We work from a minority stress perspective to theorize health disparities across union status at the intersection of sexual minority status, race-ethnicity, and gender. We use pooled data from the Integrated National Health Interview Surveys (1997–2014) to assess a wide range of health outcomes, including self-rated physical health, psychological distress, and health behaviors. Results suggest that same-sex cohabitors face substantial health disadvantages relative to different-sex married individuals, with little variation by race-ethnicity and gender. Fewer health differences are found for same-sex cohabitors in comparison with both different-sex cohabitors and unpartnered singles, although greater variation by gender and race-ethnicity is found across these comparisons. This study highlights the importance of integrating intersectionality and minority stress theories to guide future research examining sexual minority health disparities. Results suggest that the sexual minority health disadvantage, as well as the potential health boost of same-sex marriage, may depend on the intersection of race-ethnicity and gender.
AgrestiAlanFinleyBarbara. 2009. Statistical Methods for the Social Sciences. Upper Saddle River, NJ: Prentice Hall.
2.
AngelRonald J.AngelJacqueline L.2009. Hispanic Families at Risk: The NEW Economy, Work, and the Welfare State. New York: Springer.
3.
AustinS. BrynNelsonLauren A.BirkettMichelle A.CalzoJerel P.EverettBethany. 2013. “Easting Disorder Symptoms and Obesity at the Intersections of Gender, Ethnicity, and Sexual Orientation in US High School Students.”American Journal of Public Health103(2):e16–22.
4.
BeckerGary S.1993. A Treatise on the Family. Cambridge, MA: Harvard University Press.
5.
BlackDan A.SandersSeth G.TaylorLowell J.2007. "The Economics of Lesbian and Gay Families."The Journal of Economic Perspectives21(2):53–70.
6.
BlosnichJohn R.JarrettTraciHornKimberly. 2011. “Racial and Ethnic Differences in Current Use of Cigarettes, Cigars, and Hookahs among Lesbian, Gay, and Bisexual Young Adults.”Nicotine & Tobacco Research13(6):487–491.
7.
BonillaLouisPorterJudith. 1990. “A Comparison of Latino, Black, and Non-Hispanic White Attitudes toward Homosexuality.”Hispanic Journal of Behavioral Sciences12(4):437–452.
8.
BowlegLisa. 2008. “When Black + Lesbian + Woman ≠ Black Lesbian Woman: The Methodological Challenges of Qualitative and Quantitative Intersectionality Research.”Sex Roles59(5–6):312–325.
9.
BrinesJulieJoynerKara. 1999. “The Ties That Bind: Principles of Cohesion in Cohabitation and Marriage.”American Sociological Review64(3):333–355.
10.
BuffieWilliam C.2011. “Public Health Implications of Same-sex Marriage.”American Journal of Public Health101(6):986–990.
11.
BurgardSarah A.CochranSusan D.MaysVickie M.2005. “Alcohol and Tobacco Use Patterns among Heterosexually and Homosexually Experienced California Women.”Drug and Alcohol Dependence77(1):61–70.
12.
BurmanBonnieMargolinGayla. 1992. “Analysis of the Association between Marital Relationships and Health Problems: An Interactional Perspective.”Psychological Bulletin112(1):39–63.
13.
CarrDeborahSpringerKristen W.2010. “Advances in Families and Health Research in the 21st Century.”Journal of Marriage and Family72(3):743–761.
14.
CherlinAndrew J.2013. “Health, Marriage, and Same-sex Partnerships.”Journal of Health and Social Behavior54(1):64–66.
15.
ColeElizabeth R.2009. “Intersectionality and Research in Psychology.”American Psychologist64(3):170–180.
16.
CollinsPatricia Hill. 2000. Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment. New York: Routledge.
17.
CrenshawKimberle. 1991. “Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color.”Stanford Law Review43(6):1241–1299.
18.
DenneyJustin T.GormanBridget K.BarreraCristina B.2013. “Families, Resources, and Adult Health: Where Do Sexual Minorities Fit?”Journal of Health and Social Behavior54:46–63.
19.
FieldsJason M.ClarkCharles L.1999. “Unbinding the Ties: Edit Effects of Marital Status on Same Gender Couples.” Population Division Working Paper No. 43, U.S. Bureau of the Census, Washington, DC.
20.
FlegalKatherine M.CarrollMargaret D.OgdenCynthia L.CurtinLester R.2010. “Prevalence and Trends in Obesity among US Adults, 1999-2008.”The Journal of the American Medical Association303(3):235–241.
21.
FuHaishanGoldmanNoreen. 1996. “Incorporating Health into Models of Marriage Choice: Demographic and Sociological Perspectives.”Journal of Marriage and Family58(3):740–758.
22.
GormanBridget K.DenneyJustin T.DowdyHilaryMedeirosRose Anne. 2015. “A New Piece of the Puzzle: Sexual Orientation, Gender, and Physical Health Status.”Demography52(4):1357–1382.
