Laws allowing denial of services to same-sex couples associated with increase in sexual minority adults reporting mental distress

Bottom Line: Laws that allow same-sex couples to be denied services are associated with an increase in sexual minority adults reporting mental distress.

Why The Research Is Interesting: Laws allowing the denial of services to same-sex couples exist in a dozen states and are under consideration by the U.S. Supreme Court.

Who and When: 109,089 adults from nine states; 37,514 adults from three states (Utah, Michigan and North Carolina) that passed laws permitting services to be denied to same-sex couples and 71,575 from six nearby states used for comparison (Idaho, Nevada, Ohio, Indiana, Virginia and Delaware); data from the Behavioral Risk Factor Surveillance System were from 2014 through 2016

What (Study Measures): Whether individuals identified as a sexual minority (defined as those who identified as gay, lesbian, bisexual or not sure of their sexual orientation) and lived in a state with a law permitting the denial of services to same-sex couples in 2015 (exposures); mental distress, which was defined as poor mental health on 14 or more the past 30 days (outcome)

How (Study Design): This was an observational study. Researchers evaluated changes in mental distress among sexual minority adults in states that passed the laws compared to changes in mental distress among heterosexual adults in the same states and among sexual minority adults in control states. They controlled for all state characteristics that did not change over the study period and for a number of individual characteristics of study participants.

Authors: Julia Raifman, Sc.D., of the Boston University School of Public Health, and coauthors

Results:  Of the 109,089 participants, 4,656 (4.8 percent) identified as sexual minorities; the proportion of sexual minority adults reporting mental distress increased between 2014 and 2016 in states that passed laws permitting services to be denied to same-sex couples compared with control states.

Study Limitations: Analysis conducted only in states and years with data on sexual orientation; findings may not be generalizable to other states

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/ jamapsychiatry.2018.0757)

Editor's Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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