial intelligence tool that helps
retrieve Zoom meeting conversations.
I interviewed 16 women living with MS who are currently or have previously been
employed. The criteria for the interviews required that individuals identify as women diagnosed
with MS. It was important to distinguish that they had previously been diagnosed with MS
because, in the MS community, some people identify as not having MS anymore because they
have no lesions and/or have not had a relapse in their disease in a year or more.
The Researcher
I am a 39-year-old woman who is a mom to Ellie Jaggard, wife to Alex Jaggard,
executive director of the University of California College of the Law, San Francisco Alumni
Association, living in Berkeley, California, a 3rd-year doctoral student at the University of
Southern California, and I live with MS. I am who I am because of the privilege of being a

35
White, heterosexual, upper-class, raised by four PhD-educated parents and only now recognize
the access and positionality it brought to my life.
Living with a disability and continuing my career aspirations fuels my desire to conduct
research on women living with a disability in the workplace because it directly ties to my current
experience and observations living with MS. As executive director and part of our senior
leadership at the law school, I am acutely aware of the traditional norms that come with
leadership roles, which include attending events, leading a team, working extended hours,
countless meetings, budgeting and strategy planning sessions, and presentations. While I am
thrilled to have a seat at the table with my microphone turned on, the table was designed for
able-bodied individuals, and the jobs are for able-bodied people. My assumptions and bias are
that I am living and breathing what I am studying, so prior knowledge and experience could have
affected my study. I mitigated those biases by using a diverse sample of interviewees, journaling
throughout the research, and ensuring I collected data to the point of saturation (Drisko, 1997). I
do have lived experiences as a member of the disability community; however, the goal of this
study will be to amplify those voices and bring awareness to a community that needs to be heard
and, more importantly, seen as valuable.
Data Sources: Interviews
For this qualitative study, I used unstructured one-on-one interviews as the main data
source to guide my research. The following section will outline the method, the participant pool,
the instruments used in the interviews, and the process for collecting data. The main source of
data in this study was interviews on Zoom.

36
Participants
To ensure that the participant pool was purposeful and diverse, I recruited from the
following sources:
• I have formed a strong relationship over the past 8 years of living with MS through
fundraising and advocacy with the National Multiple Sclerosis Society.
• I am active and a participant in MS community groups. I posted flyers, inquired at
group meetings, and posted about this study in online forums, requesting participants.
• In July 2023, I attended the Disability: In Conference and formed strong relationships
with women living with MS.
I had 16 interviews lasting up to 60 minutes each. All the interviews followed the
research questions and conceptual framework. The criteria for participation were individuals who
identify as women currently living with MS and employed full- or part-time at the time of the
interview or in the past.
Inclusion and Exclusion Criteria
I recruited participants through social media networks from a flyer (Appendix B). In
order to have a focused participant group to support and explore the research questions,
participants met the following inclusion criteria:
• Participants must be, or identify as, a woman.
• Participants must live with MS.
• Participants must be employed, full or part-time, or have previously been employed,
full or part-time.
Participants were excluded from the study based on the following criteria:
• participants who are men or identify as men

37
• participants who do not live with MS
• participants who live with MS but have never been employed
The pre-qualifying survey allowed for a clear understanding of whether participants were
included or excluded from this study.
Instrumentation
Twelve interview questions helped guide the interviews, allowing for structure and
flexibility for the interviewees to share their lived experiences. I ensured that questions promoted
conversation and interviewees did not feel stifled by ridged questions (Castillo-Montoya, 2016),
especially since the questions could have been about traumatic and personal experiences. There
were 12 interview questions centered on pillars of the conceptual framework: belonging,
discrimination, marginalization, and upward career mobility. Appendix A includes a full list of
the interview questions.
Data Collection Procedures
I conducted interviews virtually from September 2023 to October 2023. Each interview
lasted up to 60 minutes, and all the questions were open-ended. I captured data and responses
from participants on Zoom by using the recording function and Otter AI. All of those methods
ensured I had two sources of data in case there was a malfunction with one of the technologies.
Data Analysis
Analyzing interview data was a valuable step in this research. Patton (2002) outlined the
process to include transcriptions of the interviews, coding to identify themes, and interpreting the
data to draw conclusions. I recorded the interviews on Zoom, transcribed them using software,
and then edited the transcripts. Validity and reliability, covered in the next section, followed
thorough data analysis.

38
The first step I took after each interview was transcribing all the interviews using the
Zoom recording features, which typed out what was said. I also utilized Otter AI, another
transcribing feature. While reviewing the interviews, I used axial coding to identify themes in the
data. After finding themes, I categorized them into similar concepts and patterns. From that
information, I drew conclusions and interpreted the data to report on the findings in Chapter
Four.
Validity and Reliability
To maximize the study’s validity and reliability, I used methods outlined by CastilloMontoya (2016), specifically the interview protocol refinement framework, to refine the
interviews. First, I ensured that all interview questions aligned with the research question. The
focus of my research questions was women who live with MS, their barriers to belonging, and
how gender and disability affect upward mobility in the workplace. Second, I made sure that all
conversations during the interviews were inquiry-based for the purpose of research. Third, my
participation in Inquiry II through the Organizational Change and Leadership Program at the
University of Southern California was instrumental in providing peer review for our planned
interview protocols. Finally, through Inquiry II again, practicing interviews with proposed
research questions was instrumental in setting us up for success.
Selecting the appropriate theoretical and conceptual framework ensured that the study
was reliable. According to Osanloo and Grant (2014), the theoretical framework is the blueprint
of the study, and selecting an intersectionality framework aids in grounding the examination of
women living with a disability. The intersection of those two marginalized groups provided a
framework for the study and helped to examine the conceptual framework and establish research
questions. The conceptual framework helped guide my research and interpret information based

39
on theories and beliefs (Miles & Huberman, 1994). In turn, it supported examining the research
questions and interpreting information, ensuring a comprehensive exploration for my study.
Data used for the literature review and to guide the research questions were grounded in
the literature from peer-reviewed sources. I used triangulation to increase the study’s credibility
and ensured that each source could be verified, that its substance was relevant to the research
questions, and that I took note of who provided the source (Bowen, 2009; Merriam & Tisdell,
2016). I also utilized respondent validation, a powerful tool, during the interviews to solicit
feedback from the participants about emerging findings. All of this helped validate that I was not
misinterpreting what I was hearing from the interviewees (Merriam & Tisdell, 2016). All of
those steps safeguarded the study’s reliability and credibility.
There were many steps I took to establish credibility and trust with the participants in the
interviews. First, and possibly most important, was a critical examination (Merriam & Tisdell,
2016) of myself and my positionality in regard to the subject of a woman living with MS. I
believe that being a working woman living with MS allowed the participants to feel validated
and heard, however checking my biases was crucial to having a valid study. Second, I made sure
that there was a wide variety of participants to ensure the study was purposeful and diverse
(Merriam & Tisdell, 2016), allowing for a large range of answers. Finally, conducted a
systematic review of the current literature and studies, which ensured my study was credible
(O’Leary, 2014). All of the steps outlined made for a credible and trustworthy study.
Ethics
Working with women living with MS and interviewing them to find out about their
workplace experiences of marginalization, discrimination, and belonging was something I held
with honor. The experience anyone living with MS has in the workplace is, first and foremost,

40
valid. My responsibility as the researcher was to ensure that each participant felt a sense of
psychological safety during the interview (Bogdan & Biklen, 2007). Making sure each
participant felt validated and heard brought their personal stories was at the forefront of the
research and guided this study (Patton, 2002). By prioritizing validation and active listening, I
wanted to elevate the personal stories of the women and allow their narratives to shape and guide
the study.
Before the interviews began, I outlined the purpose of the study, reviewed how the
interview flowed, and discussed what informed consent means (Burkholder et al., 2019). The
interviewees agreed to participate voluntarily by affirming with a yes before the interview began.
Each interview was private and confidential. During the interviews, there was no one in the room
or on Zoom, allowing participants to feel confident that their stories were safe (Bowen, 2009). I
stored interview transcripts and recordings on a locked, password-protected drive on my personal
computer stored in my home. My home was secured with an alarm when I was away, and the
computer was locked in a filing cabinet when I was not in my office.
The participants could have seen my living with MS as negative or positive. In the
positive sense, participants felt more comfortable sharing traumatic or harmful experiences with
someone who understands their challenges. Although MS affects every person differently and no
disease course is the same, the MS community finds comfort in others who have shared
experiences. On the negative side, those who live with MS face many challenges and barriers
and, at times, do not find comfort in sharing their experiences. Experiences are personal and can
be a hardship and embarrassing. So, sharing them with anyone is not a point of pride or
conversation. I respected, however, that all participants showed up, and I was understanding of
their experiences without agreeing or disagreeing with their lived story since I live with MS, too.

