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Research Brief
Gay newlywed couple celebrating with two other people, illustration by Good Studio/Adobe Stock

Illustration by Good Studio/Adobe Stock

Key Findings

  • Across 96 empirical studies conducted over the past 20 years, research has consistently found that same-sex couples; lesbian, gay, bisexual, and transgender (LGBT) individuals; and their children have benefited from the granting of legal status to the marriages of same-sex couples.
  • In contrast, research has not identified any reliable adverse consequences of granting same-sex couples access to legal marriage.
  • When states legalized marriage for same-sex couples, same-sex households in those states experienced more-stable relationships, higher earnings, and higher rates of homeownership.
  • Married same-sex couples report greater positive mood, lower stress, fewer depressive symptoms, and higher life satisfaction than unmarried same-sex couples, and these differences are more consistent for married couples than for those in domestic partnerships or civil unions.
  • When states legalized marriage for same-sex couples, the physical health of LGBT individuals in those states also improved, demonstrated by higher levels of health care use, higher levels of health insurance coverage, and declining rates of sexually transmitted infections and problematic substance use.
  • Legalizing marriage for same-sex couples led to significant declines in suicide attempts among LGBT adolescents; declines in mental health care visits and mental health care costs for sexual-minority men; and declines in perceived discrimination and depressive symptoms for sexual-minority women.
  • The availability of legal marriage for same-sex couples greatly reduces disparities in access to private health insurance between children of same-sex couples and children of different-sex couples. Differences in academic progress between the children of same-sex couples and children of different-sex couples were also greatly reduced when states granted same-sex couples access to legal marriage and have disappeared entirely since 2010.
  • Marriage bans for same-sex couples had adverse consequences. For example, LGBT residents of states with marriage bans for same-sex couples reported higher anxiety and lower life satisfaction than residents of states without bans.

Two decades ago, the United States was divided by heated debates over the merits of legalizing marriage for same-sex couples. Those who were in favor argued that granting same-sex couples access to marriage would strengthen commitment for same-sex couples, extend the financial benefits of marriage to same-sex households, and improve outcomes for children being raised by same-sex parents. Those who were opposed argued that granting legal status to marriages between same-sex partners would alter the foundation of marriage and thereby diminish its value for different-sex couples, ultimately harming children by making them less likely to be raised in stable, two-parent families. Twenty years have passed since the first marriage licenses were issued to same-sex couples in Massachusetts in May 2004, making it possible to evaluate the evidence for these arguments.

Toward this goal, RAND researchers conducted a review of existing evidence and new analyses to identify the effects of granting legal status to the marriages of same-sex couples in the United States. This research brief highlights the findings from the review of studies addressing the effects of granting that legal status on same-sex couples; their children; and lesbian, gay, bisexual, and transgender (LGBT) individuals more generally. A companion research brief highlights the effects of granting marriage rights to same-sex couples on the general population.

To identify relevant studies, the research team searched four independent databases (Web of Science, Scopus, Social Sciences Abstracts, and Policy File Index) for published work that examined the effects of granting legal status to same-sex couples, either in civil unions or in marriages, in the United States. From the original search and after identifying additional articles from research reviews and citations, the team identified 96 relevant articles that examined the effects of granting legal status to same-sex couples on same-sex couples, their children, and the general population. As shown in Figure 1, research on this topic began immediately after the first marriage licenses were issued to same-sex couples by the state of Massachusetts in 2004, and scholarly interest expanded after the Supreme Court's Obergefell v. Hodges decision legalized marriage for same-sex couples nationwide in 2015.

Across all of these studies, the findings have been unambiguous and consistently positive. In nearly every area that research has examined (see Figure 2), same-sex couples, LGBT individuals, and their children and family members have benefited greatly from the granting of legal status to the marriages of same-sex couples. The following sections review the documented benefits to each of these groups.

