Science
Q&A: These researchers examined 20 years of data on same-sex marriage. They didn't find any harms
Twenty years ago this month, Marcia Kadish and Tanya McCloskey exchanged wedding vows at Cambridge City Hall in Massachusetts and became the first same-sex couple to legally marry in the United States.
The couple had been together since 1986, but their decision to wed was radical for its time. In 2004, only 31% of Americans supported same-sex marriage, while 60% were opposed, according to a Pew Research Center poll.
Much of that opposition was fueled by fears that expanding the definition of marriage beyond the traditional union of a man and a women would undermine the institution and be destabilizing to families. Researchers at the Rand Corp. decided to find out if those predictions turned out to be true.
A team from the Santa Monica-based think tank spent a year poring over the data. The result is a 186-page report that should be reassuring to supporters of marriage equality.
“If there were negative consequences in the last 20 years of the decision to legalize marriage for same-sex couples, no one has yet been able to measure them,” said Benjamin Karney, an adjunct behavioral scientist at Rand.
Karney, who is also a social psychologist at UCLA, led the report with Melanie Zaber, a labor economist and economic demographer at Rand. They spoke with The Times about what they learned.
Does marriage make people better off?
Benjamin Karney: On average, yes. People who are married experience fewer health problems, they live years longer, they make more money, and they accumulate more wealth than people who marry and divorce or who don’t marry at all. People who are married also experience more stable and positive psychological health, and they have sex more frequently than people who are not married.
All those benefits accrue primarily to people who are in happy marriages. Unhappy marriage is very, very harmful. But most people who are married are happy — that’s why they stay married.
What prompted you to examine same-sex marriage now?
BK: At the time that these policies were changing, there were a lot of arguments on both sides about whether the consequences would be positive or negative. Twenty years is a long time, and during that time, a lot of research has been conducted. It seemed like a good time to ask the question: What did happen as a consequence of legalizing marriage for same-sex couples? So that’s one reason.
The second reason is that in the Dobbs decision that overturned Roe vs. Wade, Justice Clarence Thomas in his concurring opinion said explicitly that this Supreme Court should consider reviewing and potentially overturning other decisions, and he named the 2015 Obergefell vs. Hodges decision that legalized marriage for same-sex couples by name. Given that people may be wondering about the merits of that decision, it seemed like a good time to evaluate the consequences of that decision, and that’s what we’ve done.
What did you find?
BK: We found 96 studies across a range of disciplines. Some are in economics. Some are in psychology. Some are in medicine. Some are in public health.
Melanie Zaber: We wanted it to be research that actually measured something. There were a number of more qualitative or theoretical or legal arguments that we excluded.
BK: What I found most notable is that all of the studies drew the same conclusions: There was either no effect or beneficial effects on any outcome you could look at. That’s 20 years of research, 96 studies, and no harms.
Does it seem plausible that the results could be so one-sided?
BK: I was not surprised. There’s a lot of good theory in family science and relationship science to argue that if you extend rights to a group that’s been stigmatized, that group should do better, and the majority group should not be affected. Indeed, that’s what we found.
MZ: I don’t find it particularly surprising. When we say there are no harms, that doesn’t mean everything’s coming up sunshine and roses — it means sunshine and roses or nothing. In this case, where the prediction was something negative, then nothing still feels like sunshine and roses.
What sorts of things did these studies measure?
BK: There were three general categories. The largest group was looking at outcomes for LGBT individuals and same-sex couples. The second bucket looked at the children of same-sex parents. And the third bucket was the effect on everybody else.
There was no evidence of harms anywhere.
That’s interesting because opponents of these policy changes very strongly — and very explicitly — predicted there would be harms. They predicted it in front of the Supreme Court, arguing that if we allow same-sex couples to marry, the consequences for the country will be negative and severe and unavoidable and irreversible.
Same-sex marriage cake toppers are displayed on a shelf in San Francisco.
(Justin Sullivan / Getty Images)
Who benefits the most from legalizing same-sex marriage?
BK: Same-sex couples. Their relationships last longer when they are able to marry and cement their commitment. Their incomes go up. Their mental health improves.
That mental health improvement extends to LGBT individuals whether or not they are married. Even if you’re not married, if you’re a member of a sexual minority and live in a world that validates same-sex relationships, that relieves a stressor and has measurable benefits on physical and mental health.
What’s behind these improvements?
BK: The effects on health seem like they operate partly through employer-based health insurance being extended to spouses.
