CitationEverett, Bethany G.; Limburg, Aubrey; McKetta, Sarah; & Hatzenbuehler, Mark L. (2022). State-Level Regulations Regarding the Protection of Sexual Minorities and Birth Outcomes: Results from a Population-Based Cohort Study. Psychosomatic Medicine. , PMCID: PMC9271587
AbstractObjectives We leverage state-level variability in social policies that confer legal protections for sexual minorities (e.g., employment non-discrimination acts) and examine their association with birth outcomes among sexual minority women. Methods We link measures of structural protections (i.e., social policies) to a prospective, population-based cohort of U.S. adults—the National Longitudinal Study of Adolescent to Adult Health (n = 7,913 total singleton births; n = 274 singleton births to bisexual women; n = 53 singleton births to lesbian women)—which includes measurement of key risk factors for birth outcomes over the life course. Results LGB policy protections were associated with better birth outcomes for lesbian women. For example, among lesbian women, the predicted birthweight for infants in states with no policy protections was 3.01 kg (95% CI: 2.71, 3.30) but was 3.71 kg (95% CI: 3.46, 3.96) in states with 3 or 4 policy protections. In negative control analyses, there was no association between LGB policy protections and birth outcomes among the non-stigmatized group (i.e., heterosexual women), providing evidence of specificity. Furthermore, in states with the most LGB policy protections, lesbian women were at lower risk for preterm births and had infants with higher birthweights than heterosexual and bisexual women. These associations remained robust after adjusting for 13 risk factors, including demographics, prior and current indicators of socioeconomic status, preconception and perinatal risk factors, and neighborhood characteristics. Conclusions These results provide novel evidence that sexual orientation-related policy protections, measured at the state level, are associated with a decreased risk for adverse birth outcomes among lesbian women. Copyright © 2022 by the American Psychosomatic Society
Reference TypeJournal Article
Journal TitlePsychosomatic Medicine
Author(s)Everett, Bethany G.
Hatzenbuehler, Mark L.