Revisiting Marriage and Physical and Mental Health Among Partnered Gay and Lesbian Adults: An Analysis of Behavioral Risk Factor Surveillance System Data, 2014-2023.

Abstract

Purpose: The purpose of this study was to reexamine the association between marriage and health among partnered gay and lesbian adults, comparing married individuals with those in unmarried couples. Methods: Using a decade of large-scale, representative data from the Behavioral Risk Factor Surveillance System 2014-2023, we analyzed partnered, cisgender gay and lesbian adults aged 18-65 (N = 10,973). Negative binomial regression models estimated the number of poor mental and physical health days, whereas logistic regression models predicted the probability of frequent mental and physical distress. Analyses adjusted for sociodemographic factors and explored the role of socioeconomic factors. To enhance comparability between married and partnered, unmarried individuals, a propensity score-based inverse probability weighting approach was adopted. Results: Married gay and lesbian individuals exhibited mental and physical health comparable to their partnered, unmarried counterparts. However, an exception was that married gay men experienced a mental health advantage, even after adjusting for socioeconomic resources. Conclusion: The mental health advantage among married gay men highlights the importance of symbolic resources such as social recognition. Overall, however, the findings did not support the marital advantage theory among partnered lesbian and gay individuals, potentially due to the weaker institutionalization of same-sex marriage and elevated couple-level minority stress. Future research should further investigate sexual minority health within family contexts, incorporating diverse gender and sexual identities.