41
Limitations and Delimitations
Multiple sclerosis is an unpredictable disease, making each day different from the next.
Knowing those limitations was at the forefront of my strategy while conducting my study. I used
a set date for participants based on their schedule and the time of the day that best suited them.
Then, a day before the interview, I checked in to make sure they were feeling up for the
discussion. I sent a text or email an hour before the interview to make sure they were clearminded and wanted to proceed with the meeting with me. While some may think those extra
steps were limitations, it is the nature of the MS disease.
This study’s delimitations included the timing of the interviews, the topic of MS, and
how much I probed regarding the answers to questions. Timing was a major factor for the
women interviewees. Elements considered were the actual time of day for the interview and
whether they slept well the night before, affecting their cognitive brain function. Second,
speaking about living with MS and the experiences in the workplace was very triggering for
some of the women. Finally, related to triggering subjects, it was difficult to probe once I
received an answer because, at times, the interviewee interpreted the inquiry as negative or
intrusive to an already highly sensitive subject. Regardless of the study’s limitations or
delimitations, I ensured the interview protocol and process were prepared for all scenarios, and I
was ready to pivot. The study was approved by the University of Southern California’s
Institutional Review Board on September 15, 2023.

42
Chapter Four: Findings
Women living with MS in the workplace face obstacles to belonging and advancement.
Conducting a qualitative study of 16 women living with MS who are currently or previously
employed revealed several prominent themes guided by the following research questions:
1. What are the lived experiences of women living with multiple sclerosis (MS) in the
workplace regarding belonging, opportunity, and oppression?
2. What are the perceived ways in which gender and disability intersect, affecting the
upward mobility of women with disabilities?
First, the women often face significant challenges, including the need for
accommodations due to their condition, and they frequently feel misunderstood or marginalized
by colleagues and supervisors who may lack awareness of MS. The invisibility of MS
compounds these challenges, leading to skepticism and disbelief regarding their diagnosis,
creating a sense of isolation and frustration. Additionally, the intersectionality of gender,
ethnicity, and disability further complicates their experiences, with some perceiving disparities in
treatment compared to their male counterparts or those without disabilities.
Second, education, advocacy, and building a support network emerged as critical coping
strategies for the interviewees. They emphasized the necessity of understanding the legal rights
provided by the ADA and seeking resources and information related to their condition. They also
highlighted the value of connecting with others who share similar experiences, both within and
outside the workplace, to exchange insights, support, and potential solutions. Overall, these
themes underscore the resilience and determination of women living with MS, who navigate
complex workplace dynamics, advocating for themselves and seeking allies to help them
overcome the challenges they face due to their condition, gender, and ethnicity.

43
Framework for Research
The study used intersectionality as the theoretical framework because it is based on the
idea that individuals have multiple identities that intersect to create unique experiences and helps
to center marginalized voices. Using an intersectionality framework helped gain a deeper and
more holistic understanding of the interviewees’ experiences, allowing for more inclusive and
effective strategies to address the challenges they face in the workplace and beyond.
Intersectionality acknowledges that individuals possess multiple social identities, such as gender,
race, and disability, and that these identities intersect and interact in complex ways. To illustrate,
the gender, ethnicity, and disability of the women interviewed shaped their experiences.
Understanding how these different aspects of identity intersect helps us appreciate the challenges
and discrimination they may face due to the interplay of these factors.
Interviewees
I recruited women for the study using a flyer posted on social media, online MS
communities, and personal relationships. The following were the inclusion criteria for the
women interviewed:
• Participants must be, or identify as, a woman.
• Participants must have been diagnosed with MS by a neurologist or doctor with a
medical degree.
• Participants must be employed, full or part-time, or have previously been employed,
full or part-time.
The interviews were conducted on Zoom, which allowed for a broad geographical area to
participate. To protect the anonymity of the participant’s identifiable attributes, pseudonyms

44
replaced actual names. The following sections present an overview of the women interviewed
and highlights from their stories shared about women living with MS in the workplace. Table 2
highlights the participant demographics.
Table 2
Participant Demographic Information
Participant Age Years since
diagnosis
Ethnicity Type of MS
Anna 44 4 years White Primary
progressive MS
(PPMS)
Emma 64 38 years White Relapsing
remitting MS
(RRMS)
Emily 39 23 years Costa Rican RRMS
Grace 39 7 years Latina RRMS
Hannah 60 2 years Unspecified RRMS
Jessica 38 10 years White RRMS
Lauren 40 12 years Latina RRMS
Lily 40 20 years White RRMS
Megan 47 17 years White RRMS
Olivia 43 10 years Black RRMS
Rachel 54 23 years White RRMS
Sam 38 7 years White RRMS
Sarah 35 2 years Black RRMS.
Taylor 44 19 years Latina RRMS
Victoria 41 10 years White RRMS
Zoe 35 10 years White RRMS
Zara 24 4 years White RRMS

45
A more detailed overview of each participant’s life and information about their MS
symptoms follows.
Anna
Anna is a 44-year-old White woman who lives with primary progressive MS (PPMS),
diagnosed 4 years ago. She experiences challenges with her walking, relying on a motorized
wheelchair and accessible van. Due to her MS progression, she is no longer employed; however,
she works tirelessly advocating for MS rights and volunteers with multiple organizations. Anna
is a mother, wife, student, and sailor in the Bay Area. She believes accessibility is a love note
that lets people be seen as they are in their bodies.
Emma
Emma is a 64-year-old White woman who lives with relapsing remitting MS (RRMS),
diagnosed 38 years ago. She has a visible limp and, at times, uses assistive devices to help with
her walking. Emma holds three jobs, all of which are part-time, because she “just wants parity,
so we work; it is the equalizer.” She is always on the lookout for others who live with MS or a
disability. Emma enjoys reading, family, and music.
Emily
Emily is a 39-year-old Costa Rican woman who lives with RRMS, diagnosed 23 years
ago. She currently works remotely in the technology field, and it has been very beneficial to her
MS and walking challenges. In Costa Rica, there are very few people who live with MS, so the
population is not familiar with the disease or how it presents. Due to being unfamiliar with MS,
Emily was fired from her previous job for appearing to come to work drunk. Misaligned walking
is a classic MS symptom.

46
Grace
Grace is a 39-year-old Latina woman who lives with RRMS, diagnosed 7 years ago. She
experiences challenges with her walking, using assistive devices when needed, in her role in DEI
at a higher education institution. Grace values her work ethic and values community as a source
of empowerment. She is a firm believer that if “you take care of your community, they will take
care of you,” and that has been true for how she tackles living and working with MS.
Hannah
Hannah is a 60-year-old Canadian woman who lives with RRMS, diagnosed 2 years ago.
After serving in the police force for over 25 years, she retired early due to navigating MS
symptoms, which include fatigue, incontinence, and walking challenges. The MS diagnosis has
been particularly challenging for Hannah since it came late in her life and career. She does not
have immediate family nearby and is planning to move to the other side of Canada so she can
have more support.
Lauren
Lauren is a 40-year-old Latina woman who lives with RRMS, diagnosed 12 years ago.
Undoubtedly, her work ethic and determination to hold employment and be a mother, a wife, and
a friend are her top priorities, as she is determined to do it all. People at her job do not know
about her MS diagnosis, as she is a self-proclaimed good faker and does not have any plans to
disclose her diagnosis. She attributes her success in her career and personal life to a solid routine,
which begins with a strong morning start.
Lily
Lily is a 40-year-old woman who lives with RRMS, diagnosed 20 years ago. She is a
proud teacher, working with children most of her career, and has learned to live with her MS

47
symptoms. The community at her school has allowed her to live her truth about living with MS,
and she is an advocate for others to do the same. Family is a pillar in her life and a source of
driving determination to keep doing all the things.
Megan
Megan is a 47-year-old woman who lives with RRMS, diagnosed 17 years ago. She has
had quite the career journey, finding the right boss with whom she can live out loud with her MS.
In her previous positions, she kept quiet at work, head down, and felt it was easier that way
because of the toxic environment. Thankfully, she is in a role now that understands her needs,
and those are honored across company values. She thrives in her workplace now because they
judge her holistically and not on a day-by-day basis. Megan attributes symptom management and
ability to thrive at work to remote work, flexibility in hours worked during the day, and routine.
Olivia
Olivia is a 43-year-old Black woman who lives with RRMS, diagnosed 10 years ago. For
her, the MS stigma is real. Thus, not many people know about her diagnosis. Although sharing is
empowering to her personally and her career in DEI higher education work, the intersection of
being a Black woman living with MS and previous marginalization makes her cautious to live
out loud with her MS. She experiences challenges with her walking, fatigue, and numbness in
her body. Self-care is a value she promotes daily to help combat MS by enjoying plants, daily
affirmations, and taking care of her mind.
Rachel
Rachel is a 54-year-old White woman who lives with RRMS, diagnosed 23 years ago.
Speciosity and body numbness are two of her largest challenges with MS, and most recently (48
hours before our interview), she had four lumps removed from her breasts because they were

