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Back to Section One | Back to Arts & Entertainment
posted Friday, March 23, 2012 - Volume 40 Issue 12
Dr. J: The marriage effect
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Dr. J: The marriage effect

by Dr. Joanne Stekler - Special to the SGN

Joanne Stekler, M.D., MPH, is deputy director of community services for the HIV/STD Program at Public Health - Seattle & King County. She is also an internal medicine and infectious disease physician at Harborview Medical Center, and assistant professor of medicine and epidemiology at the University of Washington.

This article is part of a series focusing on HIV and other STD prevention and care topics for Gay/Bisexual men and Transgender individuals in Seattle & King County.

On February 13, Gov. Christine Gregoire signed a bill into law that made Washington state the seventh state to legalize Gay marriage. One week later, a federal district court in California ruled that the Defense of Marriage Act (DOMA) is unconstitutional. Then, on March 1, Maryland legalized same-sex marriage.

There's a clear and growing support for same-sex marriage in the United States. And Public Health - Seattle & King County knows that having the opportunity to marry could improve your health and the health of the community.

Domestic partnerships have given committed same-sex relationships a 'separate but equal' status for years. It's common sense that domestic partnerships increase social, emotional, and economic support. But domestic partnerships probably also improve your health. Compared to men without a domestic partner, men in domestic partnerships have fewer sex partners and are less likely to have unprotected anal sex with a casual partner - risk factors for getting HIV and other STDs. But 'separate but equal' is not enough.

The health benefits of same-sex marriage may be even greater than those of domestic partnerships. Partnered Gay men are less likely to have health insurance compared to married heterosexuals. Having health insurance leads to better health outcomes. When Massachusetts legalized same-sex marriage, there was a decrease in medical and mental health visits and health-care costs among Gay and Bisexual men, perhaps due to decreased stress-related health conditions. In contrast, states that ban same-sex marriage see higher rates of mental illness and substance abuse. Outcomes for cancer, heart disease, Alzheimer's, and other diseases are all better for people who are married, though this hasn't been studied yet for Gay and Bi men.

Now all of this is information from observational studies. No one has randomized men to either find them a husband or not! So there may be other factors that impact these outcomes that we don't know about.

However, many health-care organizations support marriage equality. The American Medical Association (AMA) issued a policy statement in 2009 to support same-sex marriage with the goal of reducing health disparities in the LGBT community. The American Psychiatric Association did the same in 2004.

And why do I support marriage equality? Because happier and healthier people lead to happier and healthier communities & and I'm hoping to get invited to at least a wedding or two!

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