Opposition at the community level marriage equality and the stress that got here with it continues to be making some Australians in same-sex relationships sick, even years after the vote, our research suggests.
In a study published today in American Journal of Public HealthWe found that individuals in same-sex relationships living in areas where there was more opposition to marriage equality had higher rates of chronic health problems after the vote, in comparison with people living in areas where there was less opposition.
For example, in areas where there was the biggest opposition to marriage equality, people in same-sex relationships were more more likely to have long-term heart, respiratory and mental health problems.
Our study is the first to indicate a link between opposition to marriage equality and health in this fashion.
It also reminds us how hidden social attitudes can reinforce stigma, which may have long-term consequences for people’s health.
What have we done
In our study, we used two principal data sets. One got here from Postal vote on marriage equality 2017which gave us a measure of opposition to same-sex marriage in each constituency. While we couldn’t see how individuals voted, the data gave us the percentage of “no” votes per constituency.
The remaining data comes from the 2021 census, the first 12 months Australians were asked about their long-term health problemsequivalent to asthma, heart disease and mental health problems equivalent to depression and anxiety. The census data covered the health of Australians in same-sex and heterosexual relationships.
We then analyzed these two phenomena to indicate the relationship between opposition to marriage equality and folks’s health 4 years after the vote.
Julia Amaral, CEO of JLco
What we found
As community opposition to marriage equality has grown, long-term health problems have turn into more common amongst Australians in same-sex relationships than amongst those in different-sex relationships.
In areas where opposition to marriage equality was lowest (around 13–26% “no” votes), people in same-sex relationships were 56% more more likely to report any chronic health problem in comparison with people in opposite-sex relationships.
However, in areas where opposition was strongest (around 34–56% “no” votes), this figure rose to 63%.
The health of young people, men, and people living in areas of greater socioeconomic drawback was particularly affected. These same-sex couples were amongst those that had higher rates of mental, respiratory, and heart disease. All of these strongly related to emphasize.
These effects continued even after taking into consideration other aspects which will affect health, equivalent to age, income and education.
This suggests that community-level attitudes – in this case, votes against marriage equality – could also be an expression of stigmatization of sexual minorities.
How does stigma affect health?
International studies show that sexual minorities living in environments with higher stigmatization usually tend to experience stress aspects because of their sexual orientation. This includes harassment or intimidation.
In environments with greater stigmatization, sexual minorities are also more likely to have interaction in dangerous behaviors equivalent to: smoking AND drinking to assist “cope” with these stressors. The greater effects we see on lungs, mental health, and other stress-related conditions support this theory.
AND lack of inclusive healthcare Or past experiences with discrimination (in health care or more broadly) may additionally discourage sexual minorities from accessing needed health care.
Previous research has shown that lesbian, gay and bisexual Australians living in areas with greater opposition to marriage equality use less preventive AND basic healthcare (equivalent to visits to a family doctor) than their counterparts living in areas where there may be less opposition.
In summary, we will state that delayed access to preventive health care and greater social stress can result in deterioration of health and, consequently, to the development of chronic diseases.
Such chronic conditions could be costly to the healthcare system. This implies that the health disparities we’ve got highlighted usually are not only a human rights issue, but in addition an economic issue.
Lukasz Coch/AAP
What can we do?
Unfortunately, discrimination against sexual minorities stays widespread In Australia.
For example, religious organizations can still discriminate against LGBTQ+ students and employees. Conversion practices that try and change or suppress someone’s sexuality or gender identity are still legal in some states and territories.
Structural discrimination can even affect access to healthcare for sexual minorities. For example, in regions where there may be more stigmatization, sexual minorities could also be less more likely to disclose their sexual orientation to healthcare staff because of fear of discrimination.
Disclosure is needed since it results in higher resultsincluding improved quality AND continuity Care.
Finding healthcare that gives access to healthcare could be harder in areas with higher stigma, and even harder in areas where few healthcare options.
We must urgently invest in inclusive and responsive healthcare. The federal government has committed to Ten Year Action Plan for LGBTQ+ health and well-being. But we also need funding for LGBTQ+ community-led health organizations that might help sexual minorities access needed and precious health care that’s culturally appropriate.
In particular, our research suggests that resources needs to be targeted to areas where there is bigger opposition to marriage equality, in addition to to young people living in socio-economically disadvantaged regions.
We need more data
Our research only looks at health inequalities for Australians in same-sex relationships. We cannot draw any conclusions about the health of unpartnered sexual minorities, or any effects on the broader LGBTQ+ community. We simply should not have reliable, comprehensive data.
We subsequently support recent calls for higher and more inclusive data collection on sexual orientation and gender identityin this in Census 2026.
Better data would allow us to find out what strategies and interventions can reduce stigma and subsequently reduce the health inequalities faced by sexual minorities in Australia.
We would really like to thank Ian Down from LGBTIQ+ Health Australia for his feedback on this text.