Figure 1. Recent Literature Focuses on Impacts for LGBT Individuals

bar graph showing the number of studies published on marriage impacts for LGBT individuals

Number of studies published

Year Children General population LGBT individuals
2004

0

0

1

2005

0

0

1

2008

0

1

0

2009

0

2

1

2010

1

0

2

2011

0

0

1

2012

0

0

3

2013

1

0

4

2014

0

2

5

2015

0

0

4

2016

2

3

4

2017

1

4

6

2018

1

3

4

2019

0

5

5

2020

0

4

7

2021

0

1

6

2022

0

0

10

2023

0

1

2

2024

0

2

1

SOURCE: Features data from Benjamin R. Karney, Melanie A. Zaber, Molly G. Smith, Samuel J. Mann, Marwa AlFakhri, Jessie Coe, Jamie L. Ryan, Catria Gadwah-Meaden, Christy Mallory, Brad Sears, and Chandra Garber, 20 Years of Legal Marriage for Same-Sex Couples in the United States: Evidence Review and New Analyses, RAND Corporation, RRA29121, 2024 (Appendix B, Table B.1).

NOTE: Studies covering multiple topics are listed multiple times.

Figure 2. Literature on the Effects of Marriage Recognition Is Wide-Ranging

bar chart showing the amount of articles on the effects of marriage recognition

SOURCE: Features data from Karney et al., 2024 (Appendix B, Table B.1).

NOTE: Studies covering multiple topics are listed multiple times.

aTopic focuses on the broader U.S. population (i.e., all U.S. residents).

  • Psychological well-being: 27 articles
  • Public opinion: 15 articles
  • Physical health: 15 articles
  • Couple well-being: 13 articles
  • Financial well-being: 12 articles
  • Trends in family formation: 8 articles
  • Health insurance: 7 articles
  • Social connection: 5 articles
  • Employment: 4 articles
  • Children of same-sex parents: 4 articles
  • Public health: 3 articles
  • Economic trends: 3 articles

Effects on Same-Sex Couples and LGBT Individuals

Same-sex couples and LGBT individuals are the populations most directly affected by laws and policies granting or withholding legal marriage for same-sex couples. Accordingly, the greatest impacts of policy changes affecting the legal status of same-sex couples have been observed in these populations. These impacts include benefits to psychological and emotional well-being, physical health, insurance coverage, and financial security and employment.

Psychological Well-Being

On average, when members of sexual- and gender-minority groups are subject to stigma and discrimination, the stress of these experiences negatively affects their mental health. By validating same-sex relationships, legalizing marriage for same-sex couples alleviated some of that stress, leading to greater psychological well-being among same-sex couples and LGBT individuals. Specifically, across 25 studies of this issue, married same-sex couples reported greater positive mood, lower stress, fewer depressive symptoms, and higher life satisfaction than unmarried same-sex couples, and these differences were more consistent for married couples than for those in domestic partnerships or civil unions. In contrast, when states banned or proposed bans on marriage between same-sex partners, LGBT residents of those states reported higher anxiety, stress, depression, and negative mood and experienced increased rates of multiple psychiatric disorders, compared with residents of states that were not considering or enacting such bans. Prior to the Obergefell v. Hodges decision in 2015, even already-married same-sex couples experienced less negative affect when they resided in states that recognized their marriages than when they resided in states that failed to recognize their marriages.

Repeated surveys and longitudinal analyses suggest that these effects are causally related to changes in policy. For example, state-level rates of suicide attempts among LGBT adolescents declined significantly after states legalized marriage for same-sex couples, even after controlling for other differences among states. In Massachusetts, mental health care visits and mental health care costs for sexual-minority men declined significantly after legalization. Research following sexual-minority women from 2000 to 2012 found that perceived discrimination and depressive symptoms declined after legal rights were extended to same-sex couples, especially among women with less education and women who were sexual and racial minorities.

Couple Well-Being

Among different-sex couples, marriage decreases the risk of relationship dissolution, promotes investment in the relationship, and is associated with higher relationship quality compared with cohabitation. Thirteen studies addressing the effects of marriage on same-sex couples found that, when same-sex couples were given the opportunity to marry, their relationships similarly became more stable than those of cohabiting same-sex couples. On average, same-sex couples with any legal status dissolve their relationships at the same rate as married different-sex couples, although couples consisting of two women are more likely to dissolve than couples consisting of two men. Marriage increases investment in the relationship, and married same-sex couples report greater relationship satisfaction and commitment than unmarried same-sex couples do. Couples consisting of two women take up marriage at higher rates than couples consisting of two men and are more likely to increase specialization of household and caregiving labor in response to relationship recognition policies.

