Greedy Spouse, Needy Parent: The Marital Dynamics of Gay, Lesbian, and Heterosexual Intergenerational Caregivers

Lack of social support, gender and colorectal cancer screening participation across Europe: How do screening programmes mitigate the effect of social support for men and women?

This study investigates how a lack of social support differentially affects men and women's colorectal cancer (CRC) screening participation, considering different screening strategies implemented across European countries. Although health sociology has stressed gender differences in social support and its effects on health behaviours, this was overlooked by cancer screening research. Using a data set of 65,961 women and 55,602 men in 31 European countries, we analysed the effect of social support variables on CRC screening uptake. We found that living alone and lower perceived social support were associated with lower screening uptake for both men and women. These effects were, however, stronger among men. Population-based screening programmes mitigated these effects, particularly for women, but not for men living alone. In countries with opportunistic screening programmes, social support variables remained associated with screening uptake. We conclude that cancer screening interventions should pay attention to social support and its gender-differentiated effects.

Who Cares? Unpaid Caregiving by Sexual Identity, Gender, and Partnership Status Among U.S. Adults

Recent scholarship indicates that sexual minority adults have higher caregiving rates than heterosexuals and that women are more likely to be caregivers than men. However, little research has addressed how gender and sexuality intersect in shaping caregiving status. This study uses data from the Behavioral Risk Factor Surveillance System and aggregates a probability-based sample of adults living in 36 U.S. states between 2015 and 2021. We examine who provides care among adult heterosexual, lesbian, gay, and bisexual men and women. Results reveal that women are more likely to be caregivers than men, but only among heterosexuals. We find little variation in caregiving by sexuality among women, but bisexual men are more likely than heterosexual men to be caregivers; the latter result appears to be driven by unpartnered, bisexual men. Lastly, we contextualize caregivers' experiences and reveal selected descriptive differences in patterns of care recipient-caregiver relationships across gender and sexual identity groups. Our findings advance understanding of caregiving and changing family ties in an era of population aging and increasing diversity in sexual identities.

Effects of Subjective Orgasm Experience in Sexual Satisfaction: A Dyadic Analysis in Same-Sex Hispanic Couples

Subjective orgasm experience (SOE) is a component of sexual health that refers to the perception, sensation and/or appraisal of orgasm at a psychological level. This construct has scarcely been studied in non-heterosexual individuals and couples, and never before from a dyadic perspective. In this study, in which 104 same-sex Hispanic couples participated (48 male-male and 56 female-female), we explored the dyadic influence of SOE dimensions on sexual satisfaction, the mediating role of relationship satisfaction on the association of both phases of sexual response, as well as the explanatory capacity that discrepancies in these dimensions had on sexual satisfaction. The results indicated that the orgasmic dimensions that gained more prominence were Affective and Sensory. A dyadic influence of both on sexual satisfaction was observed only in male couples, as well as a detriment of sexual satisfaction when there were discrepancies in them, especially in women. Moreover, relationship satisfaction was a significant mediator between all dimensions of SOE and sexual satisfaction in both types of couples. This work highlights the need to take into account the SOE of both partners and how this individual experience can affect other dimensions of a more interpersonal nature, such as sexual or relationship satisfaction.

How Do Own and Siblings' Genders Shape Caregivers' Risk of Perceiving Care-Related Criticism From Siblings?

OBJECTIVES

Caring for a parent takes a greater psychological toll on daughters than sons. To minimize the psychological burden of parent care, it is important to understand what contributes to this gender disparity. Inspired by the caregiver stress process model and gender-as-relational perspective, we investigate how caregivers' gender, and the genders of their siblings, shape their risk of perceiving care-related criticism from siblings, a secondary stressor of caregiving with negative implications for psychological well-being.

METHODS

Using data from 408 adult child caregivers nested within 231 families collected as part of the Within-Family Differences Study, we employ multilevel modeling to examine how caregivers' gender, as well as the gender composition of their sibship, interact to shape caregivers' probability of perceiving criticism from siblings regarding the care that they provide their mother. Qualitative data from the same caregivers are then analyzed to illuminate processes underlying these statistical associations.

