Led by Research Fellow Karinna Saxby at The Melbourne Institute of Applied Economic and Social Research, a new study has been released using data from the 2017 marriage equality postal vote (plebiscite) and the 2021 Australian census.

The research explores the link between opposition to marriage equality and people’s health in the years after the plebiscite saw marriage equality become law in Australia.

The results revealed that individuals in same-sex relationships who lived in areas with stronger opposition to marriage equality had higher rates of chronic health issues compared to those living in areas with less opposition.

It’s a stark reminder of how negative community attitudes can magnify stigma and have long-term consequences for people’s health.

In sickness or health

The study concluded that community-level opposition to marriage equality increased, and long-term health conditions were more common among Australians in same-sex relationships compared with those in different-sex relationships.

~ 56% ~

In areas with the lowest opposition to marriage equality (about 13-26% ‘No’ vote), individuals in same-sex relationships had 56% higher odds of reporting any long-term health condition compared to individuals in different-sex relationships. 

~ 63% ~

In contrast, however, in the areas with the highest opposition (about 34-55% ‘No’ vote), this increased to a worrying 63%.

The health of young people, gay men and people living in areas with more socioeconomic disadvantage were particularly affected, according to the results. Same-sex couples were among those with higher rates of mental health, respiratory and heart-related conditions. It’s important to note that all of these have been strongly linked to stress. This suggests community-level attitudes, in this case votes against marriage equality, are likely to represent stigma towards sexual minorities.

Stigma and wellbeing

Backed up by international studies, research shows that LGBTIQ+ people who are living in stigmatising environments are more likely to experience stressors due to their sexual orientation. This includes harassment or bullying. Studies also show that in these non-friendly environments, LGBTIQ+ folk are also more likely to turn to risky behaviour, such as smoking and drinking, to help cope with stress, which in turn causes significant stress-related health conditions.

A lack of available inclusive health care or past experiences of discrimination could also deter LGBTIQ+ people from accessing necessary health care services.

Research has shown THAT gay, lesbian and bisexual Australians living in areas with higher opposition to marriage equality use less preventive and primary health care than their counterparts living in areas with less opposition.

It seems that delayed access to preventative health care and heightened social stressors could lead to the deterioration of health and, eventually, the development of long-term conditions. Such chronic conditions can be costly for the health system. This means the health disparities highlighted in the study are not only a human rights issue but also an economic one.

Ongoing issues for queer health care

Unfortunately, discrimination that affects the health of sexual minorities and queer communities remains an issue. For instance, religious organisations can still discriminate against LGBTIQ+ people and staff if they decide to, and conversion practices, which try to change or suppress someone’s sexuality or gender identity, are also still legal in Western Australia, the Northern Territory and Tasmania.

In some good news, last year the Australian Federal Government committed to a ten-year action plan for LGBTIQA+ health and wellbeing.

However, Karinna Saxby said despite this:

“There is an urgent need for additional funding for LGBTIQ+ community controlled health organisations that could help support sexual minorities to access necessary and valuable culturally appropriate health care.”

In particular, she said their research suggests resources should be targeted to areas with higher opposition to marriage equality and also for young queer people living in more socioeconomically disadvantaged regions. 

More data is needed

Karinna also noted that she feels more data is needed so better decisions can be made, saying, “Our research only explores health inequities for Australians in same-sex relationships. We cannot draw any conclusions about the health of non partnered sexual minorities nor any effects among the broader LGBTIQ+ community. We don’t have reliable, comprehensive data. We support recent calls for better and more inclusive data collection on sexual orientation and gender identity, including in the 2026 census.”

It seems that better data would allow researchers and health support services to pinpoint which policies and interventions can reduce stigma and, in turn, reduce the health inequalities LGBTIQ+ people in Australia still face every day.

IMAGE : The aftermath of opposition to equality. A new study by The Melbourne Institute of Applied Economic and Social Research revealed that individuals in same-sex relationships who live in areas with stronger opposition to marriage equality have higher rates of chronic health issues compared to those living in areas with less opposition. Key: 13% Share of ‘No’ vote 55%.

Source: Australian Marriage Law Postal Survey, Person Level Integrated Data Asset.