made up for by decreased expenses for Medicaid, Medicare, and Supplemental Security Income. According to a study published in May 2020 by the Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy, the legalization of same-sex marriage boosted state and local economies by an estimated 3.8 billion dollars. The Williams Institute estimated that the 300,000 same-sex couples who married in the U.S. since 2015 generated about $3.2 billion for local and state economies. In addition, traveling wedding guests spent an additional $544 million, and about 45,000 jobs were supported by same-sex weddings. $244 million was generated in state and local taxes. Mental health Based in part on research that has been conducted on the adverse effects of stigmatization of gays and lesbians, numerous prominent social science organizations have issued position statements supporting same-sex marriage and opposing discrimination on the basis of sexual orientation; these organizations include the American Psychoanalytic Association and the American Psychological Association. Several psychological studies have shown that an increase in exposure to negative conversations, media messages, and negative reactions among peers about same-sex marriage creates a harmful environment for LGBT people that may affect their health and well-being, especially among its younger members. One study surveyed more than 1,500 lesbian, gay and bisexual adults across the nation and found that respondents from the 25 states that have outlawed same-sex marriage had the highest reports of "minority stress"—the chronic social stress that results from minority-group stigmatization—as well as general psychological distress. According to the study, the negative campaigning that comes with a ban is directly responsible for the increased stress. Past research has shown that minority stress is linked to health risks such as risky sexual behavior and substance abuse. Two other studies examined personal reports from LGBT adults and their families living in Memphis, Tennessee, immediately after a successful 2006 ballot campaign banned same-sex marriage. Most respondents reported feeling alienated from their communities. The studies also found that families experienced a kind of secondary minority stress, says Jennifer Arm, a counseling graduate student at the University of Memphis. At the Perry v. Schwarzenegger trial, expert witness Ilan Meyer testified that the mental health outcomes for gays and lesbians would improve if laws such as Proposition 8 did not exist because "when people are exposed to more stress...they are more likely to get sick..." and that particular situation is consistent with laws that say