Structural Heteropatriarchy and Birth Outcomes in the United States

Emerging evidence links structural sexism and structural discrimination against les bian, gay, and bisex ual (LGB) pop u la tions to poor health out comes, but stud ies have yet to exam ine the com bined effects of these mutu ally reinforcing sys tems of inequal- ity. Therefore, we devel oped a com pos ite mea sure of struc tural heteropatriarchy-which includes state -level LGB pol i cies, fam ily plan ning pol i cies, and indi ca tors of struc tural sex ism (e.g., women's polit i cal and eco nomic posi tion rel a tive to men)-and exam ined its rela tion ship to birth out comes using data from Waves I to V of the National Longitudinal Study of Adolescent to Adult Health. Multivariate regres sion ana ly ses dem on strated that higher levels of heteropatriarchy were asso ci ated with an increased risk of pre term birth and decreased birth weight, net of impor tant covariates. There was no asso ci a tion between clin i cal low birth weight and heteropatriarchy, or inter ac tions between heteropatriarchy and indi vid u als' race, eth nic ity or sex ual iden tity, suggesting a neg a tive effect of heteropatri- archy on birth out comes for all preg nant peo ple. This study dem on strates the impor tance of con sid er ing gen der and sex u al ity as mutu ally reinforcing sys tems of oppres sion that impact pop u la tion health. Future research should exam ine the impact of heteropatriarchy on addi tional health out comes and in con junc tion with other struc tural inequalities such as racism and transgender oppression.

Automated summary

This study finds a link between structural sexism and discrimination against LGB populations and poor health outcomes, highlighting the importance of considering gender and sexuality as mutually reinforcing systems of oppression. The study also reveals that higher levels of heteropatriarchy are associated with an increased risk of preterm birth and decreased birth weight.