Policies permitting same-sex marriage are linked to fewer suicide attempts among young people — especially those who identify as gay, lesbian, bisexual, or questioning. That might be because such policies reduce stigma perceived by LGBQ kids, according to a new study published today in JAMA Pediatrics.

Same-sex marriage policies were associated with a 7 percent reduction in the proportion of high school students reporting a suicide attempt within the past year, the authors found. That would be equivalent to an estimated 134,446 fewer adolescents attempting suicide each year. Gay marriage was legalized everywhere in the US in 2015.

Suicide is the second-leading cause of death among 10- to 24-year-olds

Suicide is the second-leading cause of death among US people ages 10 to 24 years old, according to the Centers for Disease Control and Prevention. (The most common cause of death in that age group is accidents, which includes car crashes.) Teenagers who identify as lesbian, bisexual, gay, or questioning are at a higher risk for suicide attempts. In 2015, a quarter of gay, lesbian, and bisexual high school students reported attempting suicide within the past 12 months, compared with 6 percent of heterosexual students. Why LGBQ kids are more likely to attempt suicide is not completely clear, but previous studies have suggested anti-gay hostility plays a role. Today’s study suggests that gay-friendly policies may mean happier kids.

Social policies can affect health outcomes, says lead author Julia Raifman, a postdoctoral fellow at Johns Hopkins Bloomberg School of Public Health. “It’s an important thing to consider going forward.”

Laws that prohibit same-sex marriage perpetuate anti-gay stigma. The mental health effects of these laws — especially among youth — is mostly unknown. For this research, Raifman and her colleagues analyzed data on almost 763,000 adolescents who took part in the Youth Risk Behavior Surveillance System from 1999 through 2015. They analyzed changes in suicide attempts among public high school students before and after same-sex marriage policies were implemented in 32 states. Then, they compared that data with changes in suicide attempts among students in 15 states that do not have policies permitting same-sex marriage.

Laws that prohibit same-sex marriage perpetuate anti-gay stigma

The results were pretty clear: same-sex marriage policies were associated with a 7 percent reduction in the proportion of high school students reporting a suicide attempt within the past year. That was especially true for LGBQ adolescents, who had a 14 percent decline.

The study has some limitations. It’s an association study, so it doesn’t show a direct casual link between same-sex marriage policies and suicide. It also doesn’t explain why exactly legalizing same-sex marriage would lead to fewer suicide attempts. That’s a particularly interesting question because teenagers aren’t likely to get married in the near future. Same-sex marriage was also legalized nationwide in the US in 2015, so variations among states no longer exist.

The study “raises several critical questions for future research,” Mark Hatzenbuehler, an associate professor of sociomedical sciences at Columbia University’s Mailman School of Public Health, writes in a comment published alongside the study. It’d be interesting to know if other laws and policies affecting LGBTQ youth — like harassment laws that lack protections related to students’ sexual orientation and gender identity — affect their health. On her part, Raifman says she’s interested in continuing this research. She hopes that her work will have a real-life impact, too.

“I hope that this study will inform policy makers and the public as other policies governing LGBT rights are considered,” she says.