Psychooncology. 2025 Dec;34(12):e70346. doi: 10.1002/pon.70346.
ABSTRACT
PURPOSE: Marriage is associated with better health-related quality of life (HRQOL) among cancer survivors, but it is unclear whether these benefits generalize across sexual orientation and gender identities (SOGI). We examined whether marriage is associated with better HRQOL among cancer survivors with diverse SOGI.
METHODS: We analyzed Behavioral Risk Factor Surveillance System (BRFSS) data from 2014 to 2023 among U.S. adults aged 18 and older who self-reported a cancer diagnosis and completed the optional SOGI module (N = 220,896). HRQOL was assessed using the CDC HRQOL-4, including self-rated general health, frequent mental or physical distress, and activity limitation (each defined as ≥ 14 days in the past 30 days). Logistic regression models estimated adjusted odds ratios for HRQOL outcomes by marital status (married, unmarried couple, not married) within SOGI subgroups, controlling for sociodemographic and healthcare access factors.
RESULTS: Marriage was consistently associated with better HRQOL among heterosexual men and women. Among SGM survivors, gay men and transfeminine individuals showed the clearest marriage-related benefits, including lower odds of mental distress and activity limitation. No consistent benefit was observed among lesbian or bisexual women, bisexual men, or transmasculine individuals. Unmarried couples did not consistently show similar protective effects in any group, though small cell sizes limit precision.
CONCLUSION: The health benefits of marriage vary across SOGI subgroups, challenging assumptions of a universal marriage advantage in survivorship.
IMPLICATIONS FOR CANCER SURVIVORS: Survivorship care should account for relational and structural differences in support networks, especially among SGM individuals who may not benefit equally from legal marital status.
PMID:41353709 | DOI:10.1002/pon.70346
