I've found three main ways in which artists make art. The first is to show people what the world is like: you observe the world around you and translate it into something that others can experience secondhand. Audiences from the world you're describing might find your art relatable. Audiences not from that world can get a glimpse into it and build empathy for the people in it.
The second way is to show people what the world should be like. You can show who you are by adding your own commentary to a state of affairs. In some cases, you must first identify the unidentified and name the unnamed so that others can understand what's wrong, so they can help take action against situations they previously didn't realize require change.
The third way to make art is to create new worlds. This method is probably the hardest because you have to do things that haven't been done before. If you push right up against the boundaries of what's commonly accepted, sometimes you can break through those boundaries and forge new paths, leaving others to follow in your footsteps. Sometimes creation evolves naturally from showing people how the world should be. Sometimes it develops on its own, separate from any hope of action on the existing world, because you've found that this world is broken beyond repair.
I feel like the third method is more intuitive for artists who are on the margins of mainstream society, because it's imperative for them to create their own worlds to belong in, worlds they feel safe in. They push against the boundaries of acceptability because society has already forced them to those edges. Their continued survival depends on their resourcefulness and ability to expand the tiny margins in which they are allowed to exist.