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 marking 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 report 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 spike 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 finding 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, is the president of the American Medical Association.
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