LGBTQ couple holding hands while walking their dog, illustration by Good Studio/Adobe Stock

Illustration by Good Studio/Adobe Stock

Physical Health

Relative to heterosexual and cisgender individuals, LGBT individuals have been shown to experience increased risk for several physical illnesses, including cancer and cardiovascular conditions, often as consequences of stress caused by repeated experiences of stigma and prejudice. In different-sex couples, however, satisfying marriages have been consistently linked to greater physical heath and lower mortality. Over the past 20 years, 16 studies have shown that the health benefits associated with marriage apply to same-sex couples as well, offsetting many of the health disparities LGBT individuals might otherwise face.

For example, LGBT individuals in same-sex relationships who lived in states with legal marriage reported better health than those living in states with a marriage ban or where only civil unions or domestic partnerships were permitted. Improvements in physical well-being following the availability of marriage were more robust for sexual-minority men than for sexual-minority women. Although LGBT individuals are, relative to heterosexual individuals, at increased risk for substance abuse, marriage reduces some of this elevated risk. Individuals in marriages with same-sex partners have reported levels of alcohol use that are similar to those of different-sex married couples, while individuals in same-sex partnerships without legal status have reported higher levels of problematic drinking than those who are married.

The availability of marriage for same-sex couples also appears to have improved the quality of care for LGBT individuals and encouraged them to make regular visits to health care providers. In particular, sexual-minority men who lived in a state with legal marriage for same-sex couples reported better patient-doctor communication than did those in states without it. Sexually transmitted infection (STI) rates also decreased in states that legalized marriage for same-sex couples, while bans on marriages and civil unions were associated with an increase in syphilis among the LGBT population.

Health Insurance Coverage

Accompanying, and potentially driving, the health gains experienced by married LGBT individuals are improvements in their health insurance coverage. Employers often offer health insurance plans that allow the spouse of an employee to be covered under a single employer-sponsored health insurance plan.

Before nationwide legal marriage for same-sex couples in the United States, individuals in same-sex relationships were significantly less likely to have health insurance coverage than individuals in different-sex relationships. Legal marriage for same-sex couples reduced this disparity and improved rates of health insurance coverage for LGBT individuals. This was a result of an increase in same-sex spouses enrolling in employer-sponsored health insurance. Health insurance coverage changed and improved most for women in same-sex relationships following legal marriage.

Financial Security and Employment

There is a well-documented "marriage premium" for different sex couples, such that earnings are higher and employment more secure for married couples than for unmarried couples. Over the past 20 years, research has examined whether same-sex couples receive similar marriage premiums and has shown that same-sex couples are generally better off financially when they are legally married than when they are not. With respect to wages, for example, a 2020 Journal of Labor Research study by Michael E. Martell and Peyton Nash found that married men and women in same-sex relationships earned 3 percent and 6 percent more, respectively, than their cohabiting counterparts. This marriage premium was significant in states with and without legal marriage for same-sex couples but was larger in the former. The longer that same-sex couples are married, the greater their increased income relative to similar unmarried couples. Between 2004 and 2014, states that issued marriage licenses to same-sex couples saw a 6-percent to 16-percent increase in mortgage applications from same-sex couples, according to 2018 research by Joshua J. Miller and Kevin A. Park published in the Review of Economics of the Household.

Because married same-sex couples can file their taxes jointly, legalization of marriage for same-sex couples also increased rates of eligibility for claiming of spousal Social Security benefits. Among older LGBT individuals, those who lived in a state without legal relationship recognition were more likely to have a will and to have designated durable power of attorney, suggesting that LGBT individuals living in unsupportive policy environments may have faced more barriers to arrange financial and caregiving plans in old age.

With the increased financial security that marriage provides, same-sex couples may reevaluate decisions about work and employment. On average, legalizing marriage for same-sex couples increased the probability that individuals in such couples engaged in paid labor outside the home. For women in same-sex couples, however, legalization led to more specialization in division of labor, such that the partner earning less was more likely to reduce their paid work hours to spend more time on caregiving and household labor. Men in same-sex couples did not show a similar effect.