RESULTS

Quantitative analyses reveal that daughters in predominantly-son sibships have a lower risk of perceiving care-related criticism than daughters in sibships with higher proportions of daughters. Qualitative analyses elucidate these findings. Daughters in predominantly-son sibships report that their siblings defer to them regarding their mother's care. Conversely, daughters in higher proportion-daughter sibships perceive care-related criticism because they and their sibling(s) hold conflicting views regarding care, and there is less consensus regarding who best understands their mother's care needs and preferences.

DISCUSSION

Findings demonstrate how characteristics of caregivers and their sibships interact to affect caregivers' risk of perceiving criticism regarding their care to their mothers.

Gender and Social Isolation across the Life Course

Social isolation has robust adverse effects on health, well-being, dementia risk, and longevity. Although most studies suggest similar effects of isolation on the health of men and women, there has been much less attention to gendered patterns of social isolation over the life course-despite decades of research suggesting gender differences in social ties. We build on theoretical frames of constrained choice and gender-as-relational to argue that gender differences in isolation are apparent but depend on timing in the life course and marital/partnership history. Results indicate that boys/men are more isolated than girls/women through most of the life course, and this gender difference is much greater for the never married and those with disrupted relationship histories. Strikingly, levels of social isolation steadily increase from adolescence through later life for both men and women.

Mothers' Sexual Identity and Children's Health

Sexual minority women face a plethora of structural, socioeconomic, and interpersonal disadvantages and stressors. Research has established negative associations between women's sexual minority identities and both their own health and their infants' birth outcomes. Yet a separate body of scholarship has documented similarities in the development and well-being of children living with same-sex couples relative to those living with similarly situated different-sex couples. This study sought to reconcile these literatures by examining the association between maternal sexual identity and child health at ages 5-18 using a US sample from the full population of children of sexual minority women, including those who identify as mostly heterosexual, bisexual, or lesbian, regardless of partner sex or gender. Analyses using data from the National Longitudinal Study of Adolescent to Adult Health (N=8,978) followed women longitudinally and examined several measures of their children's health, including general health and specific developmental and physical health conditions. Analyses found that children of mostly heterosexual and bisexual women experienced health disadvantages relative to children of heterosexual women, whereas the few children of lesbian women in our sample evidenced a mixture of advantages and disadvantages. These findings underscore that to understand sexual orientation disparities and the intergenerational transmission of health, it is important to incorporate broad measurement of sexual orientation that can capture variation in family forms and in sexual minority identities.

Effect of support groups on caregiver's quality of life

The objective of this study was to evaluate the effect that participating in support groups for caregivers has on the quality of life and psychotropic drug use of family caregivers of adults with limitations in activities of daily living. A controlled quasi-experimental longitudinal design was used with 134 caregivers (64 in the experimental group and 70 in the control group). The outcomes were health-related quality of life (EuroQol 5D3L test) and psychotropic drug use (no/yes). The analyses were performed using SPSS and R statistical software. An interaction was observed between the condition and the level of limitations in activities of daily living of the care receiver, having an effect on the caregiver's psychotropic drug use (p = 0.003), with this use being lower among caregivers who attend support groups when their relatives present fewer limitations in activities of daily living. Moreover, the quality of life was higher in the post-test in the experimental group (B = 8.66, p = 0.015). In conclusion, support groups could improve the caregiver's quality of life and decrease psychotropic drug use when the care receiver has low limitations in activities of daily living.

Cohabitation dissolution and psychological distress among young adults: The role of parenthood and gender

Cohabitation has become a normative experience for American young adults and a common setting for childbearing in recent decades. However, the high dissolution rate of cohabitation exposes young adults to the potential stress of intimate relationship dissolution and single parenthood during early adulthood. Drawing on data from the National Longitudinal Survey of Youth 1997, we apply growth curve models to analyze how cohabitation dissolution associates with trajectories of depressive symptoms and binge drinking behaviors for young adults (aged 17 to 35). We investigate how the presence of children moderates this association for men and women. We find that cohabitation dissolution is associated with increased depressive symptoms for both men and women. However, cohabitation dissolution is only positively associated with binge drinking behaviors for men, and a significant gender difference is observed. The presence of children when cohabitation dissolves strengthens the positive association between cohabitation dissolution and depressive symptoms among women, and this positive moderation fades away as young women age. These findings suggest that gender differences in the association of cohabitation dissolution with psychological distress are contingent on the types of psychological distress under consideration and also reveal that cohabitation dissolution intertwined with non-marital parenthood is harmful to mental health, especially for young women.

