Put the Safe Delivery App in the hands of midwives in PNG
Put the Safe Delivery App in the hands of midwives in PNG
A statement from the Macfarlane Burnet Institute for Medical Research and Public Health (Burnet Institute) on the Australian Same-Sex Marriage Survey:
An evidence-based argument in support of the LGBTI community
The Burnet Institute deeply respects views on both sides of the same-sex marriage (SSM) debate and recognises that the vast majority of individuals, regardless of their voting intention, are thoughtful and considered in their approach to this issue. Most simply want the best for their families, their wider community and for Australia. We speak to these individuals in outlining our attitude to the SSM survey.
The influences on our thinking on any issue are twofold. First, we highlight our own Institute’s mission, Equity through better health. It could just as well read better health through equity, as the evidence is overwhelming that more equitable opportunity for a productive and successful life improves people’s health, especially of those who experience entrenched disadvantage. Second, we stress that we are entirely evidence-based in our approach to every issue. We are unaligned to any other doctrine or influence. As the evidence changes with better research, accordingly, so does our attitude. We are strongly of the view that this should be the basis for decision-making on issues of social significance.
Although things have improved in Australia over recent decades, the lesbian, gay, bisexual, trans and intersex (LGBTI) community has long experienced profound marginalisation and discrimination. This has harmed their health and wellbeing. It is well documented in Australia that, as a result of discrimination, abuse, exclusion and prejudice, LGBTI people experience higher levels of psychosocial distress and are at increased risk of health problems including depression, anxiety, self-harm, suicidal ideation and suicide (Leonard, Lyons, & Bariola, 2015; Rosenstreich, 2013).
Conversely, there is a well-established body of research evidence showing the health benefits of marriage for heterosexual couples (e.g., Horwitz, White, & Howell-White, 1996; Kim & McKenry, 2002), with more recent findings, mostly originating in the US, showing this is also true for same-sex couples. A survey of 2,677 lesbian, gay, bisexual people found that these individuals in formalised relationships (such as registered domestic partnerships, civil unions, marriage) reported less homophobia, depressive symptoms, and stress, alongside enhanced wellbeing, than those in a committed but not formalised, relationship (Riggle, Rostosky, & Horne, 2010). These findings are consistent with those reported in several other US-based studies (Fingerhut & Maisel, 2010; Wienke & Hill, 2009; Wight, LeBlanc, & Badgett, 2013).
In Australia, a recent study of over 1000 Australian lesbians and gay men in same-sex relationships reported similar findings (Bariola, Lyons, & Leonard, 2015). Lesbians and gay men who formalised their relationship through marriage, commitment ceremonies, and registered domestic partnerships had significantly better mental health than those who had not formalised their relationship (Bariola et al., 2015).
In light of the social exclusion experienced by the LGBTI community, formal legal recognition of marriage for same sex couples will improve the health and wellbeing of broader members of the LGBTI community and not just those in committed relationships or those wanting to marry. Sexual minority populations living in high-prejudice communities have been shown to experience elevated rates of suicide, homicide/violence and cardiovascular diseases (Hatzenbuehler et al, 2014). Studies conducted in the US have shown that simply living in a jurisdiction that legally sanctions same-sex marriage has positive implications for the health of lesbians, gay men and bisexual men and women (Hatzenbuehler, McLaughlin, Keyes, & Hasin, 2010; Kail, Acosta, & Wright, 2015).
It also needs to be acknowledged that the current debate on SSM itself has the potential to be stressful and potentially hurtful to an already vulnerable LGBTI community, especially the young. In the US, the mental health of LGB people was shown to suffer during referendum debates on marriage equality relative to those living in states without such referenda (Hatzenbuehler, McLaughlin, Keyes, & Hasin, 2010).
As for the non-LGBTI community, there is no credible evidence in any jurisdiction that poorer outcomes for these people result when laws have changed in support of SSM.