48
cancerous. She has experienced vast discrimination in the workplace, getting passed over for
projects and being fired from her position. She had a coffee cup thrown at the wall in front of
her, all because she is a woman living with MS. Through all of these challenges, she is a
fundraiser and advocate for the National Multiple Sclerosis Society and enjoys time with her
loving husband and dog.
Sam
Sam is a 38-year-old White woman who lives with RRMS, diagnosed 7 years ago. She
experiences troubles with her vision and has MS flare-ups that keep her out of work on occasion.
The core values at her work have cemented strong relationships and support so she can thrive as
a woman living with MS in the workplace. The environment and culture of her workplace have
played a significant role in her ability to manage her MS. They do not hire individuals who do
not live the mission and values.
Sarah
Sarah is a 35-year-old Black woman who lives with RRMS, diagnosed 2 years ago. After
weight-loss surgery, she started to show signs of MS with a troubling optic nerve and severe
fatigue. She manages her symptoms now by working remotely and flexibility in her hours.
Although she works remotely, Sarah does have to travel for work and finds it challenging, as
accommodations are not always made for her, and she is fearful to ask for too many. Sarah is
determined to work hard and “do everything any able-bodied person can do.”
Taylor
Taylor is a 44-year-old Latina woman who lives with RRMS, diagnosed 19 years ago.
She has had an extensive career in higher education and spent most of that time keeping her MS
to herself. Throughout her career, teams and bosses have not made her feel a sense of belonging.

49
She experienced harassment and discrimination when it was time for promotions in the office.
Taylor’s “best day is your worst day,” so she has learned to be a fighter with her MS, keeping to
herself and not letting others in. She was diagnosed with MS in her early 20s as she was having
dreams of pursuing a doctorate. Nineteen years later, she is a doctoral candidate at a worldrenowned university.
Victoria
Victoria is a 41-year-old White woman who lives with RRMS, diagnosed over 10 years
ago. She has had a very long road to finding the right medication for her MS and has landed on
one that is allowing her to thrive. Her current workplace provides unwavering support and wraps
her in support when she needs it. There have been small examples of marginalization from staff
members, questioning her timing on treatment, but overall, she is excelling personally and
professionally.
Zoe
Zoe is a 35-year-old White woman with RRMS, diagnosed 10 years ago. She experiences
challenges with her walking and overall weakness in her body. Over the years, she has learned to
be transparent in her needs, and working at a church has helped her Christian values shine
through in that colleagues accept her as is. Through her work in the church, she has suggested
recommendations for accommodations, but elders in the church have told her that there are some
things she cannot do because of her MS. Zoe has learned that the church is not as open to new
ideas, even for accessibility, so she finds advocates to help her forge forward.
Zara
Zara is a 24-year-old White woman with RRMS, diagnosed 4 years ago. Her mother lived
with MS, so when symptoms started her 1st year in law school, she was familiar with what was

50
happening. During her 3 years in law school, she experienced numbness, brain fog, and cognition
challenges. Despite her diagnosis during law school, she graduated on time and is now a
practicing attorney. In her current role in public interest law, she finds much support and
belonging from clients and coworkers. She has not experienced marginalization in the workplace
but did feel that she saw it more in law school when she was working through her diagnosis and
during the COVID-19 pandemic when she was questioned about her ability to keep her grades up
and thrive. Currently, she experiences numbness, challenges with her walking, and “MS hug”
around her waist.
Figure 3 is a graphic representation of keywords the participants mentioned in their
interviews.

51
Figure 3
Key Words From the Interviews
Overview of Findings: Research Question 1
Understanding the lived experiences of women living with MS in the workplace
regarding belonging, opportunity, and oppression was one of the main focuses during the
interviews. All the interviewees had a similar shared experience regarding belonging and value
in the workplace. Understanding what they experience in their day-to-day lives at work helps

52
frame recommendations to make the environment more inclusive and equitable. Three themes of
belonging, value, and marginalization emerged from the data analysis. The next sections explore
in detail how those exist, according to the interviewees.
Belonging
For women who live with MS, belonging in the workplace means being seen as is. It is a
validation that they are good enough and equal to their able-bodied peers. Anna said, “Belonging
means being recognized for her contributions to the workplace,” despite her disability, and helps
in her desire for validation of her employment. Although she is not currently able to work, when
she feels a sense of belonging in her advocacy work, she is more motivated to keep fighting.
Jessica said, “I do not want my disease to define who I am but want for people to see that I have
this disease, which can be a challenge, yet I still rise above.” Elizabeth emphasized that trust is
essential for creating a sense of belonging for people with disabilities in the workplace. Table 3
outlines what the women said about belonging in the workplace and how they gain that sense.

53
Table 3
Belonging in the Workplace
Participant name How do they see belonging?
Emma Grateful for anyone who sees me.
Emily Trust is essential for creating a sense of belonging for people
with disabilities.
Grace Desire to be acknowledged for the extra effort and adjustments
she needs to make in the workplace to her condition.
Hannah Felt included and belonged despite her because her organization
was accommodating and inclusive.
Olivia Importance of creating an inclusive work environment where all
individuals, regardless of visible or invisible disabilities, feel a
sense of belonging.
Rachel Workplace culture affects her sense of belonging and value.
Taylor Value of mentorship and support networks, where individuals can
learn from others’ experiences and share knowledge and
resources.
Victoria Community through team and leadership.
Zoe Christian values of accepting.
Of the 16 interviewees, seven have not disclosed to their employer broadly that they live
with MS. They all mentioned how important their sense of belonging was, yet they did not feel
that in the workplace. However, the women who did reveal their MS diagnosis to their employer
felt a sense of belonging through their community of colleagues, and those women received
accommodations of a flexible schedule and remote work. They also receive empathy from their
community of colleagues when they have a challenging MS day. Lauren emphasized, “that
finding a workplace where people are supported by telling their truth helps create a stronger
environment.” In turn, there will be community, and the goal will be that everyone, regardless of
their abilities, will feel like they belong.

54
The women who chose not to disclose to their employer about their MS diagnosis do
have something in common: five are women of color. In particular, Olivia pointed out that she
chose not to share because she has been marginalized and discriminated against because of the
color of her skin, so adding MS does not motivate her to disclose:
I am in a group that has been historically marginalized just being an African American,
but then also when you look at gender, too. I’ve got my village. I have my people who
are going to ensure that I’m doing what I’m supposed to be doing, so that I can live the
way that I’m supposed to be living. One day, I’m going to be just as brave to share my
story and feel like I can be heard … feel like my words can be embraced. I think because
there are so many layers of me, dealing with discrimination, me dealing with racism, me
dealing with stereotypes and all the things, this [MS] is something that I have not uplifted
so much. I see it as another layer for somebody to use to discriminate.
Rachel has told her employer about MS but believes there is no belonging because of the
workplace culture. She elaborated that “when bosses or management do not value their
employees or look over her because of her disability, she does not feel like she belongs.”
Similarly, Megan described her sense of belonging as staying quiet because it was better that
way. Megan found that working and living with MS was “playing life on hard mode,” and even
an acknowledgment of the disease or struggles would have been beneficial.
Based on the interviewees’ responses, belonging in the workplace was either the
cornerstone of their experience or not belonging was the largest hardship. Having a sense of
belonging can empower workers in their job duties and strengthen their connection to the work
environment. Without belonging, it is difficult to find value.

