Article Text
Abstract
Background The UK legalised same-sex marriage in 2014. We examine whether same-sex marriage legalisation (SSML), an exogenous policy change, affected the health outcomes among ethnic minority lesbian, gay, bisexual and other (LGB+) individuals.
Methods Using the UK Household Longitudinal Survey, we applied the Callaway and Sant’Anna difference-in-differences to compare physical and mental health across (a) ethnic LGB+ individuals (treatment group), (b) ethnic heterosexual individuals (control group 1) and (c) British white LGB+ individual (control group 2). The study cohort (n=7054) comprised individuals aged 16+ years at baseline in 2011, and were employed in the study period (2011–2019). The outcomes included physical component scores from the short-form 12 health survey (physical component score (PCS-12)), long-standing illnesses and psychological distress (General Health Questionnaire (GHQ)).
Results After SSML, the PCS-12 among the ethnic LGB+ individuals improved significantly compared with both ethnic heterosexuals and British white LGB+ individuals (2.081, 95% CI 0.487 to 3.675). While no clear patterns were found for long-standing illnesses, the GHQ in the treatment group had modest decreases relative to ethnic heterosexuals, and relative to British white LGB+ individuals, by year 2 after SSML.
Conclusion SSML in the UK led to improved physical functioning and reduced psychological distress in ethnic minority LGB+ individuals. Our study shows that ethnic LGB+ individuals may derive even greater health benefits than British white LGB+ people, providing evidence that SSML may help address racial health inequalities within LGB+ communities. As countries worldwide consider legalising same-sex marriage, it is imperative for policymakers to consider the health consequences for sexual and ethnic minorities.
- ethnic groups
- gender identity
- health inequalities
- longitudinal studies
- mental health
Data availability statement
Data are available on reasonable request.
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Data availability statement
Data are available on reasonable request.
Footnotes
X @antonychum
Contributors YB: conceptualisation, formal analysis, investigation, methodology, resources, software, validation, writing—original draft, writing—review and editing. CK: conceptualisation, data curation, formal analysis, investigation, methodology, resources, software, validation, writing—original draft, writing—review and editing. AC: funding acquisition, investigation, methodology, project administration, resources, supervision, validation, writing—original draft, writing—review and editing. AC: corresponding author and guarantor. YB and CK shared the first authorship.
Funding The principal investigator (AC) is supported through the Canada Research Chair programme (CRC-2021-00269). The study was partially funded through the Social Sciences and Humanities Research Council (SSHRC) Insight Grant (435-2020-1086) andCanadian Institutes of Health Research (CIHR) project grant (165892).
Disclaimer The funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript and decision to submit the manuscript for publication.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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