The LGBT Health & Development Program

Research Blog—Why Marriage Equality Matters to Your Health

Posted on June 26th, 2015 by IMPACT in Featured, Research Blog. No Comments

Written by Stephen Whitfield, IMPACT intern.

two brides

Photo Credit: Guy of Taipei, “Buddhist Same-Sex Marriage in Taiwan,” August 11, 2012

Marriage equality means that two people of any sex or gender (which are not the same thing) may get legally married. As of June 26th, 2015, the Supreme Court has recognized that the Constitution protects this right. Besides being a big step forward for civil rights, this ruling can also help LGBT Americans live longer, healthier lives.

One important link between marriage and health is that it’s easier to get health insurance on your partner’s plan if you’re legally married [1]. People with health insurance are generally healthier than people without it [2]. This is likely because insured people are more willing to go to the doctor, since it costs less, and may thus access care earlier, before problems get more serious.

Some other benefits of marriage impact health through financial effects. A few major examples include the following:

  • Protected time off from work to take care of a sick spouse
  • Social Security’s survivors’ benefits (government support for families of deceased workers)
  • Multiple tax breaks

These legal differences have historically contributed to greater financial burdens on same-sex couples. For example, a Williams Institute study found that children in households headed by same-sex couples are nearly twice as likely as children of married different-sex couples to be poor [3].  A report last year by the Movement Advancement Project identified unequal marriage laws as one of the main factors causing such inequalities [4].

This economic burden, in turn, can lead to poor health. The mechanisms by which financial difficulties affect health are debated, but likely include poorer lifestyle and reduced access to care [5]. Decades of research implicate lower wealth as a risk factor for death from many causes, including heart and lung diseases and many cancers [5]. For example, between 1979 and 1989, the life expectancy for white men with household incomes under $10,000 was 6.6 years shorter than for those with household incomes greater than $25,000 [5]. In short, denying the full financial benefits of marriage to LGBT families put their health at risk.

However, not all the health effects of marriage are related to money. Studies show that married people, regardless of sexual orientation, experience less depression and anxiety than people in unmarried couples [6].

Of course, marriage is a personal choice, and not right for everyone. However, even people who don’t choose to get married may experience better health with the reversal of same-sex marriage bans.

As we discussed in a previous blog, sexual minority men in Massachusetts made 13% fewer medical and mental health visits in the year after marriage equality was instituted than in the year before, suggesting improved mental and physical health [7]. The effects were equal for those who stayed single. One explanation might be that unequal treatment by the law creates stress, a known risk factor for many illnesses.

With the Supreme Court’s historic decision, our laws no longer deny LGBT couples more than 1000 legal benefits long granted to heterosexual couples. Striking down these inequalities has removed a major threat to the health of LGBT people all over the country. It’s no wonder that so many medical groups, from the American Medical Association, to the American Academy of Pediatrics, to the American Congress of Obstetricians and Gynecologists, have issued statements in support of marriage equality.

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[1] Ponce, N., Cochran, S., Pizer, J., & Mays, V. (2010). The Effects of Unequal Access to Health Insurance for Same-Sex Couples in California. Health Affairs, 1539-1548. doi:10.1377/hlthaff.2009.0583.

[2] Wilper, A. P., Woolhandler, S., Lasser, K. E., McCormick, D., Bor, D. H., & Himmelstein, D. U. (2009). Health Insurance and Mortality in US Adults. American Journal of Public Health, 99(12), 2289–2295. doi:10.2105/AJPH.2008.157685.

[3] M.V. Lee Badgett, Laura E. Durso, and Alyssa Schneebaum. (2013, June). New Patterns of Poverty in the Lesbian, Gay, and Bisexual Community. The Williams Institute. Retrieved June 10th, 2015, from

[4] Movement Advancement Project and Center for American Progress. Paying an Unfair Price: The Financial Penalty for Being LGBT in America (condensed version). (2014, November 24). Retrieved May 27, 2015, from

[5] Smith, J. P. (1999). Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status. The Journal of Economic Perspectives : A Journal of the American Economic Association, 13(2), 144–166.

[6] Fingerhut, A., & Maisel, N. (2010). Relationship formalization and individual and relationship well-being among same-sex couples. Journal of Social and Personal Relationships, 27(7), 956-969. doi: 10.1177/0265407510376253.

[7] Hatzenbuehler, O’Cleirigh, Grasso, Mayer, Safren, & Bradford. (2011). Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment. American Journal of Public Health, 102(2), 285-291. doi: 10.2105/ajph.2011.300382


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