55
Value
Value is a currency of worth for women living with a disability in the workplace.
Research argues that when women with a disability work, it plays into the societal stereotype,
and, in turn, their status and value are lower because of it. In other words, the currency of women
living with a disability does not hold as much value or currency due simply to their disability.
During each interview, it became clear that the participants did not see value as worth in their
company. Instead, value was more about the value of employment for normalcy, stability, and
contributing to society.
The value of work helped in their quest to have a routine, which many attributed to their
successful management of balance. Megan identified the value of a routine between work and
family as a way of managing her symptoms, “If I know what to expect, so will my body.” She
also pointed out that having a structured routine helps her conserve energy and manage her work
effectively: “Routine. Routine. Routine. That’s really how I maintain everything.” Value is not
meant to be about worth when it comes to employment for women living with MS. It is about
life sustainability, according to Megan:
The one thing that I think about is how much people with MS have to sacrifice in order to
have a job. And that is something that I don’t think employers realize. I don’t think
coworkers realize it. People talk about their big plans for the weekend. Mine is just to
recuperate. So, I can do this again next week.
Lauren had a different take on value. The value comes from her Latina heritage and the
way she was raised, “I am too embarrassed to ask for help.” When I asked her about the value
she holds in the workplace, she described it more as a matter of fact in an effort to just get the job
done at all costs, “I am a hard worker and able to do it all.” Most of her coworkers do not know

56
about her MS diagnosis because she says she is a great faker and is too embarrassed to ask for
help:
I don’t think people would judge me, but I just don’t think they would understand
because they don’t understand the pain that I lived through. Maybe they’ve had similar
pains, but it’s not really the pain that I experienced, the tingling and numbness.
For women living with MS, maintaining employment can have various important
benefits, both personal and practical. The research question sought to find out what value the
women see in themselves in the workplace. However, the answers summarized more about why
work is valuable to them and not their value in the workplace.
Marginalization and Discrimination
People living with disabilities are historically the most marginalized group in American
society. Even with the passage of the ADA, inclusion and equity with able-bodied counterparts
continue to be an obstacle. The intersection of being a woman and living with a disability in the
workplace presents even more challenges. After reviewing the interview transcripts,
marginalization and discrimination were prevailing themes.
Emily lives in Costa Rica, where little is known about MS because a few hundred people
in the country have been diagnosed. Because her colleagues were unfamiliar with MS, Emily
appeared to them as “drunk at work” due to her weak legs, stumbling while walking, and even
falling to the ground when her legs gave out. At the time, she had not disclosed her diagnosis, so
she was fired, accused of showing up to work drunk. Emily also described dealing with
managers who would tell her “to go home, rest, get better,” meaning that if she took a few days
off, her MS would heal itself. Currently, she works remotely for another company and attributes

57
her success to a more supportive and healthier environment, taking on more of an advocacy role
and starting support groups:
I think, as a society, sometimes we are very quick to get scared and judge something that
we are not very familiar with. And around disability. I see a lot of people who end up
discriminating against people with disabilities. It’s not necessarily on purpose, but a lot
because they’re afraid. They don’t have the language.
Rachel’s career has been troublesome for quite a long time. Her experience with
marginalization because she is a woman and lives with MS is startling. The two jobs she most
recently held were filled with discrimination and marginalization and were troublesome, to say
the least. She described the experience of trying to get the job done while working with the “ole
boys club, like an episode of Mad Men.” There were advancement opportunities and special
projects that she believed she was passed over for because she was a woman living with MS. The
company also did not invite Rachel to meet with male clients. Rachel also recounted a time when
she had to switch medications, and the doctor needed an MRI. The day before her appointment,
her boss was angry at her and threw a coffee mug against the wall. Then, when she returned from
her appointment, she was brought into a closed-door meeting and was fired.
Olivia discussed her experiences of marginalization and discrimination through the lens
of her intersectionality as a Black woman living with MS. On top of a history of discrimination
in society and the workplace, she has not disclosed her MS openly because it could be used
against her:
Dealing with discrimination, dealing with racism, dealing with stereotypes and all the
things, MS is something that I have not uplifted so much. It’s something that I’m

58
experiencing, and I can overcome. I see it as another layer for somebody to use to
discriminate.
The experiences of marginalization spanned the spectrum for all the women interviewed.
Table 4 summarizes Emma, Emily, Grace, Hannah, Rachel, Taylor, and Zoe’s shared
experiences of marginalization. Two of the women were blatant, pointing to their diagnosis and
challenging their abilities. Others were less obvious and more of a feeling. For example, Taylor
remembered colleagues being worried they would “catch” her MS, making her feel a lack of
belonging and stereotyped in the workplace. However, after living with MS for almost 20 years,
she is happy to report, “I’m not afraid of it anymore.”
Table 4
Marginalization and Discrimination in the Workplace
Participant name How have you been marginalized or discriminated against
in the workplace?
Emma If there was an opportunity for promotions, would be
overlooked.
Emily Told she was making up MS diagnosis for attention.
Grace During job interview, she could not take the stairs and
someone from the interview committee verbally said it
was because of MS.
Rachel Unable to compete for promotions due to her abilities.
Taylor Fired from positions because of her disability.
Zoe Harassment on the job and looked over for promotions
Not asked to be on church committees.

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Accommodations
Living with a disability may require additional accommodations in the workplace to
continue employment. When asked about the need for accommodations to successfully do the
job as a woman living with MS, all participants talked about what would be a good fix or
addition, not what their employer had already done. Remote work is considered an
accommodation, but it was already a part of the job for Emily, Megan, and Sarah. While these
women reaped the benefits of remote work and managing MS symptoms, the remote work was
not provided as an accommodation. However, more flexible work schedules for Grace, Lily,
Taylor, and Victoria helped them manage their symptoms and doctors’ appointments.
When asked about specific accommodations that would make living with MS in the
workplace easier, Zoe pointed to accessible restroom facilities:
They [employer] could probably be more handicapped accessible, like parking or the
bathrooms. I think there might be one bathroom that is handicap accessible, but they’re
not really handicap accessible. There might be one handrail, but the toilet seats normal,
not raised. Same with the sinks.
Asking for appropriate accommodations to meet their specific needs is challenging
because MS presents differently. There is also a cultural stigma, depending on age or upbringing,
that asking for accommodations is seen as a weakness. Rachel noted that even getting the
courage to ask for additional accommodations is “[jumping] through hoops and filling out 2000
pieces of paper, and it makes people feel like they don’t want to do it. It’s a difficult process.”
She also talked about her age group and how asking for help is “almost frowned upon.” Lauren
said that when it comes to accommodations, “I just really feel like I’m embarrassed. I’m too
embarrassed to ask for help.” Instead, she relies on work ending when it is supposed to,

60
appropriate ranges on her driving to appointments, and taking appointments virtually. Sarah said
that accommodations need to be initial and thought out, even as simple as ensuring the workday
has breaks: “It is the pace that I struggle with.”
Disclosure
Disclosing a chronic illness at work is challenging, and adding an invisible disability can
make it even harder. Grace said disclosure in her current workplace and job interviews is
strategic:
I’m grateful that I’m in a position where I can disclose and be okay. But being
transparent about it is also another strategy. Because in the interview process, for
example, if I’m transparent about it, and they don’t receive it, well, then I know that’s not
a place for me.
She also said that disclosure is not necessarily voluntary for her because some days she can walk
freely, others when she needs a cane, and some when she cannot walk at all. Taylor decided not
to disclose her MS diagnosis because she “did not feel safe” to tell her manager because of the
stigma surrounding illness. However, when Taylor switched roles, she “was forced to go on the
record because she [her boss] started harassing me” in the workplace.
Megan highlighted the impact of choosing when and how to disclose her MS in the
workplace to ensure understanding and support was there from her employers and colleagues. In
her current job, she has unwavering support from her boss with flexible work hours, remote
work, and understanding. However, her disclosure was easier for her because she previously
worked for her boss in another role, but she noted disclosure and acceptance might not be as easy
if she had a visible disability:

61
I’ve had some friends say, and I can see where they’re coming from, life would be easier
for me with MS if I had a visible disability because the invisible folks, like, people don’t
think about it. It doesn’t occur to them from day to day. You end up being the forgotten
one, even though no day is a great day. Our baseline is so different from normal people.
Megan helped to highlight the broader theme of navigating personal boundaries and professional
relationships in the context of living with MS and the reoccurring theme from all of the women,
visible versus invisible disabilities, which makes disclosure about living with MS that much
more challenging.
Summary
The interviewees’ lived experiences provided clear answers on belonging, value, and
marginalization in the workplace. Most significant was how they interpreted the meaning of
value. The question was about their value in the workplace, but it took on a meaning of how
much they valued holding employment. They saw working as a pillar to their stability and
normalcy, something that made them equal, or normal. Working provided identity, something
they could have as theirs that was not about living with MS. On the other side, most experienced
marginalization in the workplace, yet they all compartmentalized the experiences and continued
through in their careers.
Overview of Findings: Research Question 2
The intersection of gender and disability presents a multifaceted dimension that
potentially influences the upward mobility of women living with MS. The research question
focused on examining the intersection of gender and disability, which shapes the interviewees’
lived experiences yet could significantly hinder their opportunities for advancement, both
personally and professionally. By focusing on the perceived ways in which gender and disability

62
intersect, affecting upward mobility, the goal was to establish a defined and clear guideline for
creating pathways for support and inclusion. While all the participants answered questions about
intersectionality, gender, and disability, their responses consistently revolved around themes
related to support systems and their experiences, or lack thereof, with advancement. The next
sections will explore in detail the emerging themes, according to the interviewees.
Support Systems
Support through family, community, colleagues, and online networks emerged as the
interviewees’ foundation for coping and living with MS. Of the 16 women interviewed, three
spoke of support from their direct managers or supervisors. All of the women attributed their
career stability and ability to hold employment to their support systems from their families and
communities. Oliva maintained, “My kids deserve the best of me, and family has been critical”
in her journey. Lastly, Jessica said her family, friends, and coworkers provide emotional and
practical support, encouraging other women with MS “to find some way to talk to people to help
navigate challenges.”
Jessica, Hannah, Lily, Sarah, and Zoe found online support groups beneficial in helping
to navigate daily life, questions about medication, and overall allyship. Jessica is very involved
with MS support groups and mentors women who were recently diagnosed with MS. Her
employer is very supportive of her diagnosis, so she feels empowered to give back:
I sometimes feel guilty about it [supportive employers] because I know that there’s other
people struggling with this disease, which in itself is difficult. And then not to have the
support from your employer or worry about if you’re going to get paid or keep a job. So,
I’m very involved with some MS support groups. I like to mentor people who are newly
diagnosed and active on Instagram and Twitter groups.

