ACOG's statement looks specifically at the impact on lesbian relationships, noting that "many lesbians experience barriers to health care, including concerns about confidentiality, discriminatory attitudes and treatment, limited access to health care and health insurance, and often an inadequate understanding of their own health risks. Adding to these obstacles, lesbians and their families are negatively affected by the lack of legal recognition of their relationships and the lawful protections that automatically come with legally recognized marriage. This lack of legal rights has direct health-related implications for lesbian couples and their children."