Same-sex marriage laws helped reduce suicide attempts by gay, lesbian and bisexual teens, study says

Guess what? It did get better for gay, lesbian and bisexual high schoolers when the states they were growing up in changed their laws to allow same-sex marriage, a new study finds.

More specifically, in a 16-year period during which changes in state marriage laws were sweeping the nation, states that adopted laws allowing same-sex marriage saw an immediate decline in suicide attempts by gay, lesbian and bisexual high school students – a group in which attempted suicide is two to seven times more common than among their heterosexual peers.

In the year following any state’s adoption of marriage equality, rates of attempted suicide among such high schoolers in that state fell 14 percent below that group’s rate of suicide attempts in states that had not changed their policies on gay marriage.

In short, the research suggests, the effect of state marriage equality laws passed between 1999 and 2015 extended far beyond gay men and lesbians intent on marrying: For high schoolers coming to terms with their “sexual minority” status, their state’s adoption of a marriage equality law appeared to ease a stigma that drives many to consider suicide.

All told, the researchers estimated, from 1999 to 2015, same-sex marriage policies would be associated each year with 134,000 fewer adolescents attempting suicide.

Between 1999 and 2015, when marriage equality became the law of the land, 32 states adopted laws allowing same-sex couples to wed. The new research, published in the journal JAMA Pediatrics, is the first to explore how that rapid social and legal change affected the psychological health of gay, lesbian and bisexual high school students.

To do so, public health researchers from Johns Hopkins University and Harvard University scoured a database of close to 763,000 high school students who regularly participated in a health survey of American young people between 1999 and 2015.

By scouring behavioral trends in a very large and diverse population of youths, their study aimed to detect changes within a very understudied population of a very understudied phenomenon. Rates of attempted suicide among gay, lesbian and bisexual youths are difficult to capture not only because they deal with suicide attempts – behavior that often goes unacknowledged – but because the behavior of interest happens in a group that constitutes a stigmatized minority.

To link those youths’ patterns of suicidal behavior with a change in state laws was even more complicated. Changes in marriage equality laws hopscotched across states that had widely disparate patterns of suicide, and of factors that are linked to suicide, such as poverty, joblessness and substance abuse. Researchers conducted several statistical tests allowing them to compare, apples to apples, rates of attempted suicide on one state in the year following a change in law with attempted suicide rates in states that had not adopted marriage equality.

In the study, 12.7 percent of students identified themselves as belonging to a sexual minority: 2.3 percent identified themselves as gay or lesbian, 6.4 percent as bisexual and 4 percent as unsure of their sexual orientation. Among all high school students surveyed, 8.6 percent reported they had attempted suicide at least once. The rate of past suicide attempts was much higher – 28.5 percent – among those identifying themselves as gay, lesbian, bisexual or unsure of their sexual orientation.

In an editorial published alongside the study, Columbia University public health specialist Mark L. Hatzenbuehler acknowledges that no single factor can fully explain a complex behavior such as suicide. But the new study, he wrote, “suggests that structural stigma – in the form of state laws – represents a potentially consequential but thus far largely overlooked” factor underlying suicidal behavior in young people who are gay, lesbian or bisexual.

Because suicide prevention programs have done little to reduce suicides in this vulnerable population, the social acceptance conveyed by changes in law appears to be uniquely powerful.