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
What’s in a Name? For These Snails, Legal Protection
The sun had barely risen over the Pacific Ocean when a small motorboat carrying a team of Indigenous artisans and Mexican biologists dropped anchor in a rocky cove near Bahías de Huatulco.
Mauro Habacuc Avendaño Luis, one of the craftsmen, was the first to wade to shore. With an agility belying his age, he struck out over the boulders exposed by low tide. Crouching on a slippery ledge pounded by surf, he reached inside a crevice between two rocks. There, lodged among the urchins, was a snail with a knobby gray shell the size of a walnut. The sight might not dazzle tourists who travel here to see humpback whales, but for Mr. Avendaño, 85, these drab little mollusks represent a way of life.
Marine snails in the genus Plicopurpura are sacred to the Mixtec people of Pinotepa de Don Luis, a small town in southwestern Oaxaca. Men like Mr. Avendaño have been sustainably “milking” them for radiant purple dye for at least 1,500 years. The color suffuses Mixtec textiles and spiritual beliefs. Called tixinda, it symbolizes fertility and death, as well as mythic ties between lunar cycles, women and the sea.
The future of these traditions — and the fate of the snails — are uncertain. The mollusks are subject to intense poaching pressure despite federal protections intended to protect them. Fishermen break them (and the other mollusks they eat) open and sell the meat to local restaurants. Tourists who comb the beaches pluck snails off the rocks and toss them aside.
A severe earthquake in 2020 thrust formerly submerged parts of their habitat above sea level, fatally tossing other mollusks in the snail’s food web to the air, and making once inaccessible places more available to poachers.
Decades ago, dense clusters of snails the size of doorknobs were easy to find, according to Mr. Avendaño. “Full of snails,” he said, sweeping a calloused, violet-stained hand across the coves. Now, most of the snails he finds are small, just over an inch, and yield only a few milliliters of dye.
Science
Video: This Parrot Has No Beak, But Is at the Top of the Pecking Order
new video loaded: This Parrot Has No Beak, But Is at the Top of the Pecking Order
By Meg Felling and Carl Zimmer
April 20, 2026
Science
Contributor: Focus on the real causes of the shortage in hormone treatments
For months now, menopausal women across the U.S. have been unable to fill prescriptions for the estradiol patch, a long-established and safe hormone treatment. The news media has whipped up a frenzy over this scarcity, warning of a long-lasting nationwide shortage. The problem is real — but the explanations in the media coverage miss the mark. Real solutions depend on an accurate understanding of the causes.
Reporters, pharmaceutical companies and even some doctors have blamed women for causing the shortage, saying they were inspired by a “menopause moment” that has driven unprecedented demand. Such framing does a dangerous disservice to essential health advocacy.
In this narrative, there has been unprecedented demand, and it is explained in part by the Food and Drug Administration’s recent removal of the “black-box warning” from estradiol patches’ packaging. That inaccurate (and, quite frankly, terrifying) label had been required since a 2002 announcement overstated the link between certain menopause hormone treatments and breast cancer. Right-sizing and rewording the warning was long overdue. But the trouble with this narrative is that even after the black-box warning was removed, there has not been unprecedented demand.
Around 40% of menopausal women were prescribed hormone treatments in some form before the 2002 announcement. Use plummeted in its aftermath, dipping to less than 5% in 2020 and just 1.8% in 2024. According to the most recent data, the number has now settled back at the 5% mark. Unprecedented? Hardly. Modest at best.
Nor is estradiol a new or complex drug; the patch formulation has existed for decades, and generic versions are widely manufactured. There is no exotic ingredient, no rare supply chain dependency, no fluke that explains why women are suddenly being told their pharmacy is out of stock month after month.