Perceived Discrimination and Relationship Satisfaction Among Same-Sex Couples: The Role of Dyadic Stress and Sex

Based on the fact that most research drawn from the minority stress theory on the association between minority stress and relationship satisfaction has focused on an individual perspective rather than a dyadic perspective, and the limited evidence of the systemic transactional model (STM) explore the topics of same-sex couples. This study aims to combine both theories to examine the association between perceived discrimination and relationship satisfaction among lesbian, gay, and bisexual (LGB) people on both partners and test the potential mediating role of dyadic stress and sex difference in this association. Using an actor-partner interdependence mediation model (APIMeM), we analyzed data including a sample of 241 LGB couples (133 female and 108 male same-sex dyads). Results showed that perceived discrimination had no direct actor-partner effects on relationship satisfaction. APIMeM revealed significant indirect partner effects from perceived discrimination on both individuals' and their partners' relationship satisfaction through the partner's dyadic stress. Additionally, the effect of personal dyadic stress on a partner's relationship satisfaction was stronger for women compared to men. These findings demonstrated the utility of the minority stress theory and STM framework for understanding the risk of stressors in damaging LGBs' romantic relationships. Couple interventions should integrate knowledge from a dyadic perspective with attention to sex differences.

The Gender-as-Relational Approach for Theorizing About Romantic Relationships of Sexual and Gender Minority Mid- to Later-Life Adults

We deploy the "gender-as-relational" (GAR) approach to enhance the study of the long-term romantic relationships of sexual and gender minority mid- to later-life adults. The GAR approach states that gender within relationships is shaped by three key factors: own gender, partner's gender, and the gendered relational context. This approach highlights that the relationship dynamics of men, women, and gender nonconforming people are highly diverse, reflecting that gender is a social construct formed within interactions and institutions. We explicate how GAR can reorganize the study of sexual and gender diversity in three research areas related to aging and relationships-caregiving, marital health benefits, and intimacy-and discuss theory-driven methods appropriate for a GAR research agenda. A GAR framework reorients research by complicating taken-for-granted assumptions about how gender operates within mid- to later-life romantic relationships and queering understandings of aging and romantic relationships to include experiences outside of heteronormative and cisnormative categories.

Intensive Mothers, Cautionary Tale Fathers: Adult Children's Perceptions of Parental Influence on Health

Parents strongly influence children's health, yet how parents continue to shape the health of midlife adult children remains unknown. Moreover, while most adults are married by midlife, research has failed to identify the effects of parent-in-law relationships on midlife adult wellbeing. Using interviews with 90 individuals in 45 marriages, we investigate how midlife adults perceive the influence of parents and parents-in-law on adult child health. Findings reveal that particularly mothers and mothers-in-law positively influence child's health via support during, or in anticipation of, illness and injury. The health experiences of parents and in-laws, particularly fathers/in-law, become cautionary tales preparing adult children for future health issues. Yet, parents/in-law also have negative influence on adult children during midlife due to parents' compounding health needs. We use family systems theory to show how parents/in-laws are intertwined in ways that influence health during children's midlife that has ramifications into later life.

Families in Later Life: A Decade in Review

Later-life families encompass the legal, biological, romantic, and kin-like relationships of persons ages 65 and older. Research on older families has flourished over the past decade, as population aging has intensified concerns regarding the capacities of families to care for older adults and the adequacy of public pension systems to provide an acceptable standard of living. Shifting patterns of family formation over the past half-century have created a context in which contemporary older adults' family lives differ markedly from earlier generations. Decreasing numbers of adults are growing old with their first and only spouse, with rising numbers divorcing, remarrying, forming non-marital romantic partnerships, or living single by choice. Remarriage and the formation of stepfamilies pose challenges and opportunities as older adults negotiate complex decisions such as inheritance and caregiving. Family relationships are consequential for older adults' well-being, operating through both biological and psychosocial mechanisms. We synthesize research from the past decade, revealing how innovations in data and methods have refined our understanding of late-life families against a backdrop of demographic change. We show how contemporary research refines classic theoretical frameworks and tests emerging conceptual models. We organize the article around two main types of family relationships: (1) marriage and romantic partnerships and (2) intergenerational relationships. We discuss how family caregiving occurs within these relationships, and offer three promising avenues for future research: ethnic minority and immigrant families; older adults without close kin ("elder orphans"); and the potentials of rapidly evolving technologies for intergenerational relationships and caregiving.