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Through her career in early childhood education, Lily attributes much of her continued
success with MS to her supportive family, employer, and online groups:
I’m at a really comfortable place where people come first at work and my family. When I
was hired, they said families come first; you need to take care of you. There are several
support groups on Facebook. I read those quite often, whether it be symptoms that [I]
might have with my infusions or just ways that I’m feeling. It kind of just helps me
understand there are others dealing with this because I really don’t know anybody here.
Hannah found support through her career in the police force and described it as a “tight
nit brotherhood.” She is planning to move across the country she lives in to be closer to family
since she had to retire from her 27-year career in the police force.
Career Advancement
Maintaining a job to help establish a routine and self-worth was a high priority for the
women interviewed. Out of all the women, two of the women talked about career advancement
once they were diagnosed with MS or told their workplace about MS. Even though there are
challenges in the workplace in regard to accessibility and equity, Victoria continues to advance
in her career despite their MS diagnosis. She discussed how she has taken on more
responsibilities and new positions in her current job.
Victoria works in a school system that lives by their mission and values, making her feel
support and community daily. She said what she appreciates most about her workplace is the fact
that her role and other jobs within the company are a “part of something bigger.” She said the
culture there always emphasizes “[putting] your oxygen mask on before putting it on others,”
meaning take care of yourself first, and then you can take care of your community. From her
initial diagnosis, which brings on weakness and fatigue, her company knew what challenges she

64
faced. Although she started out in the classroom, she has since been moved up to an
administrative role, working as a team for the school. Victoria continues to thrive in her job due
to the team mentality, and she “never feels alone.”
On the other hand, Megan was in a toxic work environment when she was diagnosed.
The management made it not a safe space to disclose her MS, so she kept her head down and got
the job done. She went as far as to say the culture was, “[If] you were a dull tool, you would be
replaced.” Her direct manager left the company and asked her to go with him, which helped
change her career. She now works remotely full-time, has flexible hours, and is part of a
dynamic team, which is a huge help as she noted, “our baseline [living with MS], is so different
than normal people.” In her current role, she is able to work more freely on a team and can live
openly with her MS while being a mother and avid advocate.
Stories of career advancement were not plentiful during the interviews but did shine
when they were told. Jessica works in higher education as a chief diversity officer at a major
institution and continues to climb in her career. She attributes her success to “openness about
what she needs from her employer, encouraging others to write out their needs” so they are on
paper and there will not be a need to repeat themselves. Other women interviewed did see
changes in their careers but did not receive promotions to higher positions. Instead, they received
accommodations. Most of the women did not indicate that they had hopes of career
advancement. Instead, they hoped to maintain their current positions with modifications to
support living with MS. Those modifications, outlined in Table 5, as indicated by Emily, Grace,
Megan, Olivia, Taylor, and Zara, include remote work, flexible hours, and advocacy.

65
Table 5
Accommodations in the Workplace
Participant name What accommodations have been made?
Emily Remote and flexible work.
Grace Flexibility at work. Access to mobility needs at
work and off-site retreats.
Megan Remote and flexible work.
Olivia Remote work.
Taylor Flexibility at work. Human Resources education.
Zara Remote and flexible work.
Summary
The intersection of gender and disability did not show significant proven disparities
among the interviewees. Many of them said they felt like it was a factor in career advancement,
but only one pinpointed an example. Instead, the notion of support within their community
emerged as a theme for continued success. While women continue to strive to reach a level
playing field alongside their male counterparts, currently, it is inconclusive if the intersection of
gender and disability affects career advancement for those living with MS. Instead, the women
were happy with the accommodations their employer made.

66
Chapter Five: Recommendations
The intersection of gender and disability poses distinct challenges for women living with
MS in the workplace. Despite the growing emphasis on disability rights and workplace
inclusivity, women with disabilities continue to confront significant barriers to employment and
a sense of belonging at work. This qualitative study sought to explore how the intersectionality
of gender and disability affects the employment experiences of women living with MS. The
following research questions guided the study:
1. What are the lived experiences of women living with multiple sclerosis (MS) in the
workplace regarding belonging, opportunity, and oppression?
2. What are the perceived ways in which gender and disability intersect, affecting the
upward mobility of women with disabilities?
Based on the research questions, the study used intersectionality as a framework to guide the
research as the theoretical framework because it recognized that individuals have multiple
identities that intersect to create unique experiences and help center marginalized voices. Using
the intersectionality framework, I explored how the combination of gender and disability affects
women’s employment experiences and how those experiences may differ from those of women
without disabilities.
In addition, the intersectionality framework highlighted how different forms of
discrimination interacted and contributed to the marginalization of women with disabilities in the
workplace, preventing them from career advancement, affecting their well-being, and decreasing
their sense of belonging in the workplace. Using Crenshaw’s (1989) intersectionality framework
to evaluate and understand the challenges women living with a disability face in the workplace to

67
belonging and advancement, key concepts emerged from the literature and research study as the
conceptual framework:
• Belonging: A person’s abilities in the workplace are viewed as a currency (meaning
their work holds value), and women living with a disability are viewed to have less
value or currency in their workplace (Klein, 2022).
• Marginalization and discrimination: Women living with a disability feel marginalized
in the workplace, resulting in a lack of belongingness and motivation (Koch et al.,
2021).
• Value: Working and holding a job allows women with a disability to have a positive
identity and meaning (Saunders & Nedelec, 2013).
• Career advancement: Women living with a disability continue to experience
constraints on career advancement and inclusion (Brown & Moloney, 2019).
• Support systems: There is an overwhelming lack of support for women living with a
disability in the workplace, and advancement is challenging (Wilson-Kovacs et al.,
2008).
The findings suggest that women living with MS often face significant challenges,
including the need for accommodations due to their condition, and they frequently feel
misunderstood or marginalized by colleagues and supervisors who may lack awareness of MS.
Additionally, the intersectionality of gender, ethnicity, and disability further complicates their
experiences, with some perceiving disparities in treatment.
Furthermore, the interviewees emphasized the importance of education, advocacy, and
the establishment of a support network as vital coping mechanisms. They highlighted the
significance of connecting with individuals who have faced similar challenges, both within and

68
beyond the workplace, to exchange ideas, offer support, and explore potential solutions. In sum,
these recurring themes underscore the unwavering resilience and determination of women living
with MS as they navigate intricate workplace environments. These women advocate for
themselves and actively seek allies to assist them in overcoming the obstacles arising from their
condition, gender, and ethnicity.
Summary of Findings
The interviews of 16 women revealed narratives of strength and desire to overcome
obstacles of belonging and advancement in the workplace due to them being a woman living
with MS. Each of the women has varying living experiences, but the common themes of
yearning to belong in the workplace and how much value the women place on employment for
stability in their lives. Furthermore, the perceived ways the women revealed their
intersectionality of gender and disabilities affecting their careers revolved around support
systems and challenging their career advancement. They also experienced marginalization and
discrimination because of their intersectionality. The next sections will review the major findings
and results from the research questions.
Sense of Belonging
Feeling a sense of inclusion, regardless of the setting, fosters a secure and nurturing
environment that enhances the well-being and overall quality of life for women. According to
Baumeister and Leary (1995), belonging is a cornerstone for human needs and colleagues’
acceptance of one’s disability serves as a source of “identity and feelings of normality”
(Saunders & Nedelec, 2013, p. 100). Emily noted, “There is nothing wrong with you having
something [a disability]. It’s just another characteristic. Women living with a disability want to

69
be seen in the workplace but also acknowledge that they do live with challenges that need to be
addressed. Anna said that “accessibility is like a love note saying we want you here.”
The participants desire to feel as though they belong as valuable members of the team.
According to Koch et al. (2021), one of the leading obstacles women living with a disability face
is a sense of belongingness in the workplace. The research revealed that, in order to feel like they
belong, the inclusion of their voices in decisions about their jobs and how they meet their goals is
important. “Not only being at the table but being an active participant” makes women living with
MS feel a sense of belonging, according to Grace.
Finally, a sense of belonging provides motivation. When people do not feel a sense of
belonging in their work environment, it can cause a lack of motivation (Mejias et al., 2014).
When the women discussed their sense of belonging, those who felt a sense of belonging coupled
the sentiment with motivation, loyalty, and trust. Those characteristics build a sense of
belonging, and when workplaces do not have it figured out: “It’s having the humility to work
things out once you realize they’re not working,” Emily said, which helps to motivate and build
trust.
Research and literature suggest that providing accommodations aids in building a strong
sense of belonging. Implementing remote work, flexible working hours, and assistance with
planning the needs for accommodations were the themes that the research pointed to. Women
living with a disability are often overlooked, creating a feeling of not belonging and
marginalization in the workplace in part due to a lack of accommodations to support their needs
(Kwon & Archer, 2022). With accommodations in the workplace, there is a stronger sense of
community and comradery. Lily said it also makes you “realize that you’re not the only one with
stuff going on. … It’s a morale booster.”

