Same-sex legal marriage and psychological well-being: findings from the California Health Interview Survey.

OBJECTIVES We examined whether same-sex marriage was associated with nonspecific psychological distress among self-identified lesbian, gay, and bisexual adults, and whether it had the potential to offset mental health disparities between lesbian, gay, and bisexual persons and heterosexuals. METHODS Population-based data (weighted) were from the 2009 adult (aged 18-70 years) California Health Interview Survey. Within-group analysis of lesbian, gay, and bisexual persons included 1166 individuals (weighted proportion = 3.15%); within-group heterosexual analysis included 35 608 individuals (weighted proportion = 96.58%); and pooled analysis of lesbian, gay, and bisexual persons and heterosexuals included 36 774 individuals. RESULTS Same-sex married lesbian, gay, and bisexual persons were significantly less distressed than lesbian, gay, and bisexual persons not in a legally recognized relationship; married heterosexuals were significantly less distressed than nonmarried heterosexuals. In adjusted pairwise comparisons, married heterosexuals had the lowest psychological distress, and lesbian, gay, and bisexual persons who were not in legalized relationships had the highest psychological distress (P < .001). Psychological distress was not significantly distinguishable among same-sex married lesbian, gay, and bisexual persons, lesbian, gay, and bisexual persons in registered domestic partnerships, and heterosexuals. CONCLUSIONS Being in a legally recognized same-sex relationship, marriage in particular, appeared to diminish mental health differentials between heterosexuals and lesbian, gay, and bisexual persons. Researchers must continue to examine potential health benefits of same-sex marriage, which is at least in part a public health issue.

[1]  David Grant,et al.  Exploring nonresponse bias in a health survey using neighborhood characteristics. , 2009, American journal of public health.

[2]  I. Meyer.  Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. , 2003, Psychological bulletin.

[3]  I. Meyer.  Prejudice as stress: conceptual and measurement problems. , 2003, American journal of public health.

[4]  G. Herdt,et al.  I do, but i can’t: The impact of marriage denial on the mental health and sexual citizenship of lesbians and gay men in the United States , 2006 .

[5]  R. Detels,et al.  Stress and mental health among midlife and older gay-identified men. , 2012, American journal of public health.

[6]  Sarah J. Erickson,et al.  Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: results from a prospective study of bereaved gay men. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[7]  E. Riggle,et al.  Psychological distress, well-being, and legal recognition in same-sex couple relationships. , 2010, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[8]  D. Hasin,et al.  State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations. , 2009, American journal of public health.

[9]  D. Hasin,et al.  The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: a prospective study. , 2010, American journal of public health.

[10]  I. Nazareth,et al.  A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people , 2008, BMC psychiatry.

[11]  C. Aneshensel.  Social Stress: Theory and Research , 1992 .

[12]  M. Hatzenbuehler,et al.  How does sexual minority stigma "get under the skin"? A psychological mediation framework. , 2009, Psychological bulletin.

[13]  M. Badgett.  Social Inclusion and the Value of Marriage Equality in Massachusetts and the Netherlands , 2011 .

[14]  C. Aneshensel,et al.  Depressive symptoms: how do adolescents compare with adults? , 2004, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[15]  D. Frost,et al.  Internalized Homophobia and Relationship Quality among Lesbians, Gay Men, and Bisexuals. , 2009, Journal of counseling psychology.

[16]  Robert M. Groves,et al.  The Impact of Nonresponse Rates on Nonresponse Bias A Meta-Analysis , 2008 .

[17]  L. Waite,et al.  Marital Biography and Health at Mid-Life∗ , 2009, Journal of health and social behavior.

[18]  M. Badgett,et al.  Patterns of Relationship Recognition by Same-Sex Couples in the United States , 2013 .

[19]  Stanley Presser,et al.  Changes in Telephone Survey Nonresponse over the Past Quarter Century , 2005 .

[20]  D. Umberson,et al.  Family Status and Mental Health , 1999 .

[21]  R. Kessler,et al.  Short screening scales to monitor population prevalences and trends in non-specific psychological distress , 2002, Psychological Medicine.

[22]  S. Cochran,et al.  Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. , 2003, Journal of consulting and clinical psychology.