Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment

Objectives. We sought to determine whether health care use and expenditures among gay and bisexual men were reduced following the enactment of same-sex marriage laws in Massachusetts in 2003. Methods. We used quasi-experimental, prospective data from 1211 sexual minority male patients in a community-based health center in Massachusetts. Results. In the 12 months after the legalization of same-sex marriage, sexual minority men had a statistically significant decrease in medical care visits (mean=5.00 vs mean=4.67; P=.05; Cohen's d=0.17), mental health care visits (mean=24.72 vs mean=22.20; P=.03; Cohen's d=0.35), and mental health care costs (mean=$2442.28 vs mean=$2137.38; P=.01; Cohen's d=0.41), compared with the 12 months before the law change. These effects were not modified by partnership status, indicating that the health effect of same-sex marriage laws was similar for partnered and nonpartnered men. Conclusions. Policies that confer protections to same-sex couples may be effective in reducing health care use and costs among sexual minority men. (Am J Public Health. 2012;102:285-291. doi:10.2105/AJPH.2011.300382)