The mechanisms for mental health have been described by minority stress theory. Living in a society that is constantly sending you a message that you are less worthy of equal treatment is stressful, partly because it leads to discrimination. Being the target of discrimination is stressful, and that stress has real mental and physical consequences.
You found 96 studies about gay marriage. Why did you conduct your own research as well?
MZ: Some of those studies were conducted when only a few states had marriage for same-sex couples. A state like West Virginia or Wyoming might say, “Well that’s all well and good that you have evidence from Massachusetts or Vermont, but New England isn’t the center of the universe.”
By looking at a broader range of years, we’re better able to capture some of those states that did allow same-sex couples to marry but weren’t among the first to do so. We have reason to think those states may be very different environments. Our approach was to use each state as a quasi-experiment.
What did all that data tell you?
MZ: The headline from our new analysis is no negative impacts and some positive ones.
We see an increase in marriage, and that increase is driven not just by newly marrying same-sex couples, but also by an increase in marriage among different-sex couples. That was a bit surprising to us.
What do you think was going on?
MZ: There are a few different mechanisms for this, none of which we can explicitly test.
One could be allyship. There are individuals who identify as cisgender straight individuals, but they want to show their allyship so they delay marriage until everyone’s able to marry.
There’s an increasing number of individuals who identify as bisexual in the United States. Even if they’re marrying a different-sex partner, they may be trying to have validation of their broader identity.
The argument we find most compelling is that having people loudly clamoring for all the great things that come along with marriage made people in the broader population say, “Oh hey, getting married means people can go visit me in the hospital, and that if I’m in an accident there’s no concern about who my property will go to, and we have more access to health insurance.” Talking about that may have made some people realize, “You know, marriage actually is pretty helpful.”
BK: If you hear about a restaurant that everyone’s trying to get into, you want to eat at that restaurant.
MZ: That is an excellent way of putting it!
Do you think this research will persuade those who were concerned that same-sex marriage would have terrible consequences?
MZ: That’s our goal — to put evidence out to the public so policymakers can make informed choices.
BK: I’d like to believe so. At the time those arguments were made, they were speculative. People were trying to predict the future. Now we don’t have to predict the future. Twenty years have passed and we have the data. We can document what has happened.
This interview has been edited for length and clarity.
Science
Cancer survival rates soar nationwide, but L.A. doctors warn cultural and educational barriers leave some behind
The American Cancer Society’s 2026 Cancer Statistics report, released Tuesday, marks a major milestone for U.S. cancer survival rates. For the first time, the annual report shows that 70% of Americans diagnosed with cancer can expect to live at least five years, compared with just 49% in the mid-1970s.
The new findings, based on data from national cancer records and death statistics from 2015 to 2021, also show promising progress in survival rates for people with the deadliest, most advanced and hardest-to-treat cancers when compared with rates from the mid-1990s. The five-year survival rate for myeloma, for example, nearly doubled (from 32% to 62%). The survival rate for liver cancer tripled (from 7% to 22%), for late-stage lung cancer nearly doubled (from 20% to 37%), and for both melanoma and rectal cancer more than doubled (from 16% to 35% and from 8% to 18%, respectively).
For all cancers, the five-year survival rate more than doubled since the mid-1990s, rising from 17% to 35%.
This also signals a 34% drop in cancer mortality since 1991, translating to an estimated 4.8 million fewer cancer deaths between 1991 and 2023. These significant public health advances result from years of public investment in research, early detection and prevention, and improved cancer treatment, according to the report.
“This stunning victory is largely the result of decades of cancer research that provided clinicians with the tools to treat the disease more effectively, turning many cancers from a death sentence into a chronic disease,” said Rebecca Siegel, senior scientific director at the American Cancer Society and lead author of the report.
As more people survive cancer, there is also a growing focus on the quality of life after treatment. Patients, families and caregivers face physical, financial and emotional challenges. Dr. William Dahut, the American Cancer Society’s chief scientific officer, said that ongoing innovation must go hand in hand with better support services and policies, so all survivors — not just the privileged — can have “not only more days, but better days.”
Indeed, the report also shows that not everyone has benefited equally from the advances of the last few decades. American Indian and Alaska Native people now have the highest cancer death rates in the country, with deaths from kidney, liver, stomach and cervical cancers about double that of white Americans.
Additionally, Black women are more likely to die from breast and uterine cancers than non-Black women — and Black men have the highest cancer rates of any American demographic. The report connects these disparities in survival to long-standing issues such as income inequity and the effects of past discrimination, such as redlining, affecting where people live — forcing historically marginalized populations to be disproportionately exposed to environmental carcinogens.
