Research

Journal Publications

1. Mann, S. O'Leary, N. Blackaby, D., (2026) Sexual Identity, Industrial Segregation, and Earnings
   Journal of Economic Behavior and Organization
   (link)
   Best Paper Award at 2019 Welsh Postgraduate Conference in Business, Management, and Economics
   Using longitudinal data from the UK, we examine how industrial segregation shapes earnings disparities by sexual identity. We show that sexual minorities are concentrated in lower-paying industries, particularly among men, but that greater representation can also provide within-industry protection for some groups.

2. D’Amico E.J. Dickerson, D.L. Klein, D.J. Rodriguez, A. Arvizu-Sanchez, V. Schweigman, K. Johnson, C. Mann, S. Kennedy, D.P. Holmes, P. Palimaru, A.I. Brown, R. & Malika, N., (2026) Virtual Culturally Grounded Interventions for Substance Use in Urban American Indian and Alaska Native Emerging Adults: A Randomized Clinical Trial.
   JAMA Network Open
   (link)
   We use an RCT to identify the effects of two culturally grounded substance use interventions for AIAN emerging adults on a range of substance and mental health related outcomes.
   Covered by: NIH and American Society of Addiction Medicine

3. Mann, S. Sicinolfi, D. Rodriguez, A. Seelam, R. Pederson, E. Dunbar, M. & D’Amico, E (2026) Alcohol-Free and Low-Alcohol Beverage Consumption and Concurrent and Subsequent Alcohol Outcomes Among Young Adults
   Addiction
   (link)
   We examined associations between alcohol-free and low-alcohol beverage (AFLAB) consumption and concurrent and subsequent alcohol consumption, risk and change behaviors (e.g., consequences, quit attempts, abstention) and drinking motives among emerging adults.
   Covered by: RAND  and Make Science Make Sense (coming soon)

4. Nielsen, A. Wellman, R. Mann, S. DeBar, L. and Cook, A (2026) Session-dose adequacy of acupunture therapy for low back pain in adults 65 and older: Results from the BackInAction Trial
   Integrative Medicine Research
   (link)
   Using data from the BackInAction trial we report fidelity to the acupuncture intervention and explore the association between the number of acupuncture sessions received and reductions in functional disability and pain intensity. We find that higher session-dose was associated with significant disability-related reductions and improvements on pain outcomes. 

5. Mann, S, Barbee, H. (2026) Coming Out as a Period of  Increased Vulnerability to Suicide Risk Among Sexual Minorities
   Pediatrics
   (link)
   Using individual fixed effects models we document the association between coming out to a family member or friend and suicide intentions, plans, and attempts. We demonstrate that there is an increased risk of suicide behavior after coming out.
   Covered by: NPR News and the Washington Blade.

6. Herman, P, Mann, S, DeBar, L, Avins, A, Justice, M, Nielsen, A, Pressman, A, Stone, K, Wellman, R, Cook, A. (2026) Cost-Effectiveness of Acupuncture Needling for Older Adults with Chronic Low Back Pain
   Spine
   (link)
   We calculate cost-utility and cost-effectiveness for standard and enhanced acupuncture compared to usual medical care. We demonstrate that enhanced acupuncture is cost saving and that standard acupuncture may be cost-effective, relative to usual medical care.

7. Mann, S & Barbee, H., (2025) Public Health and Ethical Risks  of Rollbacks on Medicaid Coverage for Gender Affirming Care:
   JAMA
   (link)
   We discuss the public health and ethical implications of recent federal reconsiderations of coverage of gender affirming care under Medicaid.

8. Carpenter, C, Dujeancourt, E, Mann, S, Naldi, L., (2025) Sexual Orientation and Multiple Job Holding: Evidence from Swedish Administrative Data
   Journal of Human Resources
   (link)
   We use Swedish administrative data to show that sexual minorities are more likely to be multiple job holders than heterosexuals. We find evidence in line with self-insurance mechanisms for male sexual minorities. For women, we find that career mobility is a likely explanation. We find that the higher incidence of multiple job holding has positive labor market consequences for female sexual minorities. 

9. Mann, S. (2025) Anti-Discrimination Laws and Mental Health: Evidence from Sexual Minorities
   Journal of Human Resources
   (link)

Outstanding Paper Award at 2023 Discrimination and Diversity Workshop

I exploit the roll out of employment based anti-discrimination laws that protect sexual minorities  within a difference-in-differences model to document the effect of these laws on mental health. 

10. Mann, S, Schuler, M, Paulson, A, & Dunbar, M, (2025) The Mental Health Age Gradient by Gender Identity
    Social Psychiatry and Psychiatric Epidemiology
    (link)
    Using data from the BRFSS we document how the gender minority mental health disparity varies over the life course. 

11. Bellows, L, Doss, C, Mann, S., (2025) The Prevalence of LGBTