Marriage Equality and LGB Health: What’s at stake in the Supreme Court rulings on same-sex marriage


As I dutifully changed my Facebook profile picture last week to a pink and scarlet equality sign in order to demonstrate my solidarity with the marriage equality movement, I came across surprising reactions from some of my friends. One friend, who I know to be a staunch supporter of LGBTQ rights, snidely remarked in a status update, “THE SUPREME COURT CAN’T HEAR YOU.” I was so bothered by this status update, not because I questioned her commitment to gay rights, but because I realized that this crucial moment in history might be trivialized by flippant, albeit well-meaning, online declarations of support.

I began to worry that in these emotionally charged debates about fairness and equality, concepts that are admittedly somewhat difficult to quantify, the notion of what is right is overshadowing the reasons why it is right. While the feelings in the pit of my stomach tell me that these laws are grossly unjust, evidence is what may ultimately be necessary to prove to key policymakers that these laws are also wrong. We cannot lose sight of the fact that these bans on same-sex marriage create very real and very serious negative health consequences for hundreds of thousands of LGB individuals and families. So, what I really want to talk about today are the ways in which bans on same-sex marriage directly impact the health of a class of citizens who already experience tremendous health disparities that will only be amplified by the proliferation of same-sex marriage bans.

Research has compared and analyzed the health outcomes of same-sex couples in states with legal gay marriage and states with various forms of bans on gay marriage. The results of this research found that health disparities exist at many levels for individuals, couples, and their children. In terms of mental health, same-sex marriage bans can lead to detrimental outcomes for LGB individuals. A 2012 study found that in states with same-sex marriage bans, LGB individuals experienced substantially increased mood disorders and double the rates of generalized anxiety disorder (Kertzner, 2012). LGB individuals also had a 41% increased risk of alcoholism if they lived in a state that bans same-sex marriage (ibid). These disparities are largely linked to the minority stress associated with feelings of systemic prejudice that can result from living in a region that passes laws (overtly or tacitly) seeking to delegitimize a person’s identity (Buffie, 2011).

Some argue that states should decide when, how, and if to confer legal marital status to gay couples. I ask that people first consider the effects that these state-by-state ballot initiatives themselves can have on LGB individuals. Maisel and Fingerhut found that LGB individuals living in states with ballot initiatives (regardless of whether or not the ballots passed) had higher levels of depression in comparison to LGBs in states without a ballot initiative that year (2011). Continuing to let states debate legitimacy and legality of same-sex marriage unnecessarily subjects gay individuals, couples, and their families to psychological trauma that can last for months or years of an election cycle.

The negative health effects of same-sex marriage bans extend beyond mental and emotional effects, affecting physical health and risk behaviors as well. One recent study found that bans on same-sex marriage were positively associated with higher syphilis rates (Francis, Mialon, and Peng, 2011). These findings may indicate that the minority stress imposed by same-sex marriage bans can influence health behavior and place sexual minorities at higher risk for certain sexually-transmitted infections (ibid).

Notably, many of the negative mental and physical health effects mentioned above were reversed in states where gay marriage is now legal, demonstrating that laws affirming same-sex marriage can lead to rapid health benefits for LBG individuals and couples (Kaplan, 2013).

While it isn’t the whole story, health equity is an undeniable component of our Constitutional rights to equal protection under the law. After considering the mental, emotional, and physical health effects at stake during these monumental Supreme Court cases, I once again looked at my friend’s status. My friend was right, of course. The Supreme Court can’t hear you, me, or any of the thousands of people who continue to fight for equal recognition and relationship legitimacy to be granted to the LGB community. The Supreme Court and the politicians involved in creating these laws may not be able to hear me, but I’ll keep shouting because, at the very least, I know that my gay and lesbian friends can and do hear me. As a straight ally who is fully prepared to march in the streets for this cause, I will use every outlet at my disposal to demand marriage equality and fight for these basic human rights.


Buffie, W. C., M.D. (2011). Public health implications of same-sex marriage. American Journal of Public Health, 101(6), 986-90. Retrieved from

Francis, Andrew M., Mialon, Hugo M. and Peng, Handie, In Sickness and in Health: Same- Sex Marriage Bans and Sexually Transmitted Infections (September 20, 2011). Emory Law and Economics Research Paper No. 11-97. Available at SSRN: or

Kaplan, K. (2013, March 26). Fate of same-sex marriage cases likely to influence public health. Los Angeles Times. Retrieved from,0,7958325.story.

Kertzner, R. M. (2012). A Mental Health Research Perspective on Marital Rights and Civil Marriage for Lesbians and Gay Men. Journal of Gay & Lesbian Mental Health, 16(2), 136-145.

Maisel, N. and Fingerhut, A (2011). California’s Ban on Same-Sex Marriage: The Campaign and its Effects on Gay, Lesbian, and Bisexual Individuals. Journal of Social Issues. 67 (2). 242-263.


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