23.
GreenKelly E.FeinsteinBrian A.2012. “Substance Use in Lesbian, Gay, and Bisexual Populations: An Update on Empirical Research and Implications for Treatment.”Psychology of Addictive Behaviors26(2):265–278.
24.
GreeneBeverlyHerekGregory M.1997. Psychological Perspectives on Lesbian and Gay Issues: Vol. 3. Ethnic and Cultural Diversity among Lesbians and Gay Men. Thousand Oaks, CA: Sage Publications.
25.
GreenmanEmilyXieYu. 2008. “Double Jeopardy? The Interaction of Gender and Race on Earnings in the United States.”Social Forces86(3):1217–1244.
26.
Hames-GarcíaMichaelMartínezErnesto Javier. 2011. Gay Latino Studies: A Critical Reader. Durham, NC: Duke University Press.
27.
HerekGregory M.2006. “Legal Recognition of Same-sex Relationships in the United States: A Social Science Perspective.”American Psychologist61(6):607–621.
28.
HerekGregory M.NortonAaron T.AllenThomas J.SimsCharles L.2010. “Demographic, Psychological, and Social Characteristics of Self-identified Lesbian, Gay, and Bisexual Adults in a US Probability Sample.”Sexuality Research and Social Policy7(3):176–200.
29.
HorwitzAllan V.WhiteHelene Raskin. 1998. “The Relationship of Cohabitation and Mental Health: A Study of a Young Adult Cohort.”Journal of Marriage and Family60:505–514.
30.
IdlerEllen L.BenyaminiYael. 1997. “Self-rated Health and Mortality: A Review of Twenty-seven Community Studies.”Journal of Health and Social Behavior38(1):21–37.
31.
Institute of Medicine. 2007. Lesbian, Gay, Bisexual and Transgender Health Issues and Research Gaps and Opportunities. Washington, DC: National Academies Press.
32.
Institute of Medicine. 2011. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: National Academies Press.
33.
Katz-WiseSabra L.BloodEmily A.MillirenCarly E.CalzoJerel P.RichmondTracy K.GoodingHolly C.AustinS. Bryn. 2014. “Sexual Orientation Disparities in BMI among US Adolescents and Young Adults in Three Race/Ethnicity Groups.”Journal of Obesity2014:537242.
34.
KesslerRonald C.GreenJennifer GreifGruberMichael J.SampsonNancy A.BrometEvelynCuitanMariusFurukawaToshi A.GurejeOyeHinkovHristoHuChi-YiLaraCarmenLeeSingMneimnehZeinaMyerLandonOakley-BrowneMarkPosada-VillaJoseSagarRajeshVianaMaria CarmenZaslavskyAlan M.2010. “Screening for Serious Mental Illness in the General Population with the K6 Screening Scale: Results from the WHO World Mental Health (WMH) Survey Initiative.”International Journal of Methods in Psychiatric Research19(S1):4–22.
35.
LaitinenJaanaEkEllenSovioUlla. 2002. “Stress-related Eating and Drinking Behavior and Body Mass Index and Predictors of This Behavior.”Preventative Medicine34(1):29–39.
36.
LewisGregory B.2003. “Black-white Differences in Attitudes toward Homosexuality and Gay Rights.”Public Opinion Quarterly67(1):59–78.
37.
LickDavid J.DursoLaura E.JohnsonKerri L.2013. “Minority Stress and Physical Health among Sexual Minorities.”Perspectives on Psychological Science8(5):5521–5548.
38.
LiuHuiReczekCorinne. 2012. “Cohabitation and U.S. Adult Mortality: An Examination by Gender and Race.”Journal of Marriage and Family74(4):794–811.
39.
LiuHuiReczekCorinneBrownDustin. 2013. “Same-sex Cohabitors and Health: The Role of Race-ethnicity, Gender, and Socioeconomic Status.”Journal of Health and Social Behavior54(1):25–45.
40.
LiuHuiUmbersonDebra. 2008. “The Times They Are a Changin’: Marital Status and Health Differentials from 1972 to 2003.”Journal of Health and Social Behavior49(3):239–253.
41.
LoftusJeni. 2001. “America’s Liberalization in Attitudes toward Homosexuality.”American Sociological Review66(5):762–782.
42.
MeyerIlan H.2003. “Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence.”Psychological Bulletin129(5):674–697.
43.
Minnesota Population Center and State Health Access Data Assistance Center. 2015. Integrated Health Interview Series: Version 6.12. Minneapolis: University of Minnesota.
44.
MusickKellyBrandJennie E.DavisDwight. 2012. “Variation in the Relationship between Education and Marriage: Marriage Market Mismatch?”Journal of Marriage and Family74(1):53–69.
45.
National Center for Health Statistics. 2000. National Health Interview Survey [computer file]. 2nd ICPSR version. Hyattsville, MD: U.S. Department of Health and Human Services, National Center for Health Statistics.