Sexual- and Gender-Minority Families: A 2010 to 2020 Decade in Review

OBJECTIVE

To review research on sexual and gender minority (SGM) families-including lesbian, gay, bisexual, transgender, queer, asexual, and intersex (LGBTQAI+) families- from 2010-2020.

BACKGROUND

Research on the SGM population has increased and diversified in the past decade.

RESULTS

This paper reviews three subareas that make up the majority of research on SGM families today: (1) SGM family of origin relationships, (2) SGM intimate relationships, and (3) SGM-parent families. This review also highlights three main gaps in the existing literature: (1) a focus on same-sex and gay and lesbian families (and to a lesser extent bisexual and transgender families) and a lack of attention to the families of single SGM people as well as intersex, asexual, queer, polyamorous, and other SGM families; (2) an emphasis on white, socioeconomically advantaged SGM people and a failure to account for the significant racial-ethnic and socioeconomic diversity in the SGM population; and (3) a lack of integration of SGM experiences across the life course, from childhood to old age.

CONCLUSION

The next decade should aim to examine the full range of SGM family ties, include more vigorous examinations of race-ethnicity and socioeconomic status, and develop more robust accounts of family across the life course with novel theory and data sources across the methodological spectrum.

A Decade of Research on Intergenerational Ties: Technological, Economic, Political, and Demographic Changes

Due to extended transitions to adulthood and declining marital rates, bonds between adults and parents have grown increasingly salient in individuals' lives. This review organizes research around these topics to address ties between parents and grown children in the context of broader societal changes over the past decade. Literature searches included tables of contents of premier journals (e.g., Journal of Marriage and Family), Psychological Info, and Google Scholar. The literature review revealed patterns of social and intergenerational changes. Technological advances (e.g., introduction of the smart phone) co-occurred with more frequent contact and interdependence between generations. The Great Recession and financial strains altered the nature of many parent/child ties, including increased rates of intergenerational coresidence. Individual life problems such as divorce, addiction, and physical health problems were reflected in complex changes in positive and negative relationship qualities, ambivalence, and intergenerational support. Government policies reflect societal values and in turn, affected the distribution of parents' and grown children's resources. Political disruptions instigated migration, separating generations across large geographic regions. Political disruptions instigated migration, separating generations across large geographic regions. Demographic changes (e.g., constellation of family members, delayed marriage, same sex marriage) were also manifest in ties between adults and parents. Findings were consistent with the Intergenerational Systems in Context Model, which posits that societal transformations co-occur with changes in intergenerational relationships via reciprocal influences.

Family Matters: Research on Family Ties and Health, 2010-2020

Family ties have wide-ranging consequences for health, for better and for worse. This decade review uses a life course perspective to frame significant advances in research on the effects of family structure and transitions (e.g., marital status), and family dynamics and quality (e.g., emotional support from family members), on health across the life course. Significant advances include the linking of childhood family experiences to health at older ages, identification of biosocial processes that explain how family ties influence health throughout life, research on social contagion showing how family members influence one another's health, and attention to diversity in family and health dynamics, including gender, sexuality, socioeconomic, and racial diversity. Significant innovations in methods include dyadic and family-level analysis and causal inference strategies. The review concludes by identifying directions for future research on families and health, advocating for a "family biography" framework to guide future research, and calling for more research specifically designed to assess policies that affect families and their health from childhood into later life.

Intergenerational Caregivers of Parents With End-Stage Heart Failure

Purpose: The purpose of this study was to longitudinally explore the experiences of young adult, adult, and older adult intergenerational caregivers caring for a parent with end-stage heart failure (HF). Design: This study was a secondary analysis of qualitative data collected during a longitudinal study that sought to determine the palliative care needs of individuals with end-stage HF and their family caregivers. Methods: Longitudinal interviews from 23 young adult, adult, and older adult children who were caring for a parent with end-stage HF were selected for thematic analysis. Researchers individually analyzed the interviews and then, as a group, came to a consensus about themes. Findings: Five major themes were identified: caregiver resources, role management, caregiver-parent relationships, filial responsibility, and personal benefits and challenges Conclusions: These intergenerational caregivers struggled to balance their busy lives and caregiving roles. However, most felt supported by other family members or external resources. Longitudinal findings support a need for improved employer-based support for intergenerational caregivers and special attention to young carers in research and practice. Recognition of and advocacy for intergenerational caregivers providing care for a chronically ill parent is needed.