Dr. René Javier Sotelo, a urologic oncologist at Keck Medicine of USC, notes that the fight against cancer in Southern California, amid long-standing disparities facing vulnerable communities, is very much about overcoming educational, cultural and socioeconomic barriers.
While access to care and insurance options in Los Angeles are relatively robust, many disparities persist because community members often lack crucial information about risk factors, screening and early warning signs. “We need to insist on the importance of education and screening,” Sotelo said. He emphasized that making resources, helplines and culturally tailored materials readily available to everyone is crucial.
He cites penile cancer as a stark example: rates are higher among Latino men in L.A., not necessarily due to lack of access, but because of gaps in awareness and education around HPV vaccination and hygiene.
Despite these persisting inequities, the dramatic nationwide improvement in cancer survival is unquestionably good news, bringing renewed hope to many individuals and families. However, the report also gives a clear warning: Proposed federal cuts to cancer research and health insurance could stop or even undo these important gains.
“We can’t stop now,” warned Shane Jacobson, the American Cancer Society’s chief executive.
“We need to understand that we are not yet there,” Sotelo concurred. ”Cancer is still an issue.”
Science
Clashing with the state, L.A. City moves to adopt lenient wildfire ‘Zone Zero’ regulations
As the state continues multiyear marathon discussions on rules for what residents in wildfire hazard zones must do to make the first five feet from their houses — an area dubbed “Zone Zero” — ember-resistant, the Los Angeles City Council voted Tuesday to start creating its own version of the regulations that is more lenient than most proposals currently favored in Sacramento.
Critics of Zone Zero, who are worried about the financial burden and labor required to comply as well as the detrimental impacts to urban ecosystems, have been particularly vocal in Los Angeles. However, wildfire safety advocates worry the measures endorsed by L.A.’s City Council will do little to prevent homes from burning.
“My motion is to get advice from local experts, from the Fire Department, to actually put something in place that makes sense, that’s rooted in science,” said City Councilmember John Lee, who put forth the motion. “Sacramento, unfortunately, doesn’t consult with the largest city in the state — the largest area that deals with wildfires — and so, this is our way of sending a message.”
Tony Andersen — executive officer of the state’s Board of Forestry and Fire Protection, which is in charge of creating the regulations — has repeatedly stressed the board’s commitment to incorporating L.A.’s feedback. Over the last year, the board hosted a contentious public meeting in Pasadena, walking tours with L.A. residents and numerous virtual workshops and hearings.
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Some L.A. residents are championing a proposed fire-safety rule, referred to as “Zone Zero,” requiring the clearance of flammable material within the first five feet of homes. Others are skeptical of its value.
With the state long past its original Jan. 1, 2023, deadline to complete the regulations, several cities around the state have taken the matter into their own hands and adopted regulations ahead of the state, including Berkeley and San Diego.
“With the lack of guidance from the State Board of Forestry and Fire Protection, the City is left in a precarious position as it strives to protect residents, property, and the landscape that creates the City of Los Angeles,” the L.A. City Council motion states.
However, unlike San Diego and Berkeley, whose regulations more or less match the strictest options the state Board of Forestry is considering, Los Angeles is pushing for a more lenient approach.
The statewide regulations, once adopted, are expected to override any local versions that are significantly more lenient.
The Zone Zero regulations apply only to rural areas where the California Department of Forestry and Fire Protection responds to fires and urban areas that Cal Fire has determined have “very high” fire hazard. In L.A., that includes significant portions of Silver Lake, Echo Park, Brentwood and Pacific Palisades.
Fire experts and L.A. residents are generally fine with many of the measures within the state’s Zone Zero draft regulations, such as the requirement that there be no wooden or combustible fences or outbuildings within the first five feet of a home. Then there are some measures already required under previous wildfire regulations — such as removing dead vegetation like twigs and leaves, from the ground, roof and gutters — that are not under debate.
However, other new measures introduced by the state have generated controversy, especially in Los Angeles. The disputes have mainly centered around what to do about trees and other living vegetation, like shrubs and grass.
The state is considering two options for trees: One would require residents to trim branches within five feet of a house’s walls and roof; the other does not. Both require keeping trees well-maintained and at least 10 feet from chimneys.
On vegetation, the state is considering options for Zone Zero ranging from banning virtually all vegetation beyond small potted plants to just maintaining the regulations already on the books, which allow nearly all healthy vegetation.
Lee’s motion instructs the Los Angeles Fire Department to create regulations in line with the most lenient options that allow healthy vegetation and do not require the removal of tree limbs within five feet of a house. It is unclear whether LAFD will complete the process before the Board of Forestry considers finalized statewide regulations, which it expects to do midyear.
