Twenty years after Massachusetts became the first state to permit marriage equality, a majority of same-sex married couples say it had a profound positive impact on their lives. A new report finds it strengthened couples' relationships, provided legal protections, financial security and greater acceptance among family and friends.

Abbie Goldberg, Clark University psychology professor, said marriage equality is part of a public health agenda.

"They have access to health insurance. They are physically and mentally healthier. They're able to share the sort of challenges and work of raising children," Goldberg said.

Still, Goldberg noted nearly 80% of couples surveyed worry about the future of marriage equality. Supreme Court Justices Samuel Alito and Clarence Thomas have both suggested the high court revisit Obergefell v. Hodges - the decision that legalized same-sex marriage in 2015.

The report reveals same-sex married couples are also concerned about what they consider to be an increasingly hostile environment in the United States. More than 500 anti-LGBTQ+ bills have been introduced since last year - including bans on classroom conversations or books about LGBTQ+ people.

Concerns are forcing couples nationwide to consider relocating to more-friendly states, including Massachusetts, or even out of the country, Goldberg said.

"It's creating not just legal uncertainty but propelling them to think about the future in ways that require time, money, planning," she continued.

Goldberg added marriage equality created families, and the report reveals the positives to ensuring people are protected. Almost 60% of participants said marriage provided more stability or security for their children, and often created new in-laws, who could help.


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Rural LGBTQ+ youth in Indiana face greater mental health challenges, but have found ways to build community online, according to a new report. 48% of the state's LGBTQ-plus youth live in a small city or town, according to the 2024 Survey on the Mental Health of LGBTQ+ Young People in Indiana study. The next largest region is the suburbs.

Michael Parent, principal researcher with HopeLab, said the demographic has difficulty finding support in their communities, compared to their urban peers, but noted that there are some positive trends too.

"They had a lot of sense of internal pride in their identity," he said. "So despite being in some more challenging circumstances, they also had really positive internal feelings about themselves."

Parent added that, while young LGBTQ+ people in rural areas struggle to connect in person, they often find friends online. Those communities can be based around a shared LGBTQ+ identity but can also involve a shared passion for gaming or art. 53% of this demographic in Indiana are aged 18-to-24, while 47% are between 13 and 17.

Data from the survey found that family and community are seen as places of affirmation - an environment of validation through a sense of belonging, safety, and respect. Parent agrees community plays an important role, but pointed to a lack of in-person support for rural LGBTQ+ youth.

"Rural LGBTQ+ young people are having a lot of challenges in their circumstances and environments," he added. "But finding that they had a lot of internal sense of pride in their identity is really positive and was surprising, because we didn't really think that would show up."

Other ways to show support for the community include not supporting politicians that advocate for anti-LGBTQ+ legislation, accepting their partner, and doing research about gender identities.


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Advocacy groups are speaking out about how they believe congressional cuts to Medicaid will disproportionately affect caregiver LGBTQ+ communities in Illinois.

Jaimie Worker, senior director of policy and research for the advocacy group Caring Across Generations, said Medicaid can be a lifeline for LGBTQ+ people who are aging or living with disabilities, especially those without traditional family support. She explained for many, care is provided by "chosen family" or friends, with support from Medicaid largely making that possible.

"LGBTQ+ communities are impacted in a unique way when it comes to self-directed care: being able to choose who your care provider is as an older adult or person with a disability," Worker pointed out. "Many of these programs are heavily supported by Medicaid."

She noted as people already face barriers to receiving the care they need, Medicaid cuts would unnecessarily force some into institutional settings like nursing homes, where they would never have chosen to receive care.

An estimated 700,000 people nationwide are on waiting lists to receive home- and community-based care through Medicaid. Last year, more than 15,000 were in Illinois. No matter how dire their need, Worker stressed people can wait years to access these services and LGBTQ+ individuals face additional barriers.

"Those are the folks who already know about the services; not everyone is aware about the services that are available. LGBTQ folks are also more likely to experience discrimination while trying to access care needs."

Currently, people who make less than $22,000 a year in Illinois could qualify for Medicaid. Worker predicts new federal qualifications will make it more difficult for people to qualify, even with extremely limited resources.

"And make it harder for people to live and age with dignity, and largely in their own homes and communities where most people would prefer to live and age," Worker underscored.

She reported starting July 24, Caring Across Generations will host a 60-hour vigil for Medicaid in Washington, D.C., to amplify the stories of caregivers, people with disabilities, older adults and families from across the country.

June is Pride Month, and people who fight for LGBTQ+ health care are speaking out against huge proposed cuts to Medicaid, known as Medi-Cal in the Golden State.

The U.S. Senate is about to vote on the reconciliation bill, known as the "One Big Beautiful Bill Act." Republican backers say they want to add more work requirements and make people reapply every six months.

Juan Carlos Guerrero, western regional organizing manager for the nonprofit Caring Across Generations, said that will kick eligible people off the program.

"This is part of a misinformation that we're trying to really address and make clear that these are cuts to Medicaid services that are going to be felt in the community around us," he said, "through people who use it for in-hospital services, people who use it for in-home supportive services."

The bill's supporters have said they want to use the Medicaid savings to fund an extension of President Donald Trump's 2017 tax cuts.

LGBTQ+ people are three to four times less likely to have children and twice as likely to be single and living alone as adults, so they often depend on Medicaid. Caring Across Generations is organizing a 60-hour vigil for Medicaid on the U.S. Capitol grounds July 24-26. By that time, Guerrero said, the Senate and House will have each passed their own version of the bill and will need to hash out a compromise.

"There will have to be a larger discussion between them to reach a strong consensus on what the cuts should include," he said, "but with both their packages being different enough where it will lead to larger-scale conversations."

The mobilization protests in July will also highlight some important anniversaries coming up. July 28 is the anniversary of the Americans with Disabilities Act, July 30 marks Medicaid's 60th birthday, and in mid-August, the Social Security Act will turn 80 years old.