Civil marriage among same-sex couples hasn’t existed long enough to permit longitudinal research studying the effects of marriage on mental health, but it seems likely that benefits described in the general population will accrue to same-sex couples and their children. Marriage dividends include a multitude of tangible and intangible benefits including financial advantages, legal protections, and psychosocial gains such as increased support during times of crises.
Pioneering research on same-sex marriage has identified comparable effects of these benefits, with several cross sectional studies of lesbians and gay adults finding distinct mental health advantages associated with marriage (in comparison with the status of being in a committed relationship or single), such as decreased psychological distress and an enhanced sense of meaning in life.
It also seems reasonable to assume that the legal recognition of both partners’ parental status conferred by civil marriage will lessen stigma experienced by the children of same-sex parents and impart additional stability and security to family life. Over 70 studies have found no difference in the psychological health and adjustment of children of gays and lesbians compared with heterosexual parents, but full legal recognition of both parents’ rights and responsibilities would further support children’s well-being during times of unplanned life events such as medical crises and relationship dissolution.
For these reasons, organizations such as the American Psychiatric Association, the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association have issued policy statements supporting civil marriage for same-sex couples. While some have argued that medical and scientific associations should not take a position on what is perceived as a social policy issue, it is difficult to ignore the environmental impact of marital enfranchisement on mental health in lesbians, gay men, and their children — a potent intervention that clinicians and researchers have already noted.
Our courts increasingly concur, with Justice Kennedy noting that states allowing same-sex marriage exercise a role and power that enhance the recognition, dignity, and protection of lesbians and gay men. Matters of heart and mind will thus loom large when the U.S. Supreme Court returns to visit the question of same-sex marriage in the current term. Mental health professionals and many of their patients will be listening closely.
Robert M. Kertzner, MD, is an associate clinical professor of psychiatry at Columbia University and an investigator at the Columbia LGBT Health Initiative, the Division of Gender, Sexuality, and Health at the New York State Psychiatric Institute. He is also in private practice in New York City.