WEDNESDAY, June 26 (HealthDay News) -- In a landmark decision
regarding gay rights, the U.S. Supreme Court effectively ruled
Wednesday that California's ban on same-sex marriages can't remain
The high court's 5-4 decision was limited to the California ban,
which became law in November 2008 after a five-month period when
gay marriages were legal in the state. The justices ruled that the
ban's architects didn't have the right to appeal lower court
rulings striking down the prohibition of same-sex unions.
In a related decision Wednesday, the Supreme Court ruled that
partners in gay marriages have the same right to federal benefits
that heterosexual couples receive.
California officials will likely use the Supreme Court ruling to
allow the resumption of same-sex marriages in about a month's time,
according to published reports.
Wednesday's decision has no impact on laws in other states
banning same-sex marriages.
Right now, gay marriage is legal in the District of Columbia and
a dozen states, including Massachusetts, Minnesota, New York and
Washington. A few other states legally recognize civil unions or
domestic partnerships, but the majority of states -- three dozen in
all -- have bans on same-sex marriage.
Whatever happens going forward, a growing body of research
suggests that state laws on gay marriage have implications for
people's mental and physical health.
When people think of the health aspect of the gay marriage
debate, they think of concerns like access to health insurance,
said Brian Mustanski, associate professor of medical social science
at Northwestern University Feinberg School of Medicine in
"People usually get the health insurance issue, but the idea that stigma [related to bans on gay marriage] has direct health effects is something that people may never have considered," Mustanski said.
Richard Wight, a researcher at the University of California, Los
Angeles School of Public Health, said his research has suggested
that legal unions, particularly marriage, could be a boon to gay
and bisexual people's mental health. In a study published in
December, Wight's team found less "psychological distress" among
same-sex couples in California who got married in the short time
window in 2008 when gay marriage was legal in the state.
That was in comparison to gay, lesbian and bisexual Californians
who were not in legalized unions. There were no major mental health
differences between same-sex couples in legal unions and their
married heterosexual counterparts, Wight said.
That was also true of gay people in domestic partnerships, which
have been an option for same-sex couples in California since 2000.
But marriage, in particular, showed a stronger statistical link to
better mental health, he said.
"This shows us there is something going on there," Wight said. You can't conclude, from those findings alone, that the right to marry boosts gay people's mental health, he noted. But his team did try to factor in some of the "usual suspects" in mental health -- such as age, income and education -- and the link between legal unions and less distress remained.
The findings, which appeared in the
American Journal of Public Health, were based on a statewide
survey of more than 47,000 Californians. It gauged people's
psychological distress by asking them how often they'd felt
nervous, hopeless, restless or depressed in the past month.
In general, people in legal unions -- whether same-sex or
heterosexual marriage, or domestic partnerships -- fared better
than single people, regardless of sexual orientation. But the
highest distress levels were seen among gay, lesbian and bisexual
Californians not in legal unions.
A limit of the study, Wight acknowledged, was that it was
conducted at one point in time. So it's not clear what the survey
respondents' mental health was like before they got married or
entered a domestic partnership. Maybe happier people -- straight or
gay -- are more likely to settle down.
But Mustanski said there's also evidence from long-term research
that the option to marry affects gay Americans' health.
He pointed to a 2010 study by Columbia University researchers
that surveyed nearly 35,000 Americans for about five years. During
that time, some U.S. states instituted bans against gay
The study found that after those bans took effect, rates of
anxiety, depression and alcohol use increased among gay, lesbian
and bisexual residents. Generalized anxiety disorder -- which
refers to chronic worry and tension -- more than doubled in
In contrast, psychiatric disorders either held steady or rose a
much smaller degree among heterosexuals living in those states.
"I think that's the most compelling evidence we have that there are negative health effects," Mustanski said.
As for why a ban on gay marriage would affect people's mental
well-being, Mustanski thinks such laws "send a message that you're
a second-class citizen."
"We know that stigma is bad for people," he said. "That's something I think any human being can identify with."
A number of medical groups, including the American Psychological
Association and the American Medical Association, have said that
barring same-sex couples from civil marriage has negative health
effects. And earlier this year, the American Academy of Pediatrics
(AAP) threw its support behind gay marriage, saying it's in the
best interests of children of same-sex couples.
Not everyone agrees with the endorsements of gay marriage.
Loren Marks, a professor at Louisiana State University,
published a review last year in
Social Science Researchthat criticized much of the evidence
base for the AAP and other groups' stance on children's well-being.
It said that of 59 widely cited studies, almost half looked only at
children raised by same-sex couples and had no "heterosexual
comparison group." And in many other studies, researchers compared
same-sex couples' children with those raised by single mothers.
Ryan Anderson, a fellow at the conservative think-tank the
Heritage Foundation, pointed to Marks' findings as one example of
the flaws in research looking at children of same-sex parents.
"The science on this is still in its infancy," Anderson said, adding that it's "premature" for scientific groups to support gay marriage based on that research.
"What we do know from years of social science data," Anderson said, "is that children tend to do best when they're raised by their two biological parents -- not just two parents."
He added that while research on single mothers gives some idea
of how children fare with no father, there's little data on "what
it's like to grow up without a mom."
As for whether marriage, itself, has benefits for gay adults'
well-being, the jury is still out, Wight acknowledged. Studies have
looked at heterosexual married couples for decades, but there is
relatively little data on same-sex couples.
Based on what's known from research on heterosexuals, both
married couples and lifelong singles tend to fare best as far as
mental and physical health, according to Wight. "It's the people
who are divorced, separated or widowed who are worst off," he
Of course, those are generalizations, Wight stressed. Someone
stuck in a bad marriage may well be worse off than someone who got
out of a bad marriage.
But whether marriage is a health boon or not, Wight said that at
least having the option to marry could be good for gay and lesbian
Americans' well-being. "If there are laws that are actually harmful
to mental health, as the evidence suggests, then that's a public
health issue," he said.
The U.S. Centers for Disease Control and Prevention has more on
lesbian, bisexual and transgender health.