Gender, Health Behavior, and Intimate Relationships: Lesbian, Gay, and Straight Contexts

Marriage is associated with more health-enhancing behaviors and fewer risky health behaviors (Umberson, 1987, Waite & Gallagher, 2000), and the influence of spouses on one another’s behavior is one of the primary explanations for how marriage benefits health. Because the link between health behavior and overall health is well-established (McGinnis et al., 2002), the influence of marriage on health behavior is increasingly viewed as important for population health (Umberson & Montez 2010). In fact, U.S. and British public health initiatives, such as Healthy People 2010 (U.S. DHHS 2000), Change4Life, and Healthy Lives, Healthy People (British DH, 2010), emphasize the importance of marital relationships in influencing health behaviors. Research consistently shows that attempts to influence a spouse’s health are not equally enacted by men and women. Women do more to promote their spouse’s health behavior, and this gender gap is identified as a primary reason that men’s health benefits more from marriage (Umberson, 1992; Waite & Gallagher, 2000). In order to explain this persistent and well-documented gender gap, previous research has relied primarily on gender socialization theory to suggest that girls are socialized from a young age to care about others’ health, while boys are not. Yet, the gender socialization approach has been criticized for placing men and women into “two fixed, static and mutually exclusive role containers” that do not vary by context or change over the life course (Kimmel, 1986, p. 521). In response, a range of cognate contemporary gender theories have been developed as a critique of gender socialization theory; these perspectives suggest that a gendered self is emergent in interactions that occur between and among men and women within broader stratified structural contexts (Connell, in press; Martin, 2004; Ferree, 2010). Such theories have been used to examine other activities that women disproportionally do in marriage—most predominantly unpaid work (Ferree, 2010)—but have not been applied to an examination of health behavior in intimate relationships. Moreover, the focus on health promotion in the context of straight marriage raises questions about whether similar health promotion dynamics occur in gay and lesbian relationships. Extending the focus to gay and lesbian partnerships is important for at least two reasons. First, ongoing debates about the value of marriage for gays and lesbians have only articulated the health benefits of marriage for straight couples, neglecting to include empirical data on gays and lesbians (Wienke & Hill, 2009). Second, an exclusive focus on straight marriages precludes analysis of how the relationship dynamics between two women or two men shape health behavior. We extend research on gender and health behavior in intimate ties with an analysis of 100 individuals in 20 long-term straight marriages as well as 15 gay and 15 lesbian couples in long-term cohabiting partnerships in the U.S. We analyze these interviews to ask: How do men and women describe relationship dynamics around health behavior in intimate relationships? We use contemporary gender theories to frame our analysis of health behavior dynamics within these partnerships.