Does gay marriage improve health?BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e8586 (Published 21 December 2012) Cite this as: BMJ 2012;345:e8586
All rapid responses
More than the health of two men and two women, there are in some instances the health and development trajectories of children to consider. Do non-straight couples have the same access to paid parental leave, and is gay marriage a marker of greater commitment and enhanced family dynamics?
For all parents and the deliberately childless, the equity and justice of paid parental leave remain pragmatic considerations that matter to society at large. The popular press rightly highlight the workplace obstacles that women face in sustaining a career and raising their children. However, we neglect to mention that the childless in society already subsidize and assist with the home and work lives respectively of women who choose to become mothers. Having children is routinely portrayed as a long financial sacrifice for, and discrimination against, women who choose to take time off from the workforce to have families. In most advanced economies, the whole of dependent childhood is already heavily subsidised by advantageous tax concessions, free schooling, affordable childcare and long stretches of generously paid parental (including fatherhood) leave.
The childless worker is expected to assume the additional responsibilities left behind by new mothers departed for the home front. Parents use sick leave entitlements to look after children when they cannot get babysitters. Every election cycle in Australia, baby bonuses and family incentives are trotted out to this voter demographic.
Yet what protects those of us who choose to not reproduce? Unlike food, water, shelter and warmth, having a child is not necessary for our physical wellbeing. Most parents in later life see it as a positive life- enhancing journey rather than a costly punishment. Adult children represent a return on a parents' investment in having a carer in frailty and old age. Children are the embodiment of a parent's genetic legacy and a darwinian imperative.
The deliberately childless being burdened with the additional work that new mothers displace to them also represents discrimination of those expected to share indirectly the upkeep of other's children. The argument that society and the workplace has deterred women from having families should also take into account that until babies become independent tax funding adults, they are represent a largely subsidised lifestyle choice exercised by aspiring parents-to-be.
Ireland, by becoming the first nation to approve same-sex marriage by referendum, powerfully bolsters the quest for gay equality, a movement that has achieved a string of victories around the world over the past decade but remains a distant goal in Australia, where leaders of both political strips have either embraced vibrant opposition to it (Abbott and company) or asked for a parliamentary conscience vote (some of the Opposition). Until we let Australia speak by popular vote, these approaches enable the entrenchment of less than tolerant attitudes of those in power in Canberra. It smacks of "Aussie, Aussie, Aussie, No! No! No!"
May 2015 marks Ireland 's emergence into the fraternity of 19 nations that have legalised same-sex marriage, eroding the entrenchment of discrimination based on outdated arguments. There is no evidence that it undermines the union between man and woman and that gay marriage erodes the sanctity of "traditional" procreation. The importance of biological ties and of motherhood and fatherhood is now more absurd as an argument to deny a fundamental human right to two men or two women who want to formalise their lives together in a recognised union.
The outcome in Ireland sends an unmistakable signal to politicians and religious leaders in Australia and around the world who continue to harbour negative views against gays and lesbians. It also should offer hope to sexual minorities in Russia, the Arab world and many African nations where intolerance and discriminatory laws remain widespread. The tide is shifting quickly. Even in unlikely places, love and justice will continue to prevail.
I encourage further research into paid parental leave, other privileges of marriage (and its societal equity), the gender composition of parents, and the formalisation of marriage (and legalisation of same sex marriage) in children's development and welfare.
Competing interests: No competing interests
It must be clear to all but the most socially ill-informed of people that Dr. Gardner's rapid response below is pure homophobia masquerading as a reasonable academic reply. You know, the way pseudo-scholarship was once used to justify prohibition of inter-racial marriages. (Just out of curiosity, did the BMJ ever publish those? Would it do so now?)
I suspect the editors indulged in those two fallacious platitudes, 'freedom of speech' and 'editorial balance,' when they decided to publish the response. But, when they did so, I wonder if they had asked themselves whether a rapid response which purported to argue the 'Bell Curve Theory' of racial intelligence, or one that suggested 'intelligent design' as the grounds for withholding palliative care, might have been published on the same grounds.
What this thread merely and clearly shows is that, even in the hallowed pages of the BMJ, homophobia is still tolerable, nay, even acceptable, provided you can dress it in sufficient academic jargon.
It affords me no pleasure to say this: but, I think the editors of the BMJ owe their readers, and their own editorial colleagues, gay or straight, an unconditional apology for this, an unpardonable decision.
Competing interests: I once used to work for the BMJ, and still occasionally write for the Journal. Oh, and I'm gay. Does that count, given the decision to publish Dr Gardner's response?
Gregory Gardner, in his "rapid response" of Aug 2 makes reference to a study by Regnerus which he should know has been thoroughly discredited, both in its content and in the editorial process surrounding it.
for an interview with Darren Sherkat who conducted an audit of the process of publishing the Regnerus study for Social Science Review, the journal that published it.