By no means is it the Burnet Institute’s role to tell anyone how to vote. But as one of Australia’s most established and trusted health research agencies with expertise in this area we are compelled to highlight the evidence associated with this debate. On the basis of the evidence summarised above, and on the understanding that equity drives better health, the Burnet Institute endorses marriage equality in Australia that is legislated in law.
Professor Brendan Crabb AC,
Director and CEO
Bariola, E., Lyons, A., & Leonard, W. (2015). The mental health benefits of relationship formalisation among lesbians and gay men in same-sex relationships. Australian and New Zealand Journal of Public Health, 39(6), 530-535. doi: 10.1111/1753-6405.12432
Fingerhut, A. W., & Maisel, N. C. (2010). Relationship formalization and individual and relationship well-being among same-sex couples. Journal of Social and Personal Relationships, 27(7), 956-969. doi: 10.1177/0265407510376253
Hatzenbuehler, M. L., McLaughlin, K. A., Keyes, K. M., & Hasin, D. S. (2010). The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: A prospective study. American Journal of Public Health, 100(3), 452-459. doi: 10.2105/ajph.2009.168815
Hatzenbuehler, M. L., O'Cleirigh, C., Grasso, C., Mayer, K., Safren, S., & Bradford, J. (2012). Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment. American Journal of Public Health, 102(2), 285-291. doi: 10.2105/ajph.2011.300382
Hatzenbuehler, M. L., McLaughlin, K. A., Keyes, K. M., & Hasin, D. S. (2010). The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: A prospective study. American Journal of Public Health, 100(3), 452- 459.
Hatzenbuehler ML, Bellatorre A, Lee Y, Finch BK, Muennig P, Fiscella K. Structural stigma and allcause mortality in sexual minority populations. Social Science and Medicine. 2014;103:33-41. Horwitz, A. V., White, H. R., & Howell-White, S. (1996). Becoming married and mental health: A longitudinal study of a cohort of young adults. Journal of Marriage and the Family, 58(4), 895-907. doi: 10.2307/353978
Kail, B. L., Acosta, K. L., & Wright, E. R. (2015). State-Level Marriage Equality and the Health of Same-Sex Couples. American Journal of Public Health, 105(6), 1101-1105. doi: 10.2105/ajph.2015.302589 Kim, H. K., & McKenry, P. C. (2002). The relationship between marriage and psychological well-being - A longitudinal analysis. Journal of Family Issues, 23(8), 885-911. doi: 10.1177/019251302237296 Leonard, W., Lyons, A., & Bariola, E. (2015). A closer look at Private Lives 2: Addressing the mental health and wellbeing of lesbian, gay, bisexual and transgender (LGBT) Australians. Monograph Series No. 103. The Australian Research Centre in Sex, Health & Society, La Trobe University: Melbourne
Mallory, C., & Sears, B. (2016). Estimating the economic impact of marriage for same-sex couples one year after Obergefell. Los Angeles, CA: The Williams Institute, UCLA School of Law.
Riggle, E. D. B., Rostosky, S. S., & Horne, S. G. (2010). Psychological distress, well-being, and legal recognition in same-sex couple relationships. Journal of Family Psychology, 24(1), 82-86. doi: 10.1037/a0017942
Rosenstreich, G. (2013) LGB People Mental Health and Suicide. Revised 2nd Edition. National LGB Health Alliance. Sydney.
Wienke, C., & Hill, G. J. (2009). Does the “Marriage Benefit” extend to partners in gay and lesbian relationships? Evidence from a random sample of sexually active adults. Journal of Family Issues, 30(2), 259-289. doi: 10.1177/0192513x08324382
Wight, R. G., LeBlanc, A. J., & Badgett, M. V. L. (2013). Same-sex legal marriage and psychological well-being: Findings from the California Health Interview Survey. American Journal of Public Health, 103(2), 339-346. doi: 10.2105/ajph.2012.301113
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Director and CEO; Co-Head Malaria Research Laboratory; Chair, Victorian Chapter of the Association of Australian Medical Research Institutes (AAMRI)