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Sense of Value
Work holds significant value for women living with MS. The research indicates that
having a job gives women with MS a sense of purpose, enabling them to contribute to their
chosen field, establish a daily routine, and make a positive impact. Crooks et al. (2009)
concluded that maintaining paid work after the onset of MS is important and beneficial to
identity and specifically found that adopting flexible schedules was central to maintaining
employment for women living with MS in the workplace. Implementing and accommodating
women who live with MS flexible work hours and remote options helps maintain value to them
by signaling an understanding of the daily challenges they face.
Accommodations of remote work and a flexible schedule made up the Number 1 finding
that helped the participants find daily balance to maintain employment. Sarah’s manager worked
with her in a previous role and recruited her to her current position with the added benefit of
fully remote work. She finds it very beneficial to work remotely because “when one to two
o’clock comes around, I feel like I’m a dead woman walking. I just don’t have any gas left in the
tank.” She also established a flexible working schedule with hours that work for her, which
“allow[s] me to be successful.” The combination of remote work and flexible working hours can
be critical for women living with MS to continue employment, “I do not know if I would be able
to maintain this level of productivity if I was in an office setting,” Sarah noted.
Flexibility in working hours is helpful for symptoms of MS and productivity. The
research suggested that allowing women options to best suit their most productive working hours
made them feel a greater sense of belonging and value. Megan said, “Give a little wiggle room to
get the most out of your talent.” Jones (1997) outlined workplace strategies to ensure women
living with disabilities will thrive, including providing accommodations according to needs.

71
The women were clear about the need for remote work and flexible schedules to aid in
getting medical care, balancing work and personal lives, and self-efficacy. Noonan et al. (2004)
stated that employers must identify barriers in their policies and advocacy work to help maintain
and build self-efficacy (Lent et al., 2000; Swanson & Woitke, 1997). The higher women’s selfefficacy is, the higher their sense of value in the workplace will be. Chapter One defined
belonging as a subjective feeling of value and respect derived from a reciprocal relationship
(Mahar et al., 2013). When a workplace works in partnership with a woman requesting flexibility
in work accommodations, it increases their sense of value and belonging.
Marginalization and Discrimination
This study uses the term discrimination to mean organizational practices that
differentially treat or affect employees who belong to a protected class (Colella & King, 2018).
According to the research, the feeling of fear or unknowingness about disclosing their MS
diagnosis for concern of discrimination was a key finding from the interviews, affecting their
upward mobility in the workplace. The worry about stigma or ableism from colleagues and
employers was at the forefront of the decision not to disclose their diagnosis. Olivia did not
initially disclose her MS diagnosis, so she was questioned about where she parked her car by the
onsite security. She “had to share with someone who did not earn the opportunity to hear about
this [MS diagnosis],” which eventually led to her disclosing to human resources.
Vitturi et al. (2022b) study on fear about disclosing their MS diagnosis stemming from
not wanting to be discriminated aligned with the research. Zoe was hesitant to request
accommodations in her workplace for fear it would “fall on deaf ears.” Emma saw other
colleagues who lived with disabilities get passed over for promotions. She believed it was
because her workplace saw “different people with different abilities [so] people switch the

72
channel. They don’t want to look at it.” To combat discrimination and marginalization in the
workplace, Rumrill et al.’s (2015) study indicated that 96.5% of participants said they would like
to be educated on dealing with discrimination at work.
Recommendations for Practice
Considering how to make the workplace better for women dealing with both gender and
disability, especially those with MS, it’s crucial to think about how they can feel a stronger sense
of belonging and better accommodations according to their needs. The study focused on
producing practical suggestions for creating an inclusive and accessible environment. For women
living with MS, the goal was to understand their challenges through lived experience and
propose ideas that fit their specific needs. By looking closely at how they can feel a sense of
belonging and have better access, the research aims to contribute real, actionable ways to
improve the lives of women living with MS. By recognizing the distinct needs, the next section
outlines recommendations from the interviews that align with the literature from Chapter 2 to
support women living with MS in the workplace.
Recommendation 1: Create Mentorship and Support Groups
Implementing workplace strategies to ensure women living with MS will thrive,
increasing their sense of belonging, including hosting and supporting mentoring/sponsorship
programs (Jones,1997). Additionally, Noonan et al. (2004) concluded that there are strategies
that can be adopted for women living with a disability that could improve the workplace
experience. The strategies begin with external factors, those that the employers could implement
to create an environment of belonging and inclusivity: connecting women living with a disability
with mentors, creating a network of women supporting women (inclusive of all abilities and
disabilities), and encouraging a strong and supportive relationship with friends and family

73
outside of the workplace (Noonan et al., 2004). These strategies continue to be the strongest
ways to promote inclusivity and congruency (Ivey & Dupré, 2022; Kulkarni et al., 2018; Mejias
et al., 2014; Noonan et al., 2004), and it aligns with the findings of the women interviewed in the
study.
Recommendation 2: Establish Remote and Flexible Work
Establishing a remote or hybrid working plan for women living with MS establishes
several advantages. The findings indicate that remote work, which includes flexibility in working
hours, was the number one theme for women living with MS. Remote and flexible work can
contribute to a more inclusive work environment by breaking down physical barriers that may
cause limitations. Remote work allows them to participate fully in professional activities,
contributing to a more diverse and inclusive workforce (Crooks et al., 2009). Finally, remote
work can contribute to a better work-life balance by giving women living with MS the flexibility
to manage their personal and professional lives. This balance is critical for overall well-being,
which can positively impact mental and emotional health (Saunders & Nedelec, 2013) and aligns
with the findings of the research.
Recommendation 3: Create Better Accommodations
Accommodations in the workplace play a crucial role in equity, fostering a supportive
work environment, and promoting the overall well-being of women living with MS. According
to the literature and findings from the research, women living with MS do not believe their
workplaces are equipped with accommodations to contribute to their success or physical
challenges. When workplaces prioritize an environment that accommodates women living with
disabilities, it enables them to fully contribute their talents and expertise (Wilson-Kovacs et al.,
2008). Accommodation for disabilities contributes to less discrimination in the workplace

74
(Randolph, 2005). When workplaces partner with women living with MS to create
accommodations, it helps to address barriers to belonging, takes away the need for selfadvocacy, and shows the desire to make changes (Randolph, 2005).
Recommendation 4: Create Training for Dealing With Discrimination
Understanding and addressing discrimination in the workplace towards women living
with MS creates a more inclusive and equitable work environment. The findings indicate that the
women interviewed experienced varying degrees of discrimination and marginalization.
Educating women on dealing with discrimination in the workplace helps them take their power
back and recognize when it is happening (Rumrill et al., 2015). Strategies to ensure women
living with MS thrive in the workplace included programs for able-bodied colleagues on
diversity training for all staff and training for persons with disabilities (Jones, 1997).
Additionally, employers should collaborate with human resources to ensure the
workplace creates a culture of inclusion and acceptance through anti-bias training and mentoring
programs (Kulkarni et al., 2018). Support and programs indicate a commitment by the workplace
to employees’ career advancement as a pillar of their culture (Wilson-Kovacs et al., 2008).
Establishing and implementing discrimination training in the workplace is a proactive step
towards fostering a culture of understanding, respect, and equity, ultimately benefiting women
with MS and contributing to a more positive and inclusive work environment.
Implementation of Recommendations
To proactively make change in an organization, based on recommendations, using a
change model is beneficial because it provides a structured framework that helps in planning,
implementing, and managing the change process effectively. Various change models can help
guide organizations through the complexities of change, ensuring that all aspects are considered

75
and nothing is looked over from all levels within the organization. Granularly, changing models
results in outlined structured communication, reduced resistance from workers in the
organization, and understanding and commitment among stakeholders. It also helps benchmark
progress.
The Burke-Litwin model of organizational performance and change, developed by
George H. Litwin and W. Warner Burke, is a comprehensive framework designed to analyze and
understand the intricacies of organizational systems. Rooted in the idea that organizational
performance is a result of the relationship of numerous factors, the model identifies 12 key
dimensions, spanning from external environment and leadership to organizational culture and
structure. The Burke-Litwin model acknowledges the intricate and interconnected nature of these
factors, emphasizing the significance of both individual and shared foundations in shaping
organizational structure and outcomes. Figure 4 is the original Burke-Litwin’s model of
organizational performance and change, and Figure 5 overviews the inclusive workplace
transformation model for women living with MS, adapted from Burke-Litwin’s model of
organizational performance and change. Figure 4 is the original Burke-Litwin model, which
identifies the elements needed for change to happen. Within the model, 12 factors that are critical
to success are highlighted. Figure 5 uses the original Burke-Litwin model with findings from the
research from Chapter Four.

