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The establishment of same-sex marriage is associated with a significant reduction in the rate of attempted suicide among children, concentrated among children of a minority sexual orientation. A study of nationwide data from across the United States from January 1999 to December 2015, conducted by the American Medical Association, revealed that the rate of attempted suicide among all schoolchildren in grades 9 to 12 declined by 7% and the rate of attempted suicide among schoolchildren of a minority sexual orientation in grades 9 to 12 declined by 14% in states which established same-sex marriage, resulting in approximately 134,000 fewer children attempting suicide each year in the United States. The researchers took advantage of the gradual manner in which same-sex marriage was established in the United States (expanding from 1 state in 2004 to all 50 states in 2015) to compare the rate of attempted suicide among children in each state over the time period studied. Once same-sex marriage was established in a particular state, the reduction in the rate of attempted suicide among children in that state became permanent. No reduction in the rate of attempted suicide among children occurred in a particular state until that state recognized same-sex marriage. The lead researcher of the study observed that "laws that have the greatest impact on gay adults may make gay kids feel more hopeful for the future".