46.
NgDebbie M.JefferyRobert W.2003. “Relationships between Perceived Stress and Health Behaviors in a Sample of Working Adults.”Health Psychology22(6):638–642.
47.
PalloniAlbertoMorenoffJeffrey D.2001. “Interpreting the Paradoxical in the Hispanic Paradox: Demographic and Epidemiologic Approaches.”Annals of the New York Academy of Sciences954(1):140–174.
48.
ParentMike C.DeBlaereCirleenMoradiBonnie. 2013. “Approaches to Research on Intersectionality: Perspectives on Gender, LGBT, and Racial/Ethnic Identities.”Sex Roles68(11–12):639–645.
49.
Ramirez-VallesJesusKuhnsLisa M.CampbellRichard T.DiazRafael M.2010. “Social Integration and Health: Community Involvement, Stigmatized Identities, and Sexual Risk in Latino Sexual Minorities.”Journal of Health and Social Behavior51(1):30–47.
50.
ReadJen’nan GhazalGormanBridget K.2006. “Gender Inequalities in US Adult Health: The Interplay of Race and Ethnicity.”Social Science & Medicine62(5):1045–1065.
51.
ReczekCorinneElliottSinikkaUmbersonDebra. 2009. “Commitment without Marriage: Union Formation among Long-term Same-sex Couples.”Journal of Family Issues30(6):738–756.
52.
ReczekCorinneLiuHuiBrownDustin. 2014. “Cigarette Smoking in Same-sex and Different-sex Unions: The Role of Socioeconomic and Psychological Factors.”Population Research and Policy Review33(4):527–551.
53.
ReczekCorinneLiuHuiSpikerRussell. 2013. “Same-sex Unions and Health: An Examination of Alcohol Use.”Paper presented at the Population Association of America, April 11–13, New Orleans, LA.
54.
ReczekCorinneUmbersonDebra. 2012. “Gender, Health Behavior, and Intimate Relationships: Lesbian, Gay, and Straight Contexts.”Social Science & Medicine74(11):1783–1790.
55.
RoblesTheodore F.Kiecolt-GlaserJanice K.2003. “The Physiology of Marriage: Pathways to Health.”Physiology & Behavior79(3):409–416.
56.
RosenfeldMichael. 2007. The Age of Independence: Interracial Unions, Same-sex Unions and the Changing American Family. Cambridge, MA: Harvard University Press.
57.
RothblumEstherSolovaySondra. 2009. The Fat Studies Reader. New York: New York University Press.
58.
SchulzAmy J.MullingsLeith. 2006. Gender, Race, Class, and Health: Intersectional Approaches. San Francisco, CA: Jossey-Bass.
59.
ShieldsStephanie A.2008. “Gender: An Intersectionality Perspective.”Sex Roles59(5):301–311.
60.
StataCorp. 2007. Stata Statistical Software: Release 10. College Station, TX: StataCorp.
61.
UmbersonDebraLiuHuiReczekCorinne. 2008. “Stress and Health Behavior over the Life Course.” Pp. 19–44 in Advances in Life Course Research: Stress Processes across the Life Course, edited by TurnerH.SchiemannS.New York: Reed Elsevier.
62.
UmbersonDebraMontezJennifer Karas. 2010. “Social Relationships and Health: A Flashpoint for Health Policy.”Journal of Health and Social Behavior51(1):S54–S66.
63.
UmbersonDebraWilliamsKristiThomeerMieke. 2013. “Family Status and Mental Health: Recent Advances and Future Directions.” Pp. 405–431 in Handbook of the Sociology of Mental Health, 2nd edition, edited by AneshenselC. S.PhelanJ. C.BiermanAlex. New York: Springer.
64.
VeenstraGerry. 2011. “Race, Gender, Class, and Sexual Orientation: Intersecting Axes of Inequality and Self-rated Health in Canada.”International Journal for Equity in Health10(1):3–13.
WaiteLinda J.GallagherMaggie. 2000. The Case for Marriage: Why Married People Are Happier, Healthier, and Better off Financially. New York: Doubleday.
67.
WHO Expert Committee. 1995. “Physical Status: The Use and Interpretation of Anthropometry.”WHO Technical Report Series 854. Geneva, Switzerland: World Health Organization.
68.
WilliamsDavid R.SternthalMichelle. 2010. “Understanding Racial-ethnic Disparities in Health Sociological Contributions.”Journal of Health and Social Behavior51(1):S15–S27.
69.
WilliamsKristiUmbersonDebra. 2004. “Marital Status, Marital Transitions, and Health: A Gendered Life Course Perspective.”Journal of Health and Social Behavior45(1):81–98.
70.
WorthenMeredith G. F.2013. “An Argument for Separate Analyses of Attitudes toward Lesbian, Gay, Bisexual Men, Bisexual Women, MtF and FtM Transgender Individuals.”Sex Roles68(11):703–723.
