Same-Sex Marriage May Be Good For Gay, Lesbian, And Bisexual Health

Several studies have found that when laws permitting same-sex marriage are passed, the health outcomes of sexual minorities in the local area seem to improve. This holds true for indicators of both physical and psychological well-being. Here's a review of the most provocative evidence to emerge so far supporting this idea:

First, a 2012 U.S. study found that, in the state of Massachusetts, there was a significant decrease in the number of visits made by gay and bisexual men to healthcare providers for both medical and mental health issues in the year after same-sex marriage was legalized in that state [1]. This effect was not specific to men in relationships—rather, there seemed to be an across-the-board health benefit for all sexual minority men. Why? Perhaps because legalized same-sex marriage reduced stigma and stress for the entire gay and bisexual community, not just those who were partnered (for more details on this study, see here). However, this study did not look at women and it only considered effects over a one-year period.

A 2013 study out of Denmark built on these limitations by tracking mortality rates of 6.5 million adults in that country between the years 1982 and 2011 [2]. Researchers looked at how living arrangements (i.e., single, cohabiting, married) and sexuality were associated with death rates over nearly three decades. Denmark is the perfect country for a study like this because it has provided at least some degree of legal recognition for same-sex relationships since 1989.

Results indicated that as more time has passed since Denmark started recognizing same-sex relationships, death rates for persons in same-sex marriages (both male and female) have dropped. This wasn't because death rates were dropping for all groups either—in fact, death rates increased for certain groups (e.g., single and divorced men). So, in other words, as same-sex marriage has become more embedded in Denmark's culture, married persons in same-sex relationships seem to be living longer.

Finally, a brand new study utilizing national U.S. data looked at how introduction of state laws permitting same-sex marriage were associated with suicide attempts among LGB high school students [3]. This study focused on data from 32 states that implemented same-sex marriage between 2004-2015 and compared suicide rates from before and after introduction of these laws.

The main finding was that introduction of same-sex marriage was associated with a 7% reduction in the proportion of students who had attempted suicide in the past year. The decrease in suicide attempts occurred primarily among LGB-identified youth.

Of course, all of these data are limited in that none of them necessarily demonstrate cause-and-effect. In other words, we're dealing with correlational data here. In addition, it's important to note that, while LGB health appeared to improve following introduction of these laws, sexual minorities still had worse health outcomes overall compared to heterosexuals. In other words, even if same-sex marriage is good for LGB health, you can't call it a cure for the health disparities affecting sexual minorities.

That said, the news from these studies is still encouraging because it suggests that as acceptance of and equality for sexual minorities increases, their health may very well stand to improve.

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[1] Hatzenbuehler, M. L., O’Cleirigh, C., Grasso, C., Mayer, K., Safren, S., & Bradford, J. (2012). Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment. American Journal of Public Health, 102, 285-291.

[2] Frisch, M., & Simonsen, J. (2013). Marriage, cohabitation and mortality in Denmark: National cohort study of 6.5 million persons followed for up to three decades (1982-2011). International Journal of Epidemiology.

[3] Raifman, J., Moscoe, E., Austin, S. B., & McConnell, M. (2017). Difference-in-differences analysis of the association between state same-sex marriage policies and adolescent suicide attempts. JAMA pediatrics.

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