Will same-sex marriage make America healthier?

A few weeks ago, Carlos Santos-Herrera was in a hospital bed, ill with a rare, severe form of strep throat. He was weak, but conscious – and worried. His family members’ religious beliefs differ from his own, and he didn’t want to leave decisions about his care in their hands.

His partner, David Herrera-Santos, was unable to make any decisions on his behalf because they weren’t legally married, and couldn’t be in their home state of Georgia, where same-sex marriage wasn’t legal.

“He was powerless. Completely powerless,” Santos-Herrera said. “The hospital would not recognize David as my partner – only as a ‘friend.’ “

He survived the medical scare, but it was on his mind last week when the pair embraced as newlyweds on the steps of an Atlanta courthouse. After a Supreme Court decision made same-sex marriage legal in all 50 states, David and Carlos married and are now able to enjoy legal benefits including decision-making power in health care and changes to their health insurance.

They believe these changes will help keep them healthier and less stressed, but what about the rest of the country? Will same-sex marriage make America healthier?

The short answer, experts said, is yes.

“Absolutely same-sex marriage will make America healthier – that’s what all the medical literature says,” said Dr. William C. Buffie, a physician at St. Francis Hospital in Indianapolis, Indiana, who researched public health implications of same-sex marriage.

Happy marriages can improve health

Little research exists specifically about same-sex marriages, and because it’s challenging to determine the number of people who identify as gay, lesbian or bisexual, it’s not clear how many people will be affected by Friday’s Supreme Court ruling.

But numerous studies have shown that a happy heterosexual marriage gives individuals a health boost, including better access to health care, longer life spans, and lower rates of depression – and, Buffie said, that applies to same-sex marriage, as well.

“As it relates to health outcomes, same-sex couples benefit from marriage in the same way as opposite sex couples,” Buffie said.

Numerous scientific associations, including the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics have acknowledged potential health benefits that same-sex marriage confers to individuals and families.

Some of the groups tweeted their support Friday:

Those health benefits are becoming clear in states where same-sex couples already had legal marriage status, researchers found. Same-sex couples who were married reported significantly better mental well-being, including less anxiety and depression.

People in same-sex marriages also benefit from improved access to employer-provided health care, according to a 2013 study from the University of Minnesota.

Although the tax and economic benefits could be substantial, the Supreme Court’s ruling will do more than provide couples with an official piece of paper, said Richard Wight, a researcher in the community health sciences department at UCLA’s Fielding School of Public Health.

“In one fell swoop we can now see the same mental health benefits of marriage for same sex couples as heterosexual couples,” Wight said.

“The main reason there is a benefit to being in a legally recognized marriage is that it introduces a level of stability into a relationship. This is going to help change the social climate. Hearing the Supreme Court say this is OK will help couples feel like they’re part of regular society.”

Not all marriages are perfect, and relationship problems such as domestic abuse and divorce are harmful to mental health for all people. Same-sex couples divorce at a lower rate than their heterosexual counterparts, according to a 2014 analysis by the Williams Institute. This particular study looked at marriage data in the year following the Supreme Court’s strike down of the Defense of Marriage Act, and the study’s authors said this wasn’t surprising, as many couples had waited years to marry.

Facing unique health challenges

The legalization of same-sex marriage might reduce other stressors more common in the lives of gay, lesbian and bisexual people, as well.

Those who identify as gay, lesbian, or bisexual generally experience higher rates of anxiety, depression, and suicide than heterosexual people. But marriage actually reduces these health disparities: Heterosexual people and those in same-sex marriages had nearly equal levels of psychological distress, according to a California study.

“Same-sex marriage has the potential to offset the health differences between heterosexual and sexual minority persons,” said Wight, who led the study.

People who identify as gay, lesbian or bisexual experience what is referred to as “minority stress,” according to Buffie’s paper about the public health implications of same-sex marriage. Minority stress results in a struggle for validation and acceptance, which “reinforces the chronic, everyday stress that interferes with optimal human development and well-being.”

Legalized same-sex marriage will reduce this particular type of stress, according to Buffie’s research.

Making same-sex marriage the law of the land could even provide a health boost to gay, lesbian, and bisexual people who aren’t getting married. Mood elevation, an increase in self-esteem, and a confidence boost are just a few of the positive health effects sexual minorities could experience after the Supreme Court’s decision, according to psychologist Wendy Walsh.

“When you get the legal and political stamp of approval on your identity, this endorses your very sense of self,” Walsh said.

Newlyweds Carlos Santos-Herrera and David Herrera-Santos were actually packing for a trip to Florida to get married on Friday when they heard the news about the Supreme Court decision.

“When we heard the news, I jumped up, and I started screaming,” Santos-Herrera said. “I called (my fiancé) up and said: ‘We need to get married now. Forget about Florida.’ ”

The couple, joined by a family member and a friend, jumped into their car and drove to an Atlanta court to make their commitment official in the eyes of the law.

“I’ve been waiting many, many years for this,” Santos-Herrera said, “and now I have the same rights as everybody else.”