We assessed the association between the health of people in same-sex relationships and the degree and nature of the legal recognition of same-sex relationships offered in the states in which they resided.We conducted secondary data analyses on the 2010 to 2013 Current Population Survey and publicly available data from Freedom to Marry, Inc. We estimated ordered logistic regression models in a 4-level framework to assess the impact of states' legal stances toward same-sex marriage on self-assessed health.Our findings indicated, relative to states with antigay constitutional amendments, that same-sex couples living in states with legally sanctioned marriage reported higher levels of self-assessed health.Our findings suggested that full legal recognition of same-sex relationships through marriage might be an important legal and policy strategy for improving the health of same-sex couples.