The motion follows a pointed report from LAFD and the city’s Community Forest Advisory Committee that argued the Board of Forestry’s draft regulations stepped beyond the intentions of the 2020 law creating Zone Zero, would undermine the city’s biodiversity goals and could result in the loss of up to 18% of the urban tree canopy in some neighborhoods.
The board has not decided which approach it will adopt statewide, but fire safety advocates worry that the lenient options championed by L.A. do little to protect vulnerable homes from wildfire.
Recent studies into fire mechanics have generally found that the intense heat from wildfire can quickly dry out these plants, making them susceptible to ignition from embers, flames and radiant heat. And anything next to a house that can burn risks taking the house with it.
Another recent study that looked at five major wildfires in California from the last decade, not including the 2025 Eaton and Palisades fires, found that 20% of homes with significant vegetation in Zone Zero survived, compared to 37% of homes that had cleared the vegetation.
Science
At 89, he’s heard six decades of L.A.’s secrets and is ready to talk about what he’s learned
Dr. Arnold Gilberg’s sunny consultation room sits just off Wilshire Boulevard. Natural light spills onto a wooden floor, his houndstooth-upholstered armchair, the low-slung couch draped with a colorful Guatemalan blanket.
The Beverly Hills psychiatrist has been seeing patients for more than 60 years, both in rooms like this and at Cedars-Sinai Medical Center, where he has been an attending physician since the 1960s.
He treats wildly famous celebrities and people with no fame at all. He sees patients without much money and some who could probably buy his whole office building and not miss the cash.
Gilberg, 89, has treated enough people in Hollywood, and advised so many directors and actors on character psychology, that his likeness shows up in films the way people float through one another’s dreams.
The Nancy Meyers film “It’s Complicated” briefly features a psychiatrist character with an Airedale terrier — a doppelganger of Belle, Gilberg’s dog who sat in on sessions until her death in 2018, looking back and forth between doctor and patient like a Wimbledon spectator.
“If you were making a movie, he would be central casting for a Philip Roth‑esque kind of psychiatrist,” said John Burnham, a longtime Hollywood talent agent who was Gilberg’s patient for decades starting in his 20s. “He’s always curious and interested. He gave good advice.”
Since Gilberg opened his practice in 1965, psychiatry and psychotherapy have gone from highly stigmatized secrets to something people acknowledge in award show acceptance speeches. His longtime prescriptions of fresh food, sunshine, regular exercise and meditation are now widely accepted building blocks of health, and are no longer the sole province of ditzy L.A. hippies.
Beverly Hills psychiatrist Dr. Arnold Gilberg, 89, is the last living person to have trained under Franz Alexander, a disciple of Sigmund Freud.
(Robert Gauthier / Los Angeles Times)
He’s watched people, himself included, grow wiser and more accepting of the many ways there are to live. He’s also watched people grow lonelier and more rigid in their political beliefs.
On a recent afternoon, Gilbert sat for a conversation with The Times at the glass-topped desk in his consultation room, framed by a wall full of degrees. At his elbow was a stack of copies of his first book, “The Myth of Aging: A Prescription for Emotional and Physical Well-Being,” which comes out Tuesday.
In just more than 200 pages, the book contains everything Gilberg wishes he could tell the many people who will never make it into his office. After a lifetime of listening, the doctor is ready to talk.
Gilberg moved to Los Angeles in 1961 for an internship at what is now Los Angeles General Medical Center. He did his residency at Mount Sinai Hospital (later Cedars-Sinai) with the famed Hungarian American psychoanalyst Dr. Franz Alexander.
Among his fellow disciples of Sigmund Freud, Alexander was a bit of an outlier. He balked at Freud’s insistence that patients needed years of near-daily sessions on an analyst’s couch, arguing that an hour or two a week in a comfortable chair could do just as much good. He believed patients’ psychological problems stemmed more often from difficulties in their current personal relationships than from dark twists in their sexual development.
Not all of Alexander’s theories have aged well, Gilberg said — repressed emotions do not cause asthma, to name one since-debunked idea. But Gilberg is the last living person to have trained with Alexander directly and has retained some of his mentor’s willingness to go against the herd.
If you walk into Gilberg’s office demanding an antidepressant prescription, for example, he will suggest you go elsewhere. Psychiatric medication is appropriate for some mental conditions, he said, but he prefers that patients first try to fix any depressing situations in their lives.
