Historically, racial-ethnic identities were considered peripheral to forensic evaluations. In the last several decades, however, forensic practitioners developed a fuller appreciation regarding the richness and complexity of intersecting identities including race and gender. The first major section of his chapter addresses in depth on how culture helps to shape psychotic presentations. It also captures how discrimination and structural racism can lead to psychosis and other forms of psychological impairment. The second major section features the Cross Ethnic-Racial Identity Scale–Adult as an effective measure cutting across racial-ethnic identities with valuable data on African Americans, Asian Americans, European Americans, and Hispanic Americans. It includes white racial identity and colorblind racial attitudes. The third and final major section focuses on test adaptation for clinical and forensic measures. This undertaking represents a formidable challenge in translating and independently validating measures for specific languages and cultures.