Same-sex marriage: Does it improve health?

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One of the less-frequently explored questions relating to the marriage equality debate around the world is: will same-sex marriage improve health? Pink Families examines this further.

Same-sex marriage: Some of the issues

Legal and financial entitlements

Many same-sex couples are currently denied the rights that many different-sex married couples are entitled to. Civil unions usually only provide comparable rights to those that are married. Civil unions therefore help address some of the imbalance, but they don’t result in the same rights.

The classic example to illustrate the difference between the rights of those that are married and those that aren’t is the case where one woman outlived her same-sex partner. As a consequence, the bereaved partner had to pay at least $363,053 (US dollars; £185,000) in taxes. The only reason she had to pay these taxes was because her partner was a woman. She sued and the court agreed. This challenged the Defense of Marriage Act (DOMA) in the US. This case and others have highlighted some of the rights that same-sex couples are denied due to marriage not being a federally sanctioned right.

But in addition to financial and legal entitlements, what are the health benefits to be gained from getting married to your same-sex partner?

Same-sex marriage: Some of the potential health benefits

1. Health insurance and better health outcomes

The first health benefit relates to access to quality care that in turn will lead to better health outcomes. For example prior to the repeal of DOMA in the US, the US federal benefits didn’t allow for health insurance to be extended to unmarried partners. Now that DOMA has been repealed, this option will be available to same-sex married couples.

Presently in the US, lesbians and gay men that are not married are significantly less likely to have health insurance as compared to straight husbands or wives. The federal legalization of same-sex marriage may help address this.

This means that the legalization of same-sex marriage may lead to lesbian women and gay men having better access to health care. In turn, this will most probably lead to better health outcomes.

2. Enjoying a healthier lifestyle

The second potential benefit relates to healthier lifestyles. For example, one study has shown that when marriage is legal, gay men go to their doctor less frequently. It might be that when same-sex marriage is legal, same-sex couples enjoy a healthier lifestyle.

3. Better psychological health

The third benefit relates to psychological health. Many experts agree that there are psychological benefits to be gained by having a long-term partner that you are married to. In the academic literature, marriage is sometimes described as a buffer to mental stress. Most health authorities around the world state that people who are married have an advantage over those that are divorced or those who are single.

4. In the best interests of the children

In addition, same-sex marriage may assist the children of same-sex couples. Evidence shows that children have similar developmental and emotional needs, regardless of the sexual or gender orientation of their parents. Enduring and supportive relationships with adults help children develop and grow. The institution of marriage can help support the enduring nature of same-sex relationships.

This means that legalizing same-sex marriage may aid the cognitive, psychological, physical, emotional and social health of our children. Therefore, it is in the best interests of the children for same-sex partners to have the choice of whether or not to be married.

5. Reduced mortality

The fifth benefit relates to reduced mortality. Marriage has long been known to be associated with a reduction in the number of deaths in a population. (This is referred to as mortality.) A large Danish study has now confirmed this beneficial effect for men who are in a legally recognized committed relationship with another man. Denmark implemented the world’s first national law on registered same-sex partnerships in 1989. Same-sex marriage became legal in Denmark in 2012.

The study showed that same-sex male couples in a legally recognized union now have mortality rates that are lower than those of unmarried or divorced men. In other words, marriage may help men who marry men to live longer.

6. National health surveillance and development

The sixth benefit relates to the development of health care services and systems that will improve the health of same-sex couples and their families. Once same-sex unions are legalized, the health of populations can be properly monitored.

For example, the large Danish study showed that female same-sex couples were at increased risk of mortality, most notably from suicide and cancer. Morten Frisch, the lead author of the study, said, “Lesbians may constitute a largely unnoticed high-risk population for suicide and breast cancer, so our findings call for efforts to identify the underlying factors responsible and ensure access to basic health care in this population”.

This study shows how the collection of health data at a population level can help identify the health needs of lesbian, gay and bisexual people. Therefore, legalizing same-sex marriage also has the potential to help nations improve the health of all of their citizens, including lesbian, gay and bisexual citizens who wish to marry their same-sex partner.

References

Committee on Psychosocial Aspects of Child and Family Health. Promoting the Well-Being of Children Whose Parents Are Gay or Lesbian. Pediatrics 2013;131(4):827-830.

Frisch M. Simonsen J. 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 2013;1–20.

Kamerow D. Does Gay Marriage Improve Health? BMJ 2012;345:e8586.

In this video below Hilary Clinton shares her view on marriage equality and how important it is to achieve equality for all citizens. The video is from The Human Rights Campaign.

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