New York City, with close runners-up of New Jersey, Pennsylvania and Washington, DC.
By 1913 many states had laws on the books requiring some sort of medical certificate or oath that the male was free of venereal disease before a marriage license would be issued. New York, Pennsylvania and Virginia required an oath.
By 1925 many states passed laws that required a physical examination of both parties, but there was not much interest in enforcement.
In 1935, however, Connecticut passed the “Premarital Examination Law,” which required a blood test for Syphilis and a physical examination of both parties before a marriage license application could be made.
In 1936, Surgeon General Thomas Parren of the Public Health Service began a nationwide drive for venereal disease testing before marriage.
New York State enacted their “Premarital Examination Law” in June 1939. Marriages in Upstate New York increased that year from 1938, and we suspect it was to get married before the new law took effect mid-year.
New Jersey enacted legislation in 1938, which may have driven those residents to seek licenses in Virginia that did not require blood tests until August 1940.
On October 1, we sorted the 1,771 1939 marriage licenses taken out at Fredericksburg, VA Circuit Court into piles of 100s. We will start digitizing them next week, and it will be at that time we will learn when the licenses of the states listed above as the “winners” were taken out. If the licenses for couples from New York were during the first half of the year, we will surmise it was to avoid the new premarital examination law passed by that state.
For further information on this subject please see Premarital Health Examination Legislation: Analysis and Compilation of State Laws, J.K. Shafer, M.D., published by the U.S. Department of Health, Education, and Welfare, Public Health Service. Digitized by Google; original from University of Michigan.