The Supreme Court has ruled that the U.S. Constitution will now require all 50 states to license and recognize same-sex marriage. Two questions stood before the Justices: Does the 14th Amendment require states to license a marriage between two people of the same gender, and does that same amendment require a state to recognize legally valid same-sex marriages performed elsewhere? In a 5-4 decision, the court ruled that the answer to both is “yes."
Phil McCabe, president of NALGAP, The Association for Lesbian, Gay, Bisexual, Transgender Addiction Professionals and Their Allies, says the decision will largely impact the degree to which LGBT partners and spouses are involved in the treatment and recovery of their loved ones in programs that aren't LGBT affirmative (dedicated) or inclusive (non-specific with an integration of LGBT services).
"If someone’s going into a program that has challenges with meeting the needs of the LGBT population, many times the significant other isn’t included with the rest of the population," he says. "Everybody else has a husband or wife who comes in with the family group, and often times the LGBT person's significant other is left out. They’ll do very minimal with them and won’t fully bring them into the program; and they don’t have the same visitation [privileges]."
If someone has a medical crisis, that can also shut out a life partner if there is no legal binding as far as a marriage, he says, and life decisions are typically handed over to next of kin. "We’ve seen that happen across the board, where partners have been removed from emergency rooms because they can’t or don’t have anything that shows that they’re the life partner," he says.
He explains that although a number of states already recognized LGBT partnerships prior to the ruling (37 states, plus the District of Columbia) often times insurance companies would send individuals to states where they weren't recognized in the state let alone the treatment program. A number of states including Mississippi, Alabama, Louisiana, Utah and Tennessee are still being resistant to change by delaying enforcement of the ruling or drafting legislation that would end state agencies’ involvement in issuing marriage licenses.
"I have clients who say they say a certain program did an outreach and sent a brochure to their partner. Sending a brochure is fine, but if someone’s going into treatment, a life partner needs a lot more than getting a pamphlet in the mail," he says. "Now facilities will have to recognize the relationship. And not just recognize it but treat it equally."
In the end McCabe says it really goes back to how programs look at and value LGBT families. "For anyone who has kind of dragged their feet and been resistant, the significance of this is that the Supreme Court is saying that LGBT partnerships are not questionably similar and it’s not a question of gay families and straight families, it’s families are families and marriage is marriage. So if there are any clients coming in, their family will have to be included if that’s the relationship they’re involved in."