Background/Purpose: Public debates on legalization of same-sex marriage occurred in Taiwan since the latter half of 2016. Taiwanese people voted on same-sex marriage referendums on November 24, 2018. The aim of this Facebook online study was to examine the changes in rates of poor mental health status among Taiwanese people during the 23-month period of public debates on and referendums for legalizing same-sex marriage. Methods: A two-wave internet survey was conducted using Facebook to gather information regarding mental health and attitudes toward same-sex marriage among 3286 participants (1456 heterosexual and 1830 nonheterosexul) in Wave 1 (one week after the first reading of the Marriage Equality Bill) and 1370 participants (540 heterosexual and 830 nonheterosexul) in Wave 2 survey (one week after the referendum of same-sex marriage). The five-item Brief Symptom Rating Scale was used for assessing mental health status. Results: The rate of poor mental health status significantly increased from the Wave 1 to Wave 2 surveys in heterosexual, lesbian, gay and bisexual (LGB) participants. In nonherterosexual groups, the rates of poor mental health status increased in LGB and female and male nonheterosexual participants of all age. The rates of poor mental health status also increased in heterosexual participants who were female, were young, and supported same-sex marriage. Conclusion: The rates of poor mental health status increased in both heterosexual and nonheterosexual people during the period of public debates on and the referendums for same-sex marriage. Heterosexual people who were female, were young, and supported same-sex marriage had also increased rates of poor mental health state during the same period.
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