Apr. 26 2016

The Health Consequences of Hate

Research by Mark Hatzenbuehler suggests discriminatory laws in North Carolina and Mississippi are a life or death matter for LGBT people living there.

It’s been ten months since Obergefell v. Hodges, the landmark Supreme Court ruling that guaranteed sex-sex couples the right to marriage, a decision embraced by most of the country. While LGBT rights have increasingly become part of the nation’s human rights fabric, isolated instances of pushback—particularly in the American South—have resulted in legislation that critics say discriminates against LGBT people.

In Mississippi, HB1523 permits businesses to refuse people services on religious grounds. The law actually specifies these beliefs, that marriage is between a man and a woman, that sex is reserved for heterosexual marriage, and that gender is determined at birth as male or female. As one example of how the law could work outlined in a Columbia Law School report, a school mental health counselor would be permitted to refuse to work with an at-risk student who identifies as gay. The North Carolina law, HB2, bans anti-discrimination protections based on sexual orientation and requires that in public buildings and schools, transgender individuals use bathrooms corresponding to their gender as assigned at birth.

Mark Hatzenbuehler, associate professor of Sociomedical Sciences, has studied the effects of laws like those in Mississippi and North Carolina. The research is clear: “State laws that promulgate stigma and discrimination against sexual and gender minorities harm the health of these populations,” he says.

In a 2010 study published in the American Journal of Public Health, Hatzenbuehler found that lesbian, gay, and bisexual adults living in states that passed constitutional amendments banning same-sex marriage experienced sharp increases in mood disorders and alcohol abuse. They also had more than double the rate of generalized anxiety disorders.

A 2014 study in Social Science & Medicine found the negative effects of stigma extend to physical health, too. The research showed that sexual minorities in communities where residents reported high levels of anti-gay prejudice were at greater risk for death compared to those living in less prejudiced communities. And the difference was stark: an average gap in life expectancy of 12 years—on the order of what is seen between individuals with and without a high school education. 

There has been comparatively less research of this kind in transgender populations—due in part, Hatzenbuehler says, to the absence of large-scale datasets that include measures of gender identity. One exception is a recent study he did with Sociomedical Sciences doctoral student Amaya Perez-Brumer. They found that transgender individuals who live in states with more negative policies and attitudes towards LGBT individuals were more likely to attempt suicide, compared to transgender individuals living in states with more supportive policies and attitudes.

Since the passage of the controversial laws in Mississippi and North Carolina earlier this year, there has been growing pressure to overturn them. The ACLU has filed a lawsuit to challenge the law in North Carolina and is considering a similar action in Mississippi. Organizations and individuals from PayPal to Bruce Springsteen have voiced protests. Last Friday, the U.K. issued a formal travel warning to its citizens heading to the two states.

Meanwhile, damage from these laws is starting to be felt on the ground. Charlotte couple Kelly Trent and Beverly Newell joined the North Carolina ACLU suit, alleging a fertility clinic in Charlotte refused to see them because they are a same-sex couple. “The bill has made it okay to harm LGBT people,” Newell said in a statement.

Hatzenbuehler’s findings concur. Taken together, he says, his research “strongly suggests that the recent laws that have been passed, as well as the prejudicial attitudes that underlie them, are likely to have negative consequences for the mental and physical health of LGBT populations.”