20 Years of Same-Sex Marriage Has Been a Boon to Health

In the aftermath of a major policy change that moves a system toward inclusion, it's important to show that the sky doesn't fall.

For example, as a combat veteran in the U.S. Navy who deployed to Afghanistan, among other places, I have seen firsthand how expanding open service to LGBTQ+ people has significantly strengthened our military and received vocal, sustained support from a bipartisan array of leaders.

Now, as we celebrate the 20th anniversary of the freedom to marry for same-sex couples in parts of our country -- with May 17, 2004 markingopens in a new tab or window the first-ever state-sanctioned weddings between same-sex couples in Massachusetts -- we have another opportunity to review the evidence and see that none of the apocalyptic predictions came to pass. Instead, the opposite happened: The health of families was helped, and no one was harmed.

This week, the RAND Corporation published a new reportopens in a new tab or window presenting one of the most comprehensive evidence reviews about marriage for same-sex couples. The report analyzes nearly 100 quantitative studies from over 20 years and underlines the many positive effects of the freedom to marry -- for same-sex couples, their kids, and the general population -- with zero adverse effects.

As the president of the American Medical Association (AMA), the nation's largest and most influential association for physicians, I'm especially heartened by the impact of marriage equality on greater health outcomes.

Some of the most important changes have been related to health insurance: Expanding marriage to same-sex couples led to a spikeopens in a new tab or window in private health insurance coverage among same-sex couples. After the decision, the number of same-sex couples in which both members had private insurance coverage increased from 79% to 88%. Reliance on Medicaid coverage slightly decreased, and marriage equality contributed to children of same-sex couples having access to private insurance. The impact of this is critical: When people and families are insured, they are better able to access the services they need and take care of themselves and their loved ones.

Other benefits are also encouraging, including a reduced number of emergency department visits among young people related to sexually transmitted infections (STIs). Decreasing state-level rates of STIs generates billions of dollars in savings to the nation's healthcare system each year. Another especially powerful, affirming findingopens in a new tab or window is the potential correlation between the freedom to marry and a reduction in the proportion of high school students who attempted suicide.

Advocating for the LGBTQ+ community in the healthcare field has been one of my greatest professional accomplishments. In past and current roles, I strive each and every day to fight against inequities in healthcare access and ensure that everyone has access to the same high-quality, effective care. Ensuring that our healthcare system treats everyone fairly has long been a professional priority, and I'm committed to doing everything I can to push forward.

This topic is also deeply personal for me: 7 years ago I married my husband Judd in Nashville, Tennessee. We are now the proud parents of two young sons who are the joys of our life.

Securing the freedom to marry was so important to both of us. It felt especially important during my deployment in Afghanistan, prior to the 2015 Supreme Court ruling in Obergefell v. Hodges that established a national right to marry. It felt strange putting my life on the line for the freedoms that we all enjoyed, yet not having the freedom to marry the man I love. Because of this inequality, we were left out of important protections, like the ability for Judd and me to see each other in case of an emergency or a medical issue.

It is a relief to be raising our boys at a time where the freedom to marry is available to all people. It's so clear to me that allowing same-sex couples to marry has led to so many critical steps forward, contributing generally to lower stress and greater health outcomes overall for same-sex couples and their children.

Same-sex couples, their families, and society at large are better off, and healthier all around, because of the freedom to marry. On this 20th anniversary of a major breakthrough, that's something we can all celebrate.

Jesse Ehrenfeld, MD, MPH,opens in a new tab or window is the president of the American Medical Association.

Do you support same-sex unions? How it is even relevant?

Less than 1% of all U.S. adults are in a same-sex marriage LGBT Americans Married to Same-Sex Spouse Steady at 10%

Meanwhile,

In 2020, male-to-male sexual contact accounted for 68% of all new HIV diagnoses in the United States and dependent areas. In the same year, heterosexual contact accounted for 22% of all HIV diagnoses.

"Young gay and bisexual men accounted for 84% (5,161) of all new HIV diagnoses in people aged 13 to 24 in 2020."

