Social Behavior
Journal of Health and
The online version of this article can be found at:
DOI: 10.1177/0022146512474430
2013 54: 64 Journal of Health and Social Behavior
Andrew J. Cherlin
Health, Marriage, and Same-Sex Partnerships
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American Sociological Association
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Journal of Health and Social Behavior
54(1) 64 –66
© American Sociological Association 2013
DOI: 10.1177/0022146512474430
For several decades now, the question of whether
marriage is beneficial to an individual’s health and
well-being has been a major topic in both the soci-
ology of the family and the sociology of health.
Numerous studies have shown that married people
are better off than unmarried people in terms of
physical health, mental health, and family income
(Waite and Gallagher 2000). These associations,
however, do not prove a cause-and-effect relation-
ship, and there has been much debate over whether
marriage makes people healthier and happier or
whether healthier and happier people self-select
into marriage and, once married, are less likely to
divorce. Certainly, self-selection plays a role, and
this role may be expanding because lifetime mar-
riage probabilities are now higher, and lifetime
divorce probabilities are now substantially lower,
for the more educated than for the less educated.
Yet it seems unlikely that selection is the whole
Until the recent legalization of same-sex mar-
riage in some jurisdictions, however, it was impos-
sible to determine how much of the advantage
marriage may provide is dependent on the marriage
partners’ being of different sexes. Now, with same-
sex marriage legal in a number of states (nine, plus
the District of Columbia, as of this writing), we have
the potential to observe marriages without gender
differences. It is too early for findings to appear in
the research literature, but I am sure we will soon
see informative studies that compare same-sex and
different-sex marriages. In the meantime, we finally
have enough data from large, national probability
samples to begin to study same-sex cohabiting
unions, which have been understudied in the
past because of their modest numbers in national
surveys—and probably because individuals were
more reluctant to disclose that they were in same-
sex unions. The two articles in this issue use pooled
data from several administrations of the National
Health Interview Survey (NHIS) to gather enough
same-sex cohabiting partners to compare their self-
rated health with that of different-sex married and
cohabiting partners.
Given this opportunity, and the possibility of
directly studying same-sex marriage in the near
future, how should we theorize the relationship
among marriage, cohabitation, and health in same-
sex partnerships in the United States? The simplest
theory, I would argue, begins with the observation
that intimate relationships appear to have similar
meanings for same-sex partners and different-sex
partners. This observation is supported by the
research literature on relationships, albeit on the
basis of small, nonrandom samples. Studies that
have compared gay, lesbian, and heterosexual cou-
ples have found no significant differences in love,
satisfaction, or the partners’ evaluations of the
strengths and weaknesses of their relationships (Pep-
lau 1991; Savin-Williams and Esterberg 2000). We
might therefore expect marriage and cohabitation
to have similar meanings for same-sex and differ-
ent-sex partners and to therefore have similar
effects on health. Should this proposition fail to
completely explain research findings, we could
Journal of Health and Social BehaviorCherlin
Johns Hopkins University, Baltimore, MD, USA
Corresponding Author:
Andrew J. Cherlin, Johns Hopkins University,
Department of Sociology, Baltimore, MD 21218, USA.
Health, Marriage, and
Same-Sex Partnerships
Andrew J. Cherlin
cohabitation, marriage, same-sex partnerships
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Cherlin 65
then invoke more complex theories, such as the
following: (1) the health benefits of marriage are
limited for same-sex married couples because of
factors such as continuing discrimination against
gay and lesbian individuals that lower the health of
both partners, or (2) the distinctive effects of mar-
riage occur only when it is the union of a man and
woman, who come to their partnership with gen-
dered upbringings, who face different labor market
conditions, and who may, on average, have some
deep-seated personality differences.
If marriage and cohabitation have similar
meanings regardless of the gender of the partners,
then we would expect cohabiting partners to be
less committed to each other and more likely to
disrupt over time regardless of gender. It is well
established that different-sex cohabiting relation-
ships show these properties compared with differ-
ent-sex marriages in the United States (Cherlin
2009). Less commitment may result in less atten-
tion by each partner to the other’s long-term health
and well-being. With respect to the analyses in the
two articles in this issue, we might then expect at
first that self-reported health in the NHIS samples
would be lower among cohabitors, different-sex or
same-sex, than among married persons. Yet there
is a complication. It is likely that some same-sex
cohabitors would have married if it were possible.
Those couples may be more committed to each
other than same-sex couples who would not have
married even if it were possible. If so, then the
same-sex cohabitor category in the NHIS data
would include a mixture of couples of varying
commitment and stability. Therefore, the better
hypothesis is that same-sex cohabitors, as a whole,
would occupy a middle position in the health hier-
archy: Their levels of self-reported health would
be better than different-sex cohabitors but not as
good as married persons.