He has counseled patients to care for their bodies long before “wellness” was a cultural buzzword. It’s not that he forces them to adopt regimens of exercise and healthy eating, exactly, but if they don’t, they’re going to hear about it.
“They know how I feel about all this stuff,” he said.
He tells many new patients to start with a 10-session limit. If they haven’t made any progress after 10 visits, he reasons, there’s a good chance he’s not the right doctor for them. If he is, he’ll see them as long as they need.
One patient first came to see him at 19 and returned regularly until her death a few years ago at the age of 79.
“He’s had patients that he’s taken care of over the span, and families that have come back to him over time,” said Dr. Itai Danovitch, who chairs the psychiatry department at Cedars-Sinai. “It’s one of the benefits of being an incredibly thoughtful clinician.”
Not long after opening his private practice in 1965, Gilberg was contacted by a prominent Beverly Hills couple seeking care for their son. The treatment went well, Gilberg said, and the satisfied family passed his name to several well-connected friends.
As a result, over the years his practice has included many names you’d recognize right away (no, he will not tell you who) alongside people who live quite regular lives.
They all have the same concerns, Gilberg says: Their relationships. Their children. Their purpose in life and their place in the world. Whatever you achieve in life, it appears, your worries remain largely the same.
When it’s appropriate, Gilberg is willing to share that his own life has had bumps and detours.
He was born in Chicago in 1936, the middle of three boys. His mother was a homemaker and his father worked in scrap metal. Money was always tight. Gilberg spent a lot of time with his paternal grandparents, who lived nearby with their adult daughter, Belle.
The house was a formative place for Gilberg. He was especially close to his grandfather — a rabbi in Poland who built a successful career in waste management after immigrating to the U.S. — and to his Aunt Belle.
Disabled after a childhood accident, Belle spent most of her time indoors, radiating a sadness that even at the age of 4 made Gilberg worry for her safety.
“It’s one of the things that brought me into medicine, and then ultimately psychiatry,” Gilberg said. “I felt very, very close to her.”
He and his first wife raised two children in Beverly Hills. Jay Gilberg is now a real estate developer and Dr. Susanne Gilberg-Lenz is an obstetrician-gynecologist (and the other half of the only father-daughter pair of physicians at Cedars-Sinai).
The marriage ended when he was in his 40s, and though the split was painful, he said, it helped him better understand the kind of losses his patients experienced.
He found love again in his 70s with Gloria Lushing-Gilberg. The couple share 16 grandchildren and seven great-grandchildren. They married four years ago, after nearly two decades together.
“As a psychoanalyst or psychiatrist ages, we have the ability, through our own life experiences, to be more understanding and more aware,” he said.
It’s part of what keeps him going. Though he has reduced his hours considerably, he isn’t ready to retire. He has stayed as active as he advises his patients to be, both personally (he was ordained as a rabbi several years ago) and professionally.
For all the strides society has made during the course of his career toward acceptance and inclusivity, he also sees that patients are lonelier than they used to be. They spend less time with friends and family, have a harder time finding partners.
We’re isolated and suffering for it, he said, as individuals and as a society. People still need care.
Unlike a lot of titles on the self-help shelves, Gilberg’s book promises no sly little hack to happiness, no “you’ve-been-thinking-about-this-all-wrong” twist.
After 60 years working with Hollywood stars and regular Angelenos, Gilberg is ready to share what he’s learned with the world.
(Robert Gauthier / Los Angeles Times)
His prescriptions run along deceptively simple lines: Care for your health. Say thank you. Choose to let go of harmless slights and petty conflicts. Find people you belong with, and stop holding yourself and others to impossibly high standards.
“People have the capacity to self-heal, and I have become a firm believer in that. Not everyone needs to be in therapy for 10 years to figure it out,” he said. “A lot of this is inside yourself. You have an opportunity to overcome the things and obstacles that are in you, and you can do it.”
So what is “it”? What does it mean to live a good life?
Gilberg considered the question, hands clasped beneath his chin, the traffic outside humming expectantly.
“It means that the person has been able to look at themselves,” he said, “and feel somewhat happy about their existence.”
The best any of us can hope for is to be … somewhat happy?
Correct, Gilberg said. “A somewhat happy existence, off and on, which is normal. And hopefully, if the person wants to pursue that, some kind of a personal relationship.”
As it turns out, there is no housing in happiness. You can visit, but nobody really lives there. The happiest people know that. They live in OK neighborhoods that are not perfect but could be worse. They try to be nice to the neighbors. The house is a mess a lot of the time. They still let people in.
Somewhat happy, sometimes, with someone else to talk to.
It is that simple. It is that hard.
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