Young Americans living in states where same-sex marriage was legalized were significantly less likely to attempt suicide than those living in states without such laws, according to a study from Harvard T.H. Chan School of Public Health and Johns Hopkins University.
The study was published online February 20, 2017 in JAMA Pediatrics.
Same-sex marriage policies were associated with a 7% reduction in the proportion of high school students reporting suicide attempts. The association was concentrated among students who were sexual minorities, who attempt suicide at a rate four times higher than heterosexual teenagers, according to the U.S. Centers for Disease Control and Prevention (CDC).
The researchers looked at data from 1999-2015 from more than 750,000 high school students who were surveyed as part of the CDC’s Youth Risk Behavior Surveillance System, which collects information each year about diet, sexual behaviors, and drug and alcohol use. The data—collected before the Supreme Court’s June 2015 ruling legalizing same-sex marriage across the U.S.—reflected 32 states that had legalized same-sex marriage between 2004 and 2015, and 15 states that had not.
Overall, 28.5% of students who identified as a sexual minority said they had attempted suicide one or more times; among heterosexual students, 6% said they had made a suicide attempt. In states that legalized same-sex marriage, suicide attempt rates dropped among all students, but the decrease was more pronounced among gay, lesbian, and bisexual students.
For the authors, the findings highlight the need for further study of the relationship between adolescent mental health and rapidly changing legal rules and social mores around sexual identity.
Lead author of the study was Dr. Julia Raifman, an epidemiologist at Johns Hopkins Bloomberg School of Public Health who began the research while a doctoral student at Harvard Chan School. Senior author was Dr. Margaret McConnell, assistant professor of global health economics at Harvard Chan School. Other Harvard Chan authors included Dr. S. Bryn Austin, professor in the Department of Social and Behavior Sciences, and doctoral student Ms. Ellen Moscoe.