MARITAL STRAIN AND PSYCHOLOGICAL DISTRESS IN SAME-SEX AND DIFFERENT-SEX COUPLES

OBJECTIVE

This study examines the association of marital strain - as reported by each spouse - with psychological distress and considers whether the associations vary for men and women in gay, lesbian, and heterosexual marriages.

BACKGROUND

Prior studies show that marital strain is associated with psychological distress. However, most studies rely on only one spouse's perspective and do not consider how appraisals of strain from both spouses may contribute to distress. Moreover, possible gender differences in these associations have been considered only for heterosexual couples.

METHOD

Analyses are based on 10 days of dyadic diary data from 756 midlife U.S. men and women in 378 gay, lesbian, and heterosexual marriages. Multilevel modeling is used to examine the association of self- and spouse-reported marital strain with psychological distress; actor-partner interdependence models (APIM) explore possible gender differences in these associations.

RESULTS

Both self- and spousal-reports of marital strain are associated with psychological distress, with notable gender differences. The associations of self- and spouse-reported marital strain with distress are stronger for women in different-sex marriages when compared to men in same-sex and different-sex marriages. The association is also stronger for women in different-sex marriages compared to women in same-sex marriages, but for self-reported strain only.

CONCLUSION

Marital appraisals by both spouses are important for psychological well-being and may be especially important for the well-being of women in different-sex marriages.

Psychological Distress Transmission in Same-sex and Different-sex Marriages

Ample work stresses the interdependence of spouses' psychological distress and that women are more influenced by their spouse's distress than men. Yet previous studies have focused primarily on heterosexual couples, raising questions about whether and how this gendered pattern might unfold for men and women in same-sex marriages. We analyze 10 days of diary data from a purposive sample of men and women in same-sex and different-sex marriages ( n = 756 individuals from 378 couples) to examine psychological distress transmission between spouses and how this process may differ for men and women in same-sex and different-sex marriages. We find that women are more strongly influenced by their partners' distress than men, regardless of whether they are married to a man or a woman, and that this relationship is particularly strong for women with male spouses.

Sex in Midlife: Women's Sexual Experiences in Lesbian and Straight Marriages

OBJECTIVE

This study examines how married straight and lesbian women understand sexual changes in midlife.

BACKGROUND

Sexual satisfaction is key to marital quality, yet marital sex typically diminishes in midlife. Little is known, however, about how married straight and lesbian women make sense of midlife sexuality. Comparing the narratives of lesbian and straight women can reveal how midlife events, relational contexts, and gender norms drive women's experiences of and responses to diminishing sex.

METHOD

Inductive and deductive analyses were performed on interviews with a convenience sample of 16 straight and 16 lesbian mostly high-status married couples in Massachusetts.

RESULTS

Lesbian and straight women suggest that sexual activity and desire diminish over time due to health, aging, and caregiving events, yet lesbian women additionally emphasize the importance of weight gain, caregiving for adult parents, and shared experiences of menopause. Women further describe distress when their sex lives diverge from norms specific to marriage and their sexual identities. Moreover, women report relationship work designed to maintain or reignite sex; when compared with straight women, lesbians describe more work and a stronger sense of duty to keep sex alive and uniquely describe medical providers as unhelpful in addressing sexual challenges.

CONCLUSION

The results suggest that relational contexts and cultural discourses shape straight and lesbian women's experiences of distress and comfort about diminishing sex in marriage.

Marriage, Social Control, and Health Behavior: A Dyadic Analysis of Same-sex and Different-sex Couples

Prior research based on studies of heterosexual populations suggests that men's health benefits more from marriage than women's, in part because women do more than men to influence the health habits of their spouse. We extend this work by using dyadic survey data from 838 spouses in 419 gay, lesbian, and heterosexual marriages to consider differences in social control tactics across same-sex and different-sex couples-that is, how spouses monitor and regulate each other's health habits. Results suggest that although gender differences in social control are common, gendered patterns sometimes differ depending on whether one is in a same-sex or different-sex marriage. Results also point to the importance of health habits as strong drivers of relationship dynamics across gay and lesbian as well as heterosexual marriages.

