In Sickness and in Health: Same-Sex Marriage Bans and Sexually Transmitted Infections

Abstract

This paper analyzes the relationship between same-sex marriage bans and sexually transmitted infections using state-level data from 1981 to 2008. We hypothesize that same-sex marriage bans may directly affect homosexual behavior; may affect or mirror social attitudes toward gays, which in turn may affect homosexual behavior; and may affect or mirror attitudes toward nonmarital sex, which may affect risky heterosexual behavior. Our findings may be summarized as follows. First, same-sex marriage bans are unrelated to gonorrhea rates, which are a proxy for risky heterosexual behavior. However, they are positively associated with syphilis rates, which are a proxy for risky homosexual behavior. Second, of the different legal measures, bans on both same-sex marriage and civil union are most strongly associated with syphilis. Third, the estimates are smaller when we exclude California, the state with the largest gay population, which may indicate it is indeed the behavior of gay men that is driving the findings.

Keywords: Same-Sex Marriage Laws, Social Tolerance, Risky Sex

JEL Classification: K36, I18, J12