captainawesome
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Since you're struggling to understand what "state sanctioned marriage" means, let's start out with a basic definitions.
Sanction: noun. approval - approbation - endorsement - authorization
State Sanctioned marriage is for the purpose of approving a pairing and confirming that it makes biological sense. That's why important restrictions to marriage have historically included things like incest, fatal venereal diseases, blood types that are incompatible for producing children and, of course, same sex partners. Marriage is official approval and endorsement of a pairing that is not biologically illogical.
Blood tests were not historical. They were required only for a very short time. George and Martha Washington had no blood test. Neither did the Lincolns.