HealthDay News — The children of same-sex parents are less likely to have private health insurance than those with opposite-sex parents, researchers found.

Results of a large national survey show that 63.3% of children with two fathers and 67.5% with two mothers were covered by private health plans compared with 77% of children with married opposite-sex parents who had the same coverage, Gilbert Gonzales, MHA, and Lynn A. Blewett, PhD, from the University of Minnesota in Minneapolis, reported in Pediatrics.

However, disparities in private health insurance access lessened when families lived in states that recognize same sex marriage, civil unions, domestic partnerships or second parent adoptions, the researchers found.

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“[G]ay and lesbian families face unique challenges that directly impact the health of their children, particularly health-related outcomes associated with health insurance,” the researchers wrote. 

Previous studies examining the well-being of children with same-sex parents have focused on psychological and social development, according to background information in the article. To better understand how having same-sex parents affects health insurance status, Gonzales and Blewett analyzed data from the 2008-2010 American Community Survey (ACS), a household survey conducted by the U.S. Census Bureau that has an annual sample size of approximately 3 million people.

The researchers identified 5,081 children from same-sex parents, 1,369,789 children of married opposite-sex parents, and 101,678 children from unmarried opposite-sex parents. Using ACS data, the researchers estimate there are approximately 125,000 same-sex couples are raising 220,000 children in the United States.

The ACS does not ask participants about sexual orientation, but asks respondents if they recognize another person of the same sex as a husband, wife or unmarried partner. Single-parent households were not included in the analysis.

After controlling for demographic characteristics, children with same-sex parents were significantly less likely to have private insurance compared with children of married opposite sex-parents (adjusted odds ratio 0.55, 95% CI 0.39–0.79). Findings were similar for children with dual mothers (aOR 0.61, 95% CI 0.47–0.79).

After stratifying children in states with legal same-sex marriage or civil unions, differences in private insurance did not persist for children with dual mothers. Narrower disparities in private insurance coverage were also seen for children with dual fathers and dual mothers for those living in a state that allowed second-parent adoptions.

Children with unmarried opposite-sex parents were also less likely to have private insurance (aOR 0.46, 95% CI 0.44–0.48), but they were significantly more likely to be covered by public insurance (aOR 1.42, 95% CI 1.36–1.48), the researchers noted. 

More than half of U.S. population currently receives insurance through their own or a family member’s employer, but children of same-sex couples may not be legally recognized as family members, and therefore may not qualify for coverage, the researchers noted.

“Disparities in private health insurance for children with same-sex parents diminish when they live in states that secure their legal relationship to both parents,” they wrote. “This study provides supporting evidence in favor of recent policy statements by the American Academy of Pediatricians endorsing same-sex marriage and second-parent adoptions.”

Study limitations included lack of data about the legal status of same-sex couples’ relationships, whether or not children were biological, adopted or a step-child of the primary respondent, and whether or not the child lived in the home. The potential for opposite-sex couples to misreport the gender of their partner was another limitation.

Including questions about sexual orientation on health surveys is the first step in improving knowledge about the children of gay and lesbian parents, Gonzales and Blewett urged. The CDC’s National Health Interview Survey will include a question about participants’ sexual orientation going forward, they added.


  1. Gonzales G and Blewett LA. Pediatrics 2013; 132: 1-9; doi:10.1542/peds.2013-0988.