Effects on the Children and Family Members of LGBT Individuals

Granting LGBT individuals the right to marry had ripple effects on their children and loved ones. The U.S. Census Bureau estimates that there are about 300,000 U.S. children being raised by same-sex couples, although this may be an underestimate given that same-sex couples tend to underreport their status. Debates over the merits of legalizing marriage for same-sex couples raised two independent questions about the likely consequences of this policy change for children. The first is whether—and, if so, how—the gender composition of parents (e.g., a man and a woman, two men, two women) affects children's outcomes. By the time the first legal marriages for same-sex couples were performed in 2004, there was already an extensive and well-developed body of research literature comparing the physical, emotional, educational, and developmental outcomes of children raised by same-sex and different-sex couples. Numerous reviews of this extensive literature, by such organizations as the American Psychological Association, the American Academy of Pediatrics, and the American Sociological Association, have all reached the same conclusion: On a vast array of outcomes, children of same-sex couples fare just as well as children of different-sex couples.

The second issue is whether children are affected when their same-sex parents are married or prevented from marrying by the state. This question has received far less scholarly attention, but all of the relevant studies identified in the evidence review suggest that having married parents has only positive consequences for the emotional and physical health of children, relative to having unmarried, cohabiting parents. For example, the availability of legal marriage for same-sex couples greatly reduces disparities in access to private health insurance between children of same-sex couples and children of different-sex couples. Moreover, since 2010, there have been no differences in educational progress between children of same-sex parents and those of different-sex parents. Prior to 2010, there were some differences in educational progress between these two groups, but only in states without legal recognition for same-sex couples. In other words, the marital status of the parents, rather than their gender composition, appears to be the strongest correlate of children's outcomes.

In addition to affecting the children of same-sex couples, policies that directly affect LGBT individuals can affect their close friends and family through processes of emotional contagion. In the states that passed bans on marriage for same-sex couples, family members of LGBT individuals reported greater exposure to negative messages about LGBT individuals and greater negative affect about the amendments compared with family members in the states that did not consider marriage bans.

Lesbian couple relaxing together, with large abstract of wedding rings to their right, , illustration by Good Studio/Adobe Stock

Illustration by Good Studio/Adobe Stock

Conclusions

The literature search identified 96 studies that assessed some form of legal status for same-sex couples (usually legal marriage, but also civil unions and domestic partnerships) and examined its association with an outcome. The outcomes examined by these studies ranged widely, from the emotional, physical, and financial health of LGBT individuals and same-sex couples to the health and well-being of their children and loved ones. Yet despite the diversity of the methods and topics in the research the team reviewed, the conclusions of these 96 studies are remarkably consistent. Granting same-sex couples access to marriage offered substantial benefits to LGBT individuals, same-sex couples, children raised by same-sex couples, and their families.

Prior to the Obergefell decision, LGBT individuals living in states that issued marriage licenses to same-sex couples experienced improved psychological well-being, while those living in states that banned marriage for same-sex couples saw declines in well-being. When states allowed same-sex couples to marry, the physical health of LGBT individuals living there increased; their levels of health care use and health insurance coverage rose, while their rates of STIs decreased. Same-sex households in states legalizing marriages for same-sex couples saw their financial security and employment prospects improve. In addition, the children and family members of LGBT individuals in states that granted legal status to same-sex couples experienced benefits compared with those living in states that considered or enacted bans on marriage for same-sex couples.

While few of the studies the team reviewed compared same-sex couples in marriages with same-sex couples with other forms of legal recognition (e.g., civil unions or domestic partnerships), those that did found unique benefits associated with marriage. These included lower levels of psychological stress for those in married same-sex couples, as well as greater earnings. More research comparing the effects of marriage with the effects of other forms of legal status for same-sex couples is warranted, but the direction of the limited research to date suggests that marriage offers benefits to LGBT individuals and same-sex couples that are not associated with other forms of legal status.

Notably, across 20 years of research and 96 studies, the team could find no reliable evidence that legalizing marriage for same-sex couples produced any lasting negative effects on any outcomes. Thus, the findings of this review offer a basis for predicting that, if future court decisions were to restrict access to marriage for same-sex couples, the consequences would be negative. LGBT individuals, same-sex couples, and their children would suffer from the loss of the social, physical, and economic benefits that are now known to be the consequences of legalizing marriage for same-sex couples.

Research conducted by

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