A new study published in the American Journal of Public Health provides insightful research suggesting that gay men were able to lead healthier, less stress-filled lives when states offer legal protections to same-sex couples (Hatzenbuehler et al., 2011).  The study showed that in the 12 months following the legalization of same-sex marriage in Massachusetts, gay and bisexual men had a significant decrease in medical care visits, mental health care visits, and mental health care costs, compared with the 12 months before the law changed. The study examined the frequency of visits of 1,211 participants, both before and after the legalization of marriage in Massachusetts (2003).  This research is unique in that data before a "natural" event were available for analysis.  Most natural events do not provide such pre-event data to sufficiently document the change following a natural event, in this case the passing of the Massachusetts same-sex marriage law.

The study found "a significant decrease in medical care visits (13%) and costs (10%) and in mental health care visits (13%) and expenditures (14%)."  The lead researcher, Mark Hatzenbuehler at Columbia University, suggested that one possible explanation is a reduced level of stressors that sexual minority men experience when institutionalized forms of stigma are eliminated, such as the passing of the same-sex marriage law.  These stressors are associated with hypertension, depression, and adjustment disorders, all of which showed reductions in frequency of associated medical visits and treatment costs after the marriage law passed. It is important to note that HIV-related visits remained unchanged-suggesting that the reported reduction did not affect routine or HIV-related costs. Also, it is notable that the benefits were similar for single gay men, not only those that were partnered.

As the U.S. continues to struggle with the societal burden of rising health care costs, "These findings suggest that marriage equality may produce broad public health benefits by reducing the occurrence of stress-related health conditions in gay and bisexual men," according to Dr. Mark L. Hatzenbuehler, lead author of the study. 

Some have claimed the research is flawed because Hatzenbuehler and his colleagues neglected to consider the declining economy or lack of affordable healthcare.  The study did only include "individuals with data at both time points (i.e., those patients with at least one health care visit in the 12 months before and after same-sex marriage was legalized)."  Controlling for contextual effects like these are extremely difficult in psychological and epidemiological research.

For more information about same-sex couples in the United States, visit the map of census data at the Williams Institute.  For more information about law pertaining to equal rights for relationships of same-sex couples, visit the Human Rights Campaign.  

What do you think?  Could same-sex marriage laws increase the physical and mental well-being of the LGBT community?

Dr. Mustanski is the Director of the IMPACT LGBT Health and Development Program. You can follow the Sexual Continuum blog by becoming a fan on Facebook.  I periodically live tweet from research conferences on sexuality and you can follow me @sexualcontinuum.

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