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Легализация однополых браков может улучшить здоровье населения и снизить расходы в системе здравоохранения

Легализация однополых браков может улучшить здоровье населения и снизить расходы в системе здравоохранения

Дискриминационное законодательство имеет серьезные последствия для психического здоровья геев и лесбиянок

За последние несколько лет психологи и врачи установили, что политика за или против однополых браков влияет на здоровье гомосексуальных мужчин и женщин. Хотя подобные исследования, главным образом, проводились среди геев в США, эти данные можно перенести на сексуальные меньшинства в других странах.

В США однополые браки - предмет ожесточенных споров. Исследовать то, как политические изменения влияют на здоровье, очень трудно, и такие попытки всегда неидеальны, но в некоторых ситуациях мы можем проследить изменения в здоровье людей до и после введения нового законодательства.

Во время выборов 2004 года 14 американских штатов ограничили определение брака как союза между мужчиной и женщиной. Одно исследование проследило изменения в психическом здоровье лесбиянок, геев и бисексуалов (ЛГБ), проживающих в штатах, которые проголосовали за запрет однополых браков в 2004 году. Это исследование показало, что у ЛГБ, проживающих в этих штатах, был повышенный уровень психиатрических расстройств, по сравнению с ЛГБ, проживающих в штатах без таких законодательных поправок.

Ученые также исследовали «срезы» в выборке ЛГБ до и после запрета однополых браков. Эффект оказался впечатляющим: после запрета однополых браков число случаев эмоциональных нарушений в выборке возросло на 38%, случаев генерализованного тревожного расстройства - на целых 248%, а случаев расстройств, связанных с употреблением алкоголя - на 42%.

Среди ЛГБ, проживающих в штатах, не принявших законодательных ограничений однополых браков, а также среди гетеросексуальных людей в штатах с ограничениями, уровень психиатрических расстройств не увеличился.

Выборки в этом исследовании были не идеальными, но в целом они были репрезентативными, так что маловероятно, что эти различия между геями и лесбиянками в штатах, поддерживающих однополые браки или выступающих против них, были случайностью.

Это исследование говорит о том, что дискриминационное законодательство имеет серьезные последствия для психического здоровья геев и лесбиянок.

Но верно ли обратное? Может ли законодательство, поддерживающее однополые браки, иметь защитный эффект для здоровья геев и лесбиянок?

Исследование, проведенное в штате Аризона, в котором попытка запретить однополые браки провалилась, показало, что лесбиянки, геи и бисексуалы, проживающие в нем, реже страдают от эмоциональных расстройств, чем те, кто проживает в штатах, где были приняты поправки против однополых браков.

Такое исследование имеет свои ограничения - изменение законодательства может оказать влияние через много лет, так что нужны более сильные научные тесты для оценки подобных «вмешательств на уровне штата». Например, мы не всегда располагаем хорошими группами для сравнения, и нам нужно знать, какими были паттерны здоровья до принятия того или иного законодательства.

Легализация однополых браков может улучшить здоровье населения и снизить расходы в системе здравоохранения

Одно важное исследование, проведенное в штате Массачусетс и опубликованное в прошлом году, посвящено решению именно этой проблемы. В рамках исследования велось наблюдение за 1211 геями и бисексуалами, посещавшими общественный медицинский центр. Их осматривали за 12 месяцев и через 12 месяцев после того, как в 2003 году был принят закон, легализующий однополые браки. Это позволило ученым напрямую оценить изменения в здравоохранении и медицинские расходы до и после изменений в законодательстве.

Ученые установили, что через 12 месяцев после изменений брачного законодательства, визиты к врачу среди геев и бисексуалов сократились на 13%, а стоимость медицинской помощи в этой группе уменьшилась на 10% по сравнению с 12 месяцами до принятия нового закона. Обращения в клинику по поводу проблем с психическим здоровьем среди геев и бисексуалов уменьшились на 13%, а связанные с ними расходы уменьшились на 14%. Эта тенденция не зависела от того, были ли у мужчин постоянные партнеры или нет.

Результаты этих исследований нельзя переносить на всех ЛГБТ без исключения, и если говорить про конкретного человека, то его психическое здоровье может зависеть от самых разных факторов. Тем не менее, все больше доказательств того, что дискриминация на государственном уровне негативно сказывается на психическом здоровье гей-сообщества в целом. Это очень важный аргумент в дебатах по этому вопросу.

В прошлый вторник Палата общин Великобритании проголосовала в поддержку однополых браков, и это хорошие новости не только для прав гомосексуалов, в долгосрочной перспективе, это хорошие новости для психического здоровья сообщества геев, лесбиянок и бисексуалов.

Автор: доктор Кази Рахман, научный сотрудник Института психиатрии Королевского колледжа Лондона. Исследователь биологии сексуальной ориентации и ее связи с психическим здоровьем.

The Guardian
Перевод www.parniplus.com

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