Competing interests: No competing interests
Douglas Kamerow in his article about the legal cases on same sex ‘marriage’ considered by the U.S. Supreme Court – and now ruled on - argues that all the ramifications be looked at. They are many and varied but nowhere in his article is there any mention of the impact of same sex ‘marriage’ legislation on the health and well-being of children. Of the countless ramifications to consider, three stand out: Does the legalisation of same sex ‘marriage’ equate to a redefinition of marriage? Is this redefinition of marriage in the interests of children? What are the implications for civil liberties?
The legalising of same sex ‘marriage’ redefines marriage. When Canada legalised same-sex ‘marriage’ in 2005 the terms ‘natural parent,’ ‘blood relationship’ etc., were replaced with ‘legal parent’ or ‘legal relationship’. In England and Wales, the Marriage (same sex couples) Bill doesn’t even define marriage at all. To exclude the procreation of children as a defining good of marriage cannot be achieved without changing the definition of the word ‘marriage’ and other words such as ‘husband’, ‘wife’, ‘consummation’ and ‘adultery’. On page 29 of the Marriage (Same Sex Couples) Bill, a man can be a ‘wife’ and a woman a ‘husband.’
This attempted transfer of the intrinsic good of marriage to a same sex couple and therefore the re-definition of marriage is what some opponents of marriage want. There are calls for the abolition of marriage altogether.  
The Defence of Marriage Act (DOMA) referred to by Douglas Kamerow and ruled on recently in the U.S. Supreme Court was passed in 1996 by an 84% margin because children need the protection of the law to maintain the only legal institution which connects them to their parents.  Strengthening the most pro-child institution on the planet is the most effective way of ensuring that a child has a fighting chance of being looked after by their own natural parents.
The retreat from marriage has hurt children from poor families with particular force since the benefits of marriage extend particularly to poor and minority communities, despite the fact that marriage has weakened in these communities in the last four decades. Marriage is an important public good, associated with a range of economic, health, educational, and safety benefits and children are most likely to thrive economically, socially, and psychologically in this family form. 
Same sex ‘marriage’ in contrast is an unproven and experimental social model and one recent study found outcomes for children raised by homosexual couples to be suboptimal in almost every category.
In Spain since the legalisation of same sex ‘marriage' in 2005, there has been a 22% decline in the marriage rate. The retreat from marriage not only harms children but has become an enormously costly social experiment. In Britain the cost to the taxpayer per annum was estimated to be £20-24 Billion in 2006  or £42 Billion in 2012 
Kamerow argues that it is unjust to deny gay couples the ‘right’ to marry but he is wrong about this. If a man wanted to ‘marry’ his sister and says this right is denied him, he is not just claiming a new right but is claiming the right to change the definition of marriage. The law is correct to deny him or any other interest group this claim.
Article 16 of The Universal Declaration of Human Rights states, ‘The family is the natural and fundamental group unit of society and is entitled to protection by society and the state’. The word ‘natural’ occurs only once in the entire declaration and testifies to the pre-eminence of the family. The family is the most important civil institution that binds a society together between generations. A state that legalises same-sex ‘marriage’ replaces natural law with an artificial creation. Same sex ‘marriage’, lacking connection to procreation and child rearing cannot claim to be natural. The U.S. Supreme Court by handing over to individual states powers to define what constitutes a marriage and a family has started an inevitable trail of legislation that makes it difficult to exclude more and more harmful relationships to children from being included within the ‘marriage’ tent.
Every country which legalises same sex ‘marriage’ facilitates a massive transfer of power to the state. In the USA the IRS handed over the personal tax records of donors to the National Organisation for Marriage, to its political opponents the Human Rights Campaign. These confidential personal records were then posted on the HRC website in violation of the law. No prosecutions have taken place to date. In France the pro-child ‘La Manif Pour Tous’, the most important social movement since May 1968 which includes homosexuals, and people from both the political left and right  has been met with police brutality, mass arrests, the firing of tear gas on children and the elderly  and the imprisonment of a student for four months with no right of appeal. 
Douglas Kamerow’s article avoids the fundamental questions of children’s rights and civil liberties but also suggests that same sex ‘marriage’ improves the mental health of older homosexuals. The evidence does not support this. The study that he cites by Wight for instance is a cross sectional survey of a small, self-selected population. It specifically states ‘when we reran the regression models using same-sex marriage as the omitted reference group, the effects of same-sex marriage were not significantly different (P>.05) from the effects of same-sex partnership.’
Redefining marriage is socially destructive. The rights of all children to be protected, nurtured, and –wherever possible – brought up by a father and a mother who are the child’s natural parents should take precedence. Every society should be judged by how it cares for its children and we are not doing well. The ramifications of same sex ‘marriage’ are a long term disaster for children and for civil liberties.
 W. Bradford Wilcox. Why marriage matters: Thirty conclusions from the Social Sciences. New York: Broadway Publications 2011.
 Regnerus, M. How different are the adult children of parents who have same-sex relationships? Findings from the New Family Structures Study. Social Science Research 2012; 41:752-770.
 Wight RG, leBlanc AJ, de Vries B, Detels R. Stress and mental health among midlife and older gay-identified men. Am J Public Health 2012;102:503-10.
Competing interests: No competing interests