Laws that prevent same-sex couples from getting married deprive them of many benefits and privileges that heterosexual married couples have under federal and state laws. Thus, bans on gay marriage are examples of institutional discrimination- societal-level conditions that constrain the opportunities, resources, and well-being of socially disadvantaged groups. Despite the existence of multiple forms of institutional discrimination toward lesbian, gay, and bisexual (LGB) populations, few studies have examined the consequences of this form of discrimination for the mental health of LGB populations. A new study by my colleague, Mark Hatzenbuehler, and his collaborators does just that.
The study was published in this month's issue of American Journal of Public Health. Researchers analyzed data from LGB individuals who were interviewed in 2001-2002 and 2004-2005 for the National Epidemiologic Survey on Alcohol and Related Conditions. Because this is a national study, some of the participants lived in states that instituted constitutional amendments banning gay marriage following the 2004-2005 elections. Other participants lived in states where there was no change in the status of gay marriage.
The study found that Psychiatric Disorders, defined by the Diagnostic and Statistical Manual of Mental Disorders IV, increased significantly between waves 1 and 2 among LGB respondents living in states that banned gay marriage for the following outcomes: any mood disorder (36.6% increase), generalized anxiety disorder (248.2% increase), any alcohol use disorder (41.9% increase), and psychiatric comorbidity (36.3% increase). In other words, there was more than a doubling in anxiety disorders among LGB people in states that passed anti-gay marriage laws. The scientists were able to rule out two alternative explanations for the pattern besides the direct effect of gay marriage bans on mental health. First, these psychiatric disorders did not increase significantly among LGB respondents living in states without constitutional amendments, which helps to rule out the possibility of the result being due to a national trend towards decreasing mental health in LGB individuals. Second, they found no evidence for increases of the same magnitude among heterosexuals living in states with constitutional amendments, which rules out the possibility that all individuals in those states were trending towards lower mental health.
This is a landmark study for the understanding of how social conditions impact the health of minority people because it used national longitudinal data that allowed them to observe changes in mental health linked to the timing of a major policy change.
According to a press release by the senior author, Dr. Deborah Hasin, "Before this study, little was known about the impact of institutional discrimination toward lesbian, gay and bisexual (LGB) individuals in our society. The study highlights the importance of abolishing institutional forms of discrimination, including those leading to disparities in the mental health and well-being of LGB individuals."
Some of my previous blog postings have discussed some of the benefits that come to same-sex couples under legal recognition of their committed relationships. This study adds evidence that banning the recognition of such relationships may cause harm to LGB individuals. There is no evidence of harm to non-LGB people when such relationships are legally recognized. Again I ask, why not allow same-sex marriage?
Photo credit: Kurt Löwenstein Educational Center International Team from Germany.