Marriage could be good for your health - unless you're bisexual

September 30, 2019 - Ning Hsieh and Hui Liu

Is marriage good for you?

A large number of studies show that married people enjoy better health than unmarried people, such as lower rates of depression and cardiovascular conditions, as well as longer lives.

However, these findings have been developed primarily based on data of heterosexual populations and different-sex marriages. Only more recently have a few studies looked into gay and lesbian populations and same-sex marriages to test if marriage is related to better health in these populations – and the evidence is mixed.

Our study, published online on Sept. 19, evaluates the advantages of marriage across heterosexual, bisexual, and gay or lesbian adults. We discovered that bisexual adults do not experience better health when married.

Marriage and health data

Using representative data from the 2013 to 2017 National Health Interview Survey, we compared reports of self-rated health and functional limitation – difficulty doing activities without assistance or special equipment – across 1,428 bisexual adults, 2,654 gay and lesbian adults and 150,403 heterosexual adults.

Both heterosexual and gay and lesbian individuals are better off in terms of health when they are married than when unmarried.

For example, the odds of reporting good health are about 36% higher among married gay and lesbian adults than never married or previously married gay and lesbian adults.

Rates of functional limitation, such as difficulty climbing stairs and going out for shopping, are 25% to 43% lower among married heterosexual adults than cohabiting, never married and previously married heterosexual adults.

Why does this happen? There are two popular explanations.

The marriage protection argument posits that marriage increases economic security and social support and encourages healthier lifestyles – for example, less smoking and drinking.

The marriage selection argument suggests that people with more education, income and other health-favorable characteristics are more likely to get married and stay in marriage.

However, unlike heterosexual and gay or lesbian adults, our study shows that married bisexuals are not healthier than unmarried bisexuals.

Interestingly, among bisexuals who are married or cohabiting, those with a same-sex partner are healthier than those with a different-sex partner. Their odds of reporting good health are 2.3 times higher and the rates of functional limitation are 61% lower.

Relationship stigma

Our findings suggest that bisexuals face unique challenges in their relationships that may reduce the health advantage linked to marriage.

A growing number of studies have found that bisexual individuals experience poorer health than heterosexual, gay or lesbian individuals. This includes higher rates of mental disorders, cardiovascular conditions and disability.

Bisexual people are often perceived by both heterosexual and gay and lesbian people as indecisive about their sexual orientation, sexually permissive, and unfaithful or untrustworthy as romantic partners. For example, an experimental study showed that people more often project such negative stereotypes onto a bisexual man dating a woman than they do onto a heterosexual man dating a woman or a gay man dating a man.

Researchers like ourselves still don’t fully understand the ways in which stigma influences bisexuals’ relationships and health.

We suspect that this stigma may undermine the health and well-being of bisexual people. It may strain their relationships and create expectations of rejection. Their efforts to conceal a bisexual identity from a partner or other people may also trigger stress.

We hope to see marriage one day become not only more accessible to all, but also equally favorable for all.