76
Figure 4
Burke-Litwin’s Model of Organizational Performance and Change
Note. Adapted from “Causal Model of Organizational Performance and Change” by W. Burke,
Warner & G. H. Litwin, 1992. Journal of Management. https://www.mindtools.com/auj0r0y/theburke-litwin-change-model

77
Figure 5
Inclusive Workplace Transformation Model Adapted From the Burke-Litwin model
The inclusive workplace transformation model integrates findings from the research to
create a comprehensive approach that addresses the unique needs of women living with MS,
aligning with the organizational change framework. The components of the inclusive workplace
transformation model are as follows:
• External environment: Inclusive policies and regulations. Establish policies that
solely support disability inclusion, complying with current regulations. This includes

78
anti-discrimination policies, reasonable accommodation procedures, and accessibility
laws.
• Transformational factors
• Leadership commitment: Guarantee visible and committed leadership support
for disability inclusion initiatives. Leadership sets the tone for the entire
organization and plays a crucial role in fostering an inclusive culture.
• Diversity and inclusion training: Implement training programs that raise
awareness about disability-related issues, including MS.
• Transactional factors
• Accessibility Infrastructure: Invest in infrastructure to ensure workplace
accessibility. This includes accessible workspaces, technologies, and
communication channels to accommodate employees with diverse abilities.
• Flexible work policies: Develop and implement policies that support flexible
work arrangements, allowing women who live with MS to balance their work
and personal needs.
• Performance: Metrics and measurement. Establish metrics to monitor the
effectiveness of disability inclusion initiatives. Regularly assess key performance
indicators related to diversity, employee satisfaction, and the success of
accommodations.
• Individual factors
• Employee support groups: Encourage the formation of support groups that
specifically focus on disability inclusion. The groups will provide a platform

79
for employees to share experiences, offer support, and contribute to shaping
inclusive policies within the workplace.
• Mentorship programs: Facilitate mentorship programs that connect employees
with disabilities to mentors within the organization.
• Task requirements: Job accommodations. Establish a streamlined process for
requesting and implementing reasonable accommodations. Ensure that employees
with MS have the tools and support they need to perform their jobs effectively.
• Informal organization:
• Inclusive culture: Foster an inclusive organizational culture where diversity is
celebrated. Encourage open communication and a sense of belonging for all
employees.
• Recognition and rewards: Integrate disability inclusion into employee
recognition and rewards programs. Acknowledge and celebrate contributions
made by employees with disabilities.
By aligning findings from the research with the Burke-Litwin model, the inclusive
workplace transformation model provides a structured and comprehensive approach to
integrating disability inclusion into the organizational fabric. This model emphasizes the
importance of leadership commitment, infrastructure development, and a supportive cultural
environment to drive meaningful change toward a more inclusive workplace for women living
with MS. To incorporate the suggestions in the workplace, according to Kirkpatrick and
Kirkpatrick’s model, it is essential to evaluate and benchmark each component as specified in
Table E1 of Appendix E.

80
Recommendations for Future Research
Most literature on women living with MS in the workplace focuses on general women’s
intersectionality: gender and disability. Research on the intersectionality of women of color
living with MS continues to be sparse. An area for future research includes examining how their
sense of belonging and career advancement are even more limited due to their race, gender, and
disability status. Their narratives will provide insights into themes of discrimination, belonging,
and advancement not represented in the current literature. A further area for future research
would be a qualitative study on the support systems of women living with MS. Analysis of the
support systems will provide insights into strategies, best practices, and training that could be
implemented in the workplace to enhance sense of belonging. Future research on women living
with MS in the workplace can contribute to understanding their challenges and needs and the
development of effective interventions.
Conclusion
The findings from interviews with 16 women living with MS in the workplace reveal
significant challenges, such as the need for accommodations and feelings of misunderstanding or
marginalization due to a lack of awareness about MS among colleagues and supervisors. The
intersectionality of gender, ethnicity, and disability further complicates their experiences, with
some perceiving disparities in treatment. The interviewees stressed the importance of education,
advocacy, and establishing support networks as vital coping mechanisms.
Themes of resilience and determination emerged, emphasizing these women’s advocacy
for themselves and their active seeking of allies to overcome obstacles related to MS and gender.
The women expressed a desire for belonging in the workplace, highlighting the importance of
inclusion, voice participation in decision-making, and accommodations in fostering a sense of

81
belonging. The research suggests that providing accommodations, such as remote work and
flexible hours, is crucial in building a strong sense of belonging for women living with MS in the
workplace.
Women living with MS derive significant value from employment, as it provides them
with a sense of purpose, a daily routine, and the ability to make a positive impact. Maintaining
paid work is crucial for their identity, with flexible schedules being central to employment
retention. The implementation of accommodations, such as remote work and flexible hours, is
identified as vital in helping these women find daily balance and sustaining employment. Remote
work and flexible schedules not only address the challenges posed by MS symptoms but also
enhance overall productivity and a sense of belonging. The research underscores that
accommodating women’s needs for remote work and flexibility is essential for medical care,
work-life balance, and self-efficacy, ultimately contributing to their sense of value in the
workplace. On the flip side, concerns about discrimination and marginalization pose challenges,
leading to hesitancy in disclosing MS diagnoses due to fear of stigma or ableism. Instances of
discrimination, such as being questioned about parking or witnessing colleagues with disabilities
being overlooked for promotions, highlight the need for education on dealing with workplace
discrimination to foster a more inclusive and supportive environment for women living with MS.

82
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Appendix A: Interview Protocol
Respondent type: Women living with multiple sclerosis who are or have been employed
(full or part-time).
Introduction to the Interview
Hello, and welcome! My name is Meredith Jaggard, and I am conducting this study as
part of my dissertation in the Organizational Change and Leadership (OCL) Program at the
University of Southern California. The purpose of this interview is to gain a deeper
understanding of the experiences of women living with multiple sclerosis (MS) in the workplace,
particularly focusing on the barriers they face in terms of belonging and advancement.
I am particularly interested in exploring the intersectional challenges faced by women
with MS, considering both their gender and their disability. By shedding light on these
experiences, we hope to identify the specific barriers that hinder their sense of belonging within
the workplace and the opportunities for career advancement that may be limited due to societal,
structural, or attitudinal factors. By sharing your insights, perspectives, and personal encounters,
we can collectively work towards creating a more inclusive and supportive work environment for
women living with MS.
To ensure accuracy and thoroughness, I request your permission to record this interview
by Zoom or my phone. This will allow me to capture all the details and nuances of our
conversation, ensuring that your valuable insights are accurately documented. Please note that
the recording will be used solely for the purpose of analysis and will be treated with strict
confidentiality and anonymity.
Additionally, if you have any questions about the interview process or the study itself,
please feel free to ask. Once again, I want to express my sincere gratitude for your participation.

100
Your contribution will significantly contribute to enhancing our knowledge and understanding of
the challenges faced by women living with MS in the workplace.
Conclusion to the Interview
Thank you so much for sharing your valuable insights and experiences during this
interview. Your openness and willingness to discuss the challenges faced by women living with
MS in the workplace have provided a deeper understanding of the barriers to belonging and
advancement that exist within our society.
Your contributions will help inform and guide efforts to create a more inclusive and
supportive work environment for women living with MS. By identifying the barriers and
limitations, we can work towards implementing changes at the structural, policy, and attitudinal
levels to foster an environment where women with MS can thrive, succeed, and feel a sense of
belonging.
I would like to express my sincere appreciation for your time, openness, and willingness
to participate in this study. Your insights will not only
contribute to academic research but also have the potential to impact real-world practices
and policies.
If you have any further questions or if there is anything else you would like to share,
please do not hesitate to reach out. Your ongoing engagement and feedback are highly valued as
we continue to delve into this important topic.
Once again, thank you for your invaluable contribution, and I wish you continued success
in your personal and professional journey.

