As a result, the negative effect of the lack of marriage equality on health and financial health will still remain for many couples. Windsor, which struck down parts of the Defense of Marriage Act DOMA , the relatively narrow scope of the ruling leaves many same-sex partners in limbo in terms of their rights when their partner is in the hospital. In the event I have any other issues, I will give this office a call. Policies supportive of same-sex marriage may be effective in reducing health care use and costs among sexual minorities Definitions Civil marriage—in the United States, civil marriage, established through a license issued by a state government, grants both legal rights and obligations to two individuals 1. The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: Until recently, civil marriage, as recognized by the federal government, must be between a man and a woman; however, the federal government now must recognize legally married same-sex couples 2 , 3. The Effect of Marriage Equality on Health Positive health outcomes are associated with marriage for heterosexual and same-sex couples 8— However, the Windsor decision left an important part of DOMA intact by preserving the right of states to decline to recognize same-sex marriages lawfully conducted in other states. Because financial matters may also need to be dealt with while you are incapacitated, you may also want to prepare a durable power of attorney so that your same-sex partner can manage your financial affairs. Living in states where same-sex relationships have legal recognition appears to diminish mental health differentials between heterosexual and lesbian, gay, and bisexual individuals The impact of marriage denial on the mental health and sexual citizenship of lesbians and gay men in the United States. The purpose is to allow you to make our end of life choices now, in the event you were unable to express your wishes at that time.