First Comes Marriage. . .Then Comes Better Health and Benefits


By James Lee

In the United States, the opportunity to marry brings about many financial and legal benefits for same-sex couples. Married couples enjoy lower tax rates, added Social Security benefits, military benefits, special financial and estate-planning benefits, and family benefits.

One of the most important benefits that married individuals receive is increased access to healthcare and improved health outcomes. For decades, married couples have taken advantage of spousal health plans and other employer perks that reduce the risk of chronic health problems. This is an opportunity that many LGBT Americans are only beginning to become acquainted with. 

LGBT people have seen their sexuality used as a wedge issue in many public debates over the past 30 years. If you grew up in the conservative South, it’s likely you couldn’t go out for a cup of coffee, dinner, or a movie without overhearing some kind of uninformed comment about “the gays.” Some of these insults don’t even come from hateful or ignorant individuals. Sometimes a friend or coworker will ask a subtle, seemingly innocent question about LGBT life, or your “lifestyle.” A lifetime of such negative interactions can take a great toll on both physical and mental health.

From a survival perspective, our bodies have evolved to combat dangerous situations with various levels of stress. When our ancient ancestors encountered predators, their heart rate and stress levels rose in order to help them get out of harm’s way. Stress was something that helped our ancestors survive, and it’s something that can still be useful in our everyday lives—such as when natural stress produces short-lived moments of motivation. Maybe you are up for a promotion and feel the need to perform at peak levels. This is good, natural stress. But when your stress levels rise in response to a discriminatory or hostile environment, and you are constantly placed in stressful situations that cause this reaction, it can lead to chronic health problems.

In recent years, the Substance Abuse and Mental Health Services Administration (SAMHSA) has released studies showing that LGBT Americans, like other minorities, face chronic health problems associated with discrimination. According to the research, common stress-related ailments include heart disease, increased risk of cancer, and upper-respiratory problems. Among lesbians, SAMHSA found an increased risk of heart disease, cancer, and obesity. Afflictions faced by gay men were similar, with additional risks for injury resulting from either criminal or partner-related violence. SAMHSA found the highest rates of injury from violence occurring among transgender men and women. Around two-thirds of transgender respondents reported they are survivors of assault, including sexual assault. The report concluded that many LGBT individuals’ circumstances of daily living contribute greatly to chronic health and mental-health problems, often resulting in substance abuse as a form of self-medication.

While our community faces many challenges to maintaining wellness in the face of discrimination, the good news is that society is changing rapidly, and with this change will come better LGBT health outcomes. With same-sex marriage now a reality, LGBT Americans are finding greater acceptance in society—and better access to health insurance makes it easier to address health concerns that might have previously gone untreated.

A study by the American Journal of Public Health recently found that married or legally recognized same-sex couples were more likely to live longer, happier, and healthier lives than those who were single or unable to marry due to legal restrictions. According to the study, married same-sex couples enjoy greater access to healthcare, are less likely to experience mental-health problems like anxiety and depression, and experience greater acceptance and support from their family and friends. Furthermore, the study found that affirming same-sex marriage is sound fiscal public policy because it reduces the likeliness of high-risk behavior and HIV infection.

Tony Aucoin, LCSW, a Houston-area therapist experienced in counseling LGBTQ couples, believes marriage equality will lead to many mental-health benefits for same-sex couples. “Our community is bogged down in some ways with shame—that feeling of ‘we don’t belong,’” Aucoin says. “I think marriage equality is one step further to sort of relieving that. [It’s] saying that we are equal to other people, and there’s not something wrong with us.”

Although Aucoin believes marriage is good for the larger community, he cautions LGBTQ clients to consider what marriage might mean for them. “Across the board, gays and lesbians grew up with a totally different set of ideas [about relationships],” he says. “Now we’re [faced] with the idea of ‘maybe we can change that.’ But it could cause some problems for couples who rush into things.” Before the proposals and wedding plans begin, Aucoin advises a couple to have a conversation and agree on exactly what marriage means—and what their marriage will mean—before moving forward.

Echoing the findings of SAMHSA and the American Journal of Public Health, Aucoin recognizes the need for same-sex couples to address longstanding mental-health problems. “People dealing with mental illness might have learned to handle their depression or anxiety in their own ways,” he says. “We think about our problems sometimes, and we don’t label it as being mentally ill.” Aucoin says a newly married couple can sometimes find mental illness surfacing after marriage. “It might be the first time that we’re looking at our behavior and questioning it,” he says. “Our partner might be the first person [who has ever] done that for us.”

Regardless of how the national same-sex marriage debate eventually gets resolved, one thing is clear: the world is beginning to look like a more loving and healthy place for our community.

James Lee is the Public Affairs Field Specialist at Legacy Community Health and focuses on minority health, mental health, and civic engagement. Lee is a graduate of the University of Houston and can be found on Twitter @jamesmateolee.


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