101
Research Questions
1. What are the lived experiences of women living with multiple sclerosis (MS) in the
workplace regarding belonging, opportunity, and oppression?
2. What are the perceived ways in which gender and disability intersect, affecting the
career experiences of women with disabilities?
Table A1
Interview Protocol
Interview questions Potential probes
RQ
addressed
Key concept
addressed
Can you describe your
sense of belonging in the
workplace as a woman
living with MS?
Tell me more. RQ1 Belonging,
marginalization,
value
In what ways do you
perceive oppression or
discrimination in the
workplace as a woman
with MS?
How did that make you
feel?
Are there any specific
instances or patterns of
mistreatment that you
have experienced or
observed?
RQ1 Discrimination,
marginalization,
ableism
How do you envision
overcoming the barriers
to belonging and
opportunity?
Tell me more. RQ1 Belonging,
challenges, barriers
Have you found any
resources or support
networks that have been
particularly helpful in
navigating issues of
belonging, opportunity,
or oppression?
Describe those in more
detail.
RQ1 Support, belonging
How do you think policies
could address or be
changed to promote a
more inclusive and
equitable workplace?
Tell me more.
Describe what success
looks like.
RQ1 Marginalization,
belonging

102
Interview questions Potential probes
RQ
addressed
Key concept
addressed
What types of
accommodations or
support have you found
helpful in overcoming
the barriers associated
with living with MS in
the workplace?
What specific
accommodations or
support did you
receive?
How did they impact your
experience?
RQ1 Support, Belonging
Can you tell me about any
times when stereotypes
or biases have affected
your professional life?
How did you feel when
you encountered that
specific barrier?
RQ1 Support, belonging,
ableism
In your experience, how do
the attitudes and
behaviors of your
colleagues and
supervisors impact your
ability to thrive in the
workplace as a woman
with MS?
How did you navigate or
cope with that situation?
RQ1 Belonging,
marginalization
Have you suggested any
recommendations or
changes to your
employer to better
support women living
with MS?
How did you
communicate your
needs or concerns to
your employer or
colleagues?
RQ2 Support, belonging
In what ways do you
believe gender
stereotypes or biases
create barriers for
women with disabilities
in their careers?
How did you manage the
emotional impact of the
barriers or
discrimination you
encountered?
RQ2 Discrimination,
belonging
Describe any differences in
the experiences of
women with disabilities
compared to men with
disabilities.
How did you navigate or
cope with that situation?
RQ2 Discrimination,
advancement,
marginalization
Are there any strategies or
coping mechanisms that
women with disabilities
employ to navigate the
challenges they face in
their careers?
Can you share any lessons
or insights you have
gained from your
experiences that could
be beneficial to other
women with disabilities
in the workplace?
RQ2 Belonging,
advancement,
support

103
Appendix B: Recruitment Email
The following is the email to potential participants with a survey to find out if they
qualify for the study.
Subject: Invitation to Participate in a Groundbreaking Research Study on Women Living
with MS in the Workplace
Dear [participant’s name],
I hope this email finds you well. My name is Meredith Jaggard, and I am a doctoral
student at the University of Southern California. I am reaching out to you today with a unique
opportunity to be a part of a significant research study aimed at understanding the experiences of
women living with multiple sclerosis (MS) in the workplace and their barriers to a sense of
belonging and advancement.
Multiple sclerosis is a complex neurological condition that affects millions of people
worldwide, and we believe that understanding the challenges faced by women with MS in the
workplace is crucial for creating a more inclusive and supportive environment for them.
I believe that your insights and experiences could make a substantial contribution to my
study. Your perspective will help shed light on the issues that many women with MS encounter
daily and pave the way for meaningful change.
Study details:
• The research study aims to explore the various challenges and barriers faced by
women living with MS while navigating their professional lives.
• To be approved for the study, participants are asked to take a confidential and
anonymous online survey, which should take approximately 2 minutes to complete.

104
• Your responses will be handled with the utmost confidentiality, and your personal
information will be kept strictly anonymous to ensure your privacy.
• The findings from this study will be used for academic purposes only, and any
publication or presentation will be devoid of any identifying information.
Benefits of participation: By taking part in this study, you will not only contribute to
advancing our understanding of the experiences of women living with MS in the workplace but
you will also play an essential role in raising awareness of the challenges they face. I am to help
employers and policymakers implement more effective strategies to foster a sense of belonging
and support for women with MS.
Should you have any questions or concerns about the study or the survey, please do not
hesitate to contact me at mjaggard@usc.edu. I am more than happy to provide any clarification
you may need.
I hope you will consider participating in this study. Your valuable input will make a
significant impact in advancing our knowledge of this important topic. Together, we can create a
more inclusive and accommodating workplace environment for women living with MS.
Thank you for your time and consideration.
Warm regards,
Meredith Jaggard
Doctoral Student, Organizational Change and Leadership
University of Southern California
mjaggard@usc.edu

105
Appendix C: University of Southern California Information Sheet
My name is Meredith Jaggard, and I am a student at the University of Southern
California. I also hold a role as Executive Director of the UC Law San Francisco Alumni
Association.
I am conducting a research study on the barriers women living with MS face in the
workplace to belonging and advancement. The name of this research study is Beyond the Glass
Ceiling: Understanding the Intersecting Challenges of Women with Disabilities in the
Workplace. I am seeking your participation in this study.
Your participation is completely voluntary, and I will address your questions or concerns
at any point before or during the study.
You may be eligible to participate in this study if you meet the following criteria:
1. Participants must identify as a woman.
2. Participants must live with multiple sclerosis.
3. Participants must be employed, full or part-time, or have previously been employed,
full or part-time.
4. You are over 18 years old.
If you decide to participate in this study, you will be asked to do the following activities:
1. Participate in a 1:1 online interview over Zoom for 45–60 minutes.
I will publish the results in my dissertation. Participants will not be identified in the
results. I will take reasonable measures to protect the security of all your personal information.
All data will be de-identified prior to any publication or presentations. I may share your data, deidentified with other researchers in the future.

106
If you have any questions about this study, please contact me: mjaggard@usc.edu. If you
have any questions about your rights as a research participant, please contact the University of
Southern California Institutional Review Board at (323) 442-0114 or email irb@usc.edu.

107
Appendix D: Recommendation for Benchmarking Success
The timing for implementing the recommendations will vary, as depicted in Table E1.
Table D1
Timing for Recommendations From Components of the Inclusive Workplace Transformation
Model
Recommendation Timing
Inclusive policies and regulations Quarterly
Leadership commitment Yearly
Diversity and inclusion training Quarterly
Accessibility infrastructure Yearly
Flexible work policies Yearly
Metrics and measurement Quarterly
Mentorship programs Quarterly
Job accommodations Quarterly
Inclusive culture Yearly
Recognition and rewards Yearly

108
Appendix E: A Priori Coding Template
Appendix E: A Priori Coding Template
Research question Area of conceptual
framework
(priori code)
Code
(thematic codes)
Participants
What are the lived
experiences of women
living with multiple
sclerosis (MS) in the
workplace regarding
belonging, opportunity,
and oppression?
Value Be heard/seen 16/16
See disability
Belonging I do not see me. 16/16
Work twice as hard
Accommodations
Marginalization Looked over 6/16
Having to do the same as
others
Equity
What are the perceived
ways in which gender
and disability intersect,
affecting the upward
mobility of women with
disabilities?
Ableism Fired for being sick 5/16
Expectations as able-bodied
Discrimination No time off for doctor 6/16
Rest and get better
Forced to disclose.
Advancement Looked over 8/16
Not capable
Other findings Accommodations Remote work 16/16
Flexible hours
Job tasks
Disclosure Not easy process 10/16
Do not trust HR
Worried about repercussions
Advocacy Need better tools 8/16
Training for staff

109
Research question Area of conceptual
framework
(priori code)
Code
(thematic codes)
Participants
If I do not advocate, who
will?

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Asset Metadata

Creator Jaggard, Meredith Anne (author)

Core Title Enduring in silence: understanding the intersecting challenges of women living with multiple sclerosis in the workplace

School Rossier School of Education

Degree Doctor of Education

Degree Program Organizational Change and Leadership (On Line)

Degree Conferral Date 2024-05

Publication Date 04/30/2024

Defense Date 02/15/2024

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag belonging,career advancement,Disability,disability critical race theory,disability rights,gender,intersectionality,multiple sclerosis,OAI-PMH Harvest,workplace challenges

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Tobey, Patricia (committee chair), Haskins, Theresa (committee member), Malloy, Courtney (committee member)

Creator Email meredithjaggard@gmail.com,mjaggard@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113911945

Unique identifier UC113911945

Identifier etd-JaggardMer-12873.pdf (filename)

Legacy Identifier etd-JaggardMer-12873

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Format theses (aat)

Rights Jaggard, Meredith Anne

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