Queering Methodologies to Understand Queer Families

Queering questions that which is normative. In this article, we discuss how, for the study of queer families, queering methodologies could reclaim traditional research methods that reflect historically dominant or privileged paradigms. We suggest that queer perspectives may be used to adapt mainstream (i.e., dominant, positivist, empirical) methods, creating possibilities for new, diverse understandings of queer families. We start with comments on the development and current standing of queer family research. We then reflect on several key conceptual and methodological tensions as they apply to queer family studies: lesbian, gay, bisexual, transgender, and queer individuals ↔ queer families, between-group ↔ within-group, and quantitative ↔ qualitative. In conclusion, we discuss how these methodological considerations provide researchers opportunities to conduct research not only about but for queer families. Such research may reflect the diversity of queer families and challenge the normativities and systems of privilege that constrain them.

Planning for Future Care and the End of Life: A Qualitative Analysis of Gay, Lesbian, and Heterosexual Couples

Two key components of end-of-life planning are (1) informal discussions about future care and other end-of-life preferences and (2) formal planning via living wills and other legal documents. We leverage previous work on the institutional aspects of marriage and on sexual-minority discrimination to theorize why and how heterosexual, gay, and lesbian married couples engage in informal and formal end-of-life planning. We analyze qualitative dyadic in-depth interviews with 45 midlife gay, lesbian, and heterosexual married couples ( N = 90 spouses). Findings suggest that same-sex spouses devote considerable attention to informal planning conversations and formal end-of-life plans, while heterosexual spouses report minimal formal or informal planning. The primary reasons same-sex spouses give for making end-of-life preparations are related to the absence of legal protections and concerns about discrimination from families. These findings raise questions about future end-of-life planning for same- and different-sex couples given a rapidly shifting legal and social landscape.

Family Relationships and Well-Being

Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships—marital, intergenerational, and sibling ties—that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses.

Millennials and Their Parents: Implications of the New Young Adulthood for Midlife Adults

The period of young adulthood has transformed dramatically over the past few decades. Today, scholars refer to "emerging adulthood" and "transitions to adulthood" to describe adults in their 20s. Prolonged youth has brought concomitant prolonged parenthood. This article addresses 3 areas of change in parent/child ties, increased (a) contact between generations, (b) support from parents to grown children as well as coresidence and (c) affection between the generations. We apply the Multidimensional Intergenerational Support Model (MISM) to explain these changes, considering societal (e.g., economic, technological), cultural, family demographic (e.g., fertility, stepparenting), relationship, and psychological (normative beliefs, affection) factors. Several theoretical perspectives (e.g., life course theory, family systems theory) suggest that these changes may have implications for the midlife parents' well-being. For example, parents may incur deleterious effects from (a) grown children's problems or (b) their own normative beliefs that offspring should be independent. Parents may benefit via opportunities for generativity with young adult offspring. Furthermore, current patterns may affect future parental aging. As parents incur declines of late life, they may be able to turn to caregivers with whom they have intimate bonds. Alternately, parents may be less able to obtain such care due to demographic changes involving grown children raising their own children later or who have never fully launched. It is important to consider shifts in the nature of young adulthood to prepare for midlife parents' future aging.

Physical Illness in Gay, Lesbian, and Heterosexual Marriages: Gendered Dyadic Experiences

The inclusion of same-sex married couples can illuminate and challenge assumptions about gender that are routinely taken for granted in studies of physical illness. We analyze gender dynamics in gay, lesbian, and heterosexual marriages with in-depth interview data from 90 spouses (45 couples) to consider how spouses co-construct illness experiences in ways that shape relationship dynamics. Overall, findings indicate that men tend to downplay illness and thus provide minimal care work, whereas women tend to construct illness as immersive and involving intensive care work-in both same-sex and different-sex marriages. Yet same-sex spouses describe similar constructions of illness much more so than different-sex couples, and as such, same-sex spouses describe less illness-related disagreement and stress. These findings help inform policies to support the health of gay and lesbian, as well as heterosexual, patients and their spouses, an important goal given health disparities of gay and lesbian populations.