Mental health and substance use shape the processes of romantic relationship formation for same-gender couples

Bidirectional links between mental health and substance use and romantic relationship dynamics are well-established, though most of this research has focused on different-gender (presumed heterosexual) couples in established, committed relationships or marriages. Given the high prevalence of mental health and substance use disparities among sexual minority adults, more research is needed on how these factors might influence them and not just in committed relationships, but early romantic relationship development, a time that can be especially turbulent for all couples. The present study used qualitative data from 60 cisgender, same-gender couples (50% female) collected during a semistructured conversation couples had regarding their relationship formation and early history. Applied content analysis was used to explore the role of mental health and substance use on couples' relationship formation and early functioning. Primary themes included the role of alcohol and substance use in accelerating relationship development, perception of partners as a mental health support promoting relationship formation, and associations between partner's psychological distress and early relationship distress and instability. More female couples than male couples described their poor mental health at relationship initiation as both promoting relationship involvement and exacerbating conflict. These findings highlight the relevance of mental health and substance use problems for same-gender couples' early romantic relationship development given the mental health disparities they face. Future research will be needed to explore if findings generalize to other types of sexual and gender minority couples and heterosexual couples. (PsycInfo Database Record (c) 2026 APA, all rights reserved).