Same-sex marriage improves the health of gay and bisexual men, even if they are not themselves married, according to new research conducted in Boston. It also reduces their healthcare expenditures.
"We've known for decades that marriage is good for health and longevity among heterosexual men; this extends it to sexual minority men as well," said Mark L. Hatzenbuehler, a Columbia University researcher and lead author of the study that appeared in the American Journal of Public Health.
It looked at the healthcare records of 1211 gay and bisexual men who visited the Fenway Health clinic at least once in the 12-month periods both before and after the Supreme Judicial Court of Massachusetts legalized same sex marriage.
The men "experienced a significant decrease in their medical and mental healthcare visits compared to the twelve months before the law changed. That resulted in a 13 percent reduction in healthcare visits and a 14 percent reduction in healthcare costs," Hatzenbuehler said.
The mean expenditure decreased by more than $300, from $2442.28 to $2137.38. The decrease was particularly striking because it occurred during a period in which average healthcare expenditures increased by 8 percent a year in the United States.
Looking at the most common reasons for visits to the clinic; there was a decrease in visits for general medical care, hypertension, and sexually transmitted infections. On the mental health side, there was a decrease in diagnoses of depressive, anxiety and adjustment disorders.
Perhaps surprisingly, one did not have to be married in order to benefit. The 40 percent of men in a partnered relationship and their single peers showed similar gains.
Hatzenbuehler attributes it to lifting the social stigma of marriage discrimination that affects both groups of men. Social discrimination contributes to stress and anxiety, which negatively affects the physical and mental health of those who experience that discrimination.
Attempts to overturn the marriage decision were still ongoing during the second year of the study. It is tempting to hypothesize that these activities served to perpetuate a sense of discrimination and stress, and that even greater health benefits might be seen at a later time point after those right wing challenges were completely laid to rest.
Hatzenbuehler agreed, but pointed out some of the difficulties of conducting longer-term research. Among them is a weakening causal link between the timing of the court decision and the observed effect.
"Because of the uncertainty [during that first year], you might expect an increase in anxiety disorders. But the fact that we are finding a reduction strengthens our case," he said.
The men in the study ranged in age from 18 to over 65, though most were 26-45. They were broadly representative of the gay and bisexual population in Massachusetts that has been found in other studies, but they were slightly younger and better educated.
Lesbians were not included in the study because there was an insufficient number with visits to the clinic at those two time points. However, he says previous studies suggest that the conclusions would hold true for them as well.