The story is far more an indictment of the broken insurance industry: market concentration, perverse incentives and the consequences of allowing insurance companies to own the pharmacy benefit managers that effectively control drug access for the majority of users. Three companies — CVS Caremark, Express Scripts and OptumRx — manage 79% of all prescription drug claims in the United States. Those companies are wholly owned subsidiaries of three insurance behemoths: CVS Health, Cigna and UnitedHealth Group, respectively. This means that the same corporation that sells you your insurance plan also decides which drugs get covered, at what price, and whether your pharmacy can stock them. This is called vertical integration. In another era, we might have called it a cartel. The resulting problems are not unique to hormone treatments; they have affected widely used medications including blood thinners, inhalers and antibiotics. When a low-cost generic such as estradiol — a medication with no blockbuster profit margins and no patent protection — runs into friction in this system, the friction is not random. It is structural. Every decision in that chain is filtered through the same corporate profit motive. And when the drug in question is an off-patent estradiol patch that has negligible profit margins because of generic competition but requires logistical investment to keep consistently in stock? The math on “how much does this company care about ensuring access” is not complicated.
Unfortunately, there is little financial incentive to ensure smooth, consistent access. There is, however, significant financial incentive to steer patients toward branded alternatives, or simply to let supply tighten — because the companies aren’t losing much profit if sales of that product dwindle. This is not a conspiracy theory: The Federal Trade Commission noted this dynamic in a report that documented how pharmacy benefit managers’ practices inflate costs, reduce competition and harm patient access, particularly for independent pharmacies and for generic drugs.
Any claim that the estradiol patch shortage is meaningfully caused by more women now demanding hormone treatments is a distraction. It is also misogyny, pure and simple, to imply that the solution to the shortage is for women’s health advocates to dial it down and for women to temper their expectations. The scarcity of estradiol patches is the outcome of a broken system refusing to provide adequate supply.
Meanwhile, there are a few strategies to cope.
- Ask your prescriber about alternatives. Estradiol is available in multiple formulations, including gel, spray, cream, oral tablet, vaginal ring and weekly transdermal patch, which is a different product from the twice-weekly patch and may be more consistently available depending on manufacturer and region.
- Consider an online pharmacy. Many are doing a good job locating and filling these prescriptions from outside the pharmacy benefit manager system.
- Call ahead. Patch shortages are inconsistent across regions and distributors. A call to pharmacies in your area, or a broader geographic radius if you’re able, can locate stock that your regular pharmacy doesn’t have.
- Consider a compounding pharmacy. These sources can sometimes meet needs when commercially manufactured products are inaccessible. The hormones used are the same FDA-regulated bulk ingredients.
Beyond those Band-Aid solutions, more Americans need to fight for systemic change. The FTC report exists because Congress asked for it and committed to legislation that will address at least some of the problems. The FDA took action to change the labeling on estrogen in the face of citizen and medical experts’ pressure; it should do more now to demand transparency from patch manufacturers.
Most importantly, it is on all of us to call out the cracks in the current system. Instead of repeating “there’s a patch shortage” or a “surge in demand,” say that a shockingly small minority of menopausal women still even get hormonal treatments prescribed at all, and three drug companies control the vast majority of claims in this country. Those are the real problems that need real solutions.
Jennifer Weiss-Wolf, the executive director of the Birnbaum Women’s Leadership Center at New York University School of Law, is the author of the forthcoming book “When in Menopause: A User’s Manual & Citizen’s Guide.” Suzanne Gilberg, an obstetrician and gynecologist in Los Angeles, is the author of “Menopause Bootcamp.”
-
Miami, FL4 minutes agoRanking the Miami Heat’s Top Trade Targets
-
Boston, MA10 minutes agoFormer Massachusetts doctor faces 81 new sexual assault charges
-
Denver, CO16 minutes agoHouston County murder suspect returns to face charges after her arrest in Denver
-
Seattle, WA22 minutes agoWest Seattle Tool Library to host annual tool sale this Saturday, April 25 | The White Center Blog
-
San Diego, CA28 minutes agoBalboa Park museums see attendance decline of 34% in first quarter
-
Milwaukee, WI34 minutes agoMilwaukee County overdose deaths continue to fall, but challenges remain
-
Atlanta, GA40 minutes agoDozens arrested during raid of drug
-
Minneapolis, MN46 minutes agoPrince’s legacy still shines in downtown Minneapolis 10 years after his death