And "in 2019, among transgender adults and adolescents, the largest percentage (93%) of diagnoses of HIV infections was for transgender MTF. And in 2019, diagnoses of HIV infection among adolescent and young adult males (85%) and females (12%) accounted for approximately 97% of HIV diagnoses (Table 8b") (https://www.cdc.gov/hiv/basics/statistics.html; https://web.archive.org/web/20210707083722/https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-32/content/special-focus-profiles.html)

Overall, the practice pf sodomy has (historically) resulted in a and effects besides HIV, from Meningitis to premature death. Which diseases includes Chlamydia, Gonorrhea, Hepatitis A and B, HPV, Syphilis, HIV to Meningitis and body dysmorphia and eating disorders and recently Monkey pox. Gay, bisexual, and other men who have sex with men have accounted for 83% of primary and secondary syphilis cases where sex of sex partner was known in the United States. Gay, bisexual, and other men who have sex with men have been found to be 17 times more likely to get anal cancer than heterosexual men. (https://www.cdc.gov/mmwr/volumes/71/wr/mm7138a1.htm)

Vanderbilt University Medical Center states: Men who have sex with men and gay men are at increased risk for certain types of chronic diseases, cancers, and mental health problems… #1: HIV/AIDS. #2: Anal Papilloma #3: Hepatitis #4: Substance Use #5: Depression and Anxiety #6: Sexually Transmitted Diseases (STDs) #7: Prostate, Testicular, and Colon Cancer #8: Alcohol #9: Tobacco #10: Body image problems and obesity. (https://www.vumc.org/lgbtq/key-health-concerns-msm-men-who-have-sex-men)

Anal cancer is particularly one of the diseases that is far more prevalent among MSM than other population groups, being diagnosed in about 2 people out of every 100,000 people in the general population. In contrast, it is estimated that MSMs that are not infected with HIV are 20 times more likely to be diagnosed with anal cancer. HPV is present in approximately 65% of HIV negative MSMs and 95% of MSMs who are HIV positive. Anal cancer is caused by the same strains of HPV (Human Papillomavirus) that cause cervical cancer in women. (https://cancer-network.org/cancer-information/gay-men-and-cancer/anal-cancer-hiv-and-gaybisexual-men)

Related to this is that,

The risk of becoming infected with HIV during condomless anal sex is 10 to 20 times greater than condomless vaginal sex. Because the rectal lining is only one-cell thick, the virus can more easily reach immune cells to infect. (https://www.mtnstopshiv.org/news/rectal-microbicides-fact-sheet)

Also, multiple studies [2017] have found a rise in unprotected sex among men who have sex with men. (https://europepmc.org/article/med/32332483)

Also reported, "People living with HIV in Canada had eight times the risk of Alzheimer’s disease and other non-AIDS-related dementia as their HIV-negative counterparts, and they were diagnosed 12.5 years earlier [which in part may be due to more medical attention], according to an analysis published in BMJ Open.

They also had higher rates of several other age-related chronic conditions....Antiretroviral treatment has been associated with kidney damage and cardiovascular disease, and viral hepatitis and alcohol use—both common among HIV-positive people—can cause liver disease." (https://www.poz.com/article/people-hiv-diagnosed-dementia-13-years-earlier)

Even when their disease is well controlled, people with HIV can develop aging-related conditions such as cardiovascular disease, certain cancers, kidney and liver disease, osteoporosis, and cognitive impairment decades ahead of their HIV-negative counterparts, and their life expectancy is significantly reduced.)

And a new study shows evidence that "HIV-positive people are at an increased risk of age-related diseases such as some cancers, frailty, osteoporosis, kidney disease, and neurocognitive disease. Researchers think that it is the HIV itself that accelerates the aging process by 14 years, rather than medications used to treat it." (https://www.hivplusmag.com/treatment/2015/03/25/study-people-hiv-age-14-years-faster)

More: negative-effects-of-homosexual.html

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