That is what the analyses in these articles show:
Same-sex couples occupy a middle position, at least
when the authors control only for exogenous charac-
teristics such as race, age, region, and year. Control-
ling for socioeconomic status reduces the difference
between the two cohabiting groups, but socioeco-
nomic status differences are such a fundamental part
of the cohabitation and marriage picture in the
United States that statistical models that include
them may be overcontrolling: discarding variation
that is a basic part of the phenomena under study.
What can we learn from this finding? First, as the
authors note, it is likely that during this historical
period, individuals in same-sex partnerships, all but
a handful of whom were unable to marry, repre-
sented a combination of those who would have
made the commitment to marriage if they could and
those who would have not. Said otherwise, same-
sex cohabitors may have represented an in-between
group that was more marriage-like, on average, than
different-sex cohabitors but more cohabitation-like,
on average, than married couples. Their middle
position suggests that something about cohabitation,
above and beyond gender dynamics, separated it
from marriage. And their middle position was
reflected in their level of health.
But we cannot really have confidence in these
findings until we see studies that directly compare
individuals in same-sex and different-sex marriages.
These studies, which sociologists eagerly anticipate,
will help us answer questions such as whether the
advantage of marriage for health and well-being has
been based on wives’ doing gendered “health behav-
ior work” (Reczek and Umberson 2012) that keeps
their husbands healthier (by providing emotional
support and promoting healthier behavior and regular
visits to a physician) or whether marriage is a more
efficient partnership for supporting and encouraging
healthy behavior, regardless of the genders of the
spouses. And even if marriage were found to be better
for health outcomes regardless of gender, its advan-
tage could be due to a number of factors: the greater
legal rights of married couples (including federal
benefits that state-by-state same-sex marriage laws
cannot currently include); the utility of two people
working in partnership, supporting and encouraging
each other for their mutual long-term benefit; or a
self-selection mechanism that could apply to both
same-sex and different-sex marriage.
For now, the results of these two studies would
suggest that as far as health benefits are concerned,
cohabiting relationships in the United States are
still less beneficial than marriages, even when the
genders of the partners are the same. Moreover, the
results are consistent with the theory that marriage
and cohabitation may have similar meanings, and
similar implications for health, regardless of the
genders of the partners. I am not suggesting that
this is the whole story; I would expect that future
studies will show the continuing relevance of
gender and sexuality. Nevertheless, I would predict
that as same-sex marriage becomes legal in more
jurisdictions, the self-reported health of individu-
als in same-sex cohabiting unions will decline, on
average, because couples who have a firmer basis
for good health will be more likely to marry rather
than to continue to cohabit.
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66 Journal of Health and Social Behavior 54(1)
Cherlin, Andrew J. 2009. The Marriage-Go-Round: The
State of Marriage and the Family in America Today.
New York: Knopf.
Denney, Justin T., Bridget K. Gorman, and Cristina B.
Barrera. 2013. “Families, Resources, and Adult
Health: Where Do Sexual Minorities Fit?” Journal of
Health and Social Behavior 54:46–63.
Liu, Hui, Corinne Reczek, and Dustin Brown. 2013.
“Same-Sex Cohabitors and Health: The Role of Race-
Ethnicity, Gender, and Socioeconomic Status.” Jour-
nal of Health and Social Behavior 54:25–45.
Peplau, Letitia A. 1991. “Lesbian and Gay Relation-
ships.” Pp. 177–96 in Homosexuality: Research
Implications for Public Policy, edited by J. C. Gon-
siorek and J. D. Weinrich. Newbury Park, CA: Sage.
Reczek, Corinne and Debra Umberson. 2012. “Gender,
Health Behavior, and Intimate Relationships: Les-
bian, Gay, and Straight Contexts.” Social Science &
Medicine 74(11):1783–90.
Savin-Williams, Ritch C. and Kristin G. Esterberg. 2000.
“Lesbian, Gay, and Bisexual Families.” Pp. 197–
215 in Handbook of Family Diversity, edited by D.
H. Demo, K. R. Allen, and M. A. Fine. New York:
Oxford University Press.
Waite, Linda J. and Maggie Gallagher. 2000. The Case
for Marriage: Why Married People Are Happier,
Healthier and Better Off Financially. New York:
Author Biography
Andrew J. Cherlin is the Benjamin H. Griswold III Pro-
fessor of Sociology and Public Policy at Johns Hopkins
University. He has written widely about American family
life. His publications include the books The Marriage-
Go-Round: The State of Marriage and the Family in
America Today (2009) and Public and Private Families:
An Introduction (Seventh Edition, 2013) and the articles
“The Deinstitutionalization of American Marriage”
(Journal of Marriage and Family, 2004, volume 66, pp.
848–61); “Demographic Trends in the United States: A
Review of Research in the 2000s” (Journal of Marriage
and Family, 2010, volume 72, pp. 1–17); and “Goode’s
World Revolution and Family Patterns: A Reconsidera-
tion at Fifty Years” (Population and Development
Review, 2012, volume 38, pp. 577–607).
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