Impact of discriminatory laws on psychopathology in LGB populations: A prospective study

Background: Policy debates regarding lesbian, gay and bisexual (LGB) populations are center stage in the public discourse in countries across the world. Few studies, however, have empirically examined the extent to which such policies impact the mental health of LGB individuals, and none have used general population data or detailed measurement of DSM-IV diagnoses. The present study examined associations between the passage of discriminatory laws during the 2004 election and changes in the prevalence of psychiatric disorders among LGB respondents assessed prior and subsequent to the change in law.

Methods: Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653), a longitudinal nationally representative study of non-institutionalized U.S. adults, conducted in 2001-2005.

Results: A significant increase in mood disorders (36.6%), generalized anxiety disorder (248.2%), alcohol use disorder (41.9%) and psychiatric comorbidity (36.3%) was observed among LGB respondents living in states that passed anti-gay marriage amendments, relative to LGB respondents living in states that did not change their marriage laws (mood disorder: 23.6% decrease; generalized anxiety disorder: 48% increase; alcohol use disorder: 28.9% increase; comorbidity: 8.5% increase). Results were consistent for comparisons between LGB respondents and heterosexuals living in states passing these amendments. Controlling for multiple sociodemographic factors did not attenuate these relationships.

Conclusions: This study provides the strongest empirical evidence to date demonstrating that discriminatory policies may have pernicious consequences for the mental health of LGB populations. These results lend timely scientific support for recent efforts that aim to overturn these policies.