WHITINSVILLE, Mass., - Twenty years after he met the love of his life, nearly five years after their wedding helped make history, it took a nasty bout of pneumonia for Gary Chalmers to fully appreciate the blessings of marriage.
"I was out of work for eight weeks, spent a week in the hospital," Chalmers said. "That was the first time I really felt thankful for the sense of the security we had, with Rich there, talking with the physicians, helping make decisions. ... It really made a difference."
At stake was the most basic recognition of marital bonds - something most spouses take for granted. But until May 17, 2004, when Chalmers and Richard Linnell were among a surge of same-sex couples marrying in Massachusetts, it was legally unavailable to American gays and lesbians. Same-sex unions are permitted by law in Canada.
Since that day, four other states - Connecticut in 2008, and Iowa, Vermont and Maine this year - have legalized same-sex marriage, and more may follow soon. A measure just approved by New Hampshire's legislature awaits the governor's decision on whether to sign. But Massachusetts was the first, providing a five-year record with which to gauge the consequences.
At the time of those first weddings, the debate was red-hot - protests were frequent, expectations ran high that legislators would allow a referendum on whether to overturn the court ruling ordering same-sex marriage. Now, although Roman Catholic leaders and some conservative activists remain vocally opposed, there is overwhelming political support for same-sex marriage and no prospect for a referendum.
According to the latest state figures, through September 2008, there had been 12,167 same-sex marriages in Massachusetts - 64 per cent of them between women - out of 170,209 marriages in all. Some consequences have been tangible - a boom for gay-friendly wedding businesses, the exit of a Roman Catholic charity from the adoption business - and some almost defy description.
Mary Bonauto, lead lawyer in the landmark lawsuit, said, "I know people who'd been together 20 years who say, 'Getting married - it knocked my socks off."'
Chalmers and Linnell were among seven gay and lesbian couples recruited by Bonauto's team to be plaintiffs in the lawsuit.
They had been partners since meeting in Worcester in 1988, and now live nearby in Linnell's childhood house in Whitinsville with their 16-year-old daughter, Paige, whom they adopted as an infant.
The town of 6,300 is relatively far from cosmopolitan Boston and the gay vacation mecca of Provincetown, but the family feels thoroughly comfortable.
Paige is helping form a gay-straight alliance at her high school. When her fathers got married, she said, "all my friends were saying they wanted to come to the wedding."
Chalmers, an elementary school curriculum co-ordinator, and Linnell, nurse manager at a medical centre, say they didn't need the wedding to prove their commitment, but they appreciate the added legal stability and the recognition they get from others.
"Before, we had wills, we had power of attorney," Chalmers said. "But the fact of the matter was, you can't make up for the thousand or so rights that are given to married couples."
Another plus: Explanations about family ties are easier now that "husband" is an option.
"More than once," Chalmers recalled, "I was introducing Rich and said, 'This is my partner' and they'd say, 'Oh, what kind of company do you own? What business are you in?"'
Another of the lawsuit couples - Gina and Heidi Nortonsmith - live in the college town of Northampton with their two sons - Quinn, 9, and Avery 12. Like their fellow plaintiffs, they married as soon as legally possible, on May 17, 2004.
Heidi runs an emergency food pantry; Gina is an elementary school classroom aide. Heidi gave birth to both sons, who are biracial, and the family name merges the moms' maiden names.
"When we were getting ready to have the kids, we wanted to cross all our T's and dot all our I's, feeling there were so many protections for heterosexual married families that just weren't available to us," Heidi said.
"When marriage finally happened, there was that emotional sigh of relief - just knowing there would be a legal framework, and a court of law would understand our family."
Heidi and Gina bridle at the contention of some gay-marriage opponents that children such as theirs will suffer from not being raised by both a mother and father.
"We have really great kids," says Gina. "It's been fun to have people see who we are."
One of the striking developments, since 2004, is the fading of opposition to gay marriage among elected officials in Massachusetts.
When the state's Supreme Judicial Court ruled in 2003 that banning same-sex marriage was unconstitutional, there seemed to be sufficient support in the legislature for a ballot measure that would overturn the decision. But a gay-marriage supporter, Deval Patrick, was elected governor; and in 2007 legislators rejected, 151-45, a push for a referendum.
The view now contrasts with 2003-04, when the debate was wrenching for legislators such as Senator Marian Walsh. Her district, including parts of Boston and some close-in suburbs, is heavily Catholic and socially conservative. Many supported overturning the high court's ruling.
"I had hundreds of requests to meet with people on both sides," Walsh said. "Everyone wanted to know how was I going to vote."
She read up on the law, wrestled with her conscience, and finally decided the court was correct - and there should be no referendum.
"I came to the decision that it really is a civil right - that the constitution was there to protect rights, not to diminish rights," she said.
The reaction? Embittered constituents, hate mail and death threats, rebukes from Catholic clergy, she said, but she won re-election in 2004 and again in 2006.
Neither the federal government nor the vast majority of other states recognize Massachusetts' same-sex unions. Partly as a backlash to Massachusetts, 26 states have passed constitutional amendments since May 2004 explicitly limiting marriage to male/female unions.
Even the 2010 census, under the Defense of Marriage Act, likely won't record legally wed couples in Massachusetts and elsewhere as married.
Gay & Lesbian Advocates & Defenders, the Boston legal firm which won the same-sex marriage case, filed a new lawsuit in March challenging the portion of the act that bars the federal government from recognizing same-sex marriages. But for now, non-recognition can be stinging.
After Michael and Rick McManus of Charlton married in 2006, they honeymooned in Panama, and on return to the United States were told at the immigration booth that they had to go through separately because U.S. law didn't consider them married.
Michael and Rick have subsequently adopted a son, turning two on May 7, and a daughter, almost one. They plan to limit international travel until the federal policy changes.
"I don't want our kids to be coming through customs and having to explain that their dads aren't married there," Michael said.
They are frustrated at having to file two sets of tax returns - as a married couple in Massachusetts and as single men for the Internal Revenue Service. And they were dismayed when Arkansas voters last fall approved a ballot measure that bans gay couples from adopting.
"There's a sense of security for our family here," Michael said. "But when we leave this state, it's a very different world."
"Holy cow, the sky hasn't fallen."
That assessment of five years of same-sex marriage came from Jennifer Chrisler, who advocates for gay and lesbian parents as head of the Boston-based Family Equality Council. But that message can be grating for those with opposing views.
"We absolutely believe the sky is falling," said Kris Mineau, president of the Massachusetts Family Institute. "But we believe it would be a generational downfall, not an overnight downfall."
Mineau and his allies say their primary concern is the welfare of children raised by same-sex couples - even though establishment groups such as the American Academy of Pediatrics say such children fare just as well as those with heterosexual parents,
"No matter how loving and how caring two women are, there's no way they can replace the role of the father," Mineau said.
Mineau also said religious liberty is at risk in Massachusetts, and cited the example of Catholic Charities of Boston, which stopped providing adoption services in 2006 because state law required it to consider same-sex parents when looking for adoptive homes.
Public schools are another venue in the dispute over gay marriage.
David Parker of Lexington objected when his youngest son brought home a book from kindergarten that depicted a gay family. He was later arrested for refusing to leave the school after officials wouldn't agree to notify him when homosexuality was discussed in his son's class.
Parker filed an unsuccessful lawsuit contending that school administrators violated a state law requiring that parents get a chance to exempt their children from sex-education curriculum. School officials said the books didn't focus on sex education, and merely depicted various families.
"Parental rights lost out in a big way - the right of parents to oversee the moral upbringing of their own children," said Parker. He and his wife Tonia now home-school their two sons.
Opposition to same-sex marriage remains strong in the Roman Catholic hierarchy. Disappointment in the legislature for blocking a referendum is still deep.
"Why was it squelched?" asked Bishop Robert McManus of Worcester. He complained that "a well-heeled, organized political action group" got more attention from legislators than average people.
He added: "The proponents of same-sex marriage argue that if you're opposed, you are exercising bigotry. No one who's proud of being an American wants to be accused of being a bigot, so some people retreat into a live-and-let-live situation."
McManus insists the church's views, over time, can still prevail.
Bonauto, the lead lawyer in the lawsuit, sees a different outcome as more states consider same-sex marriage or extend other recognition to gay couples.
The Massachusetts ruling "was a game changer," she said. "Even our opponents know it's only matter of time before there's marriage equality nationwide."
Some important dates relating to gay marriage in Massachusetts and nationally:
July 1, 2000 - Acting under a state Supreme Court order, Vermont becomes the first state with civil unions that provide same-sex couples with the same legal rights and responsibilities as marriage.
April 11, 2001 - Seven same-sex couples in Massachusetts, denied marriage licences, sue in Superior Court in Boston to challenge the state's gay marriage ban.
Nov. 18, 2003 - Massachusetts' Supreme Judicial Court rules it is unconstitutional to bar gay couples from marriage.
May 17, 2004 - Marriages of gay couples begin in Massachusetts.
June 14, 2007 - Massachusetts legislators vote to block a proposed referendum seeking to ban same-sex marriage.
July 31, 2008 - Massachusetts repeals a 1913 law that barred most out-of-state same-sex couples from marrying in the state.
Oct. 10, 2008 - The Connecticut Supreme Court strikes down the state's ban on same-sex marriage.
Nov. 4, 2008 - California voters pass Proposition 8, a ballot marriage overturning a state Supreme Court decision that had legalized same-sex marriage earlier in the year. The issue remains in legal limbo.
April 3, 2009 - The Iowa Supreme Court orders the legalization of same-sex marriage.
April 7, 2009 - Overriding the governor's veto, legislators in Vermont make their state the first to legalize same-sex marriage by a legislative vote.
May 6, 2009 - Maine's governor signs a gay marriage bill passed by legislators. Opponents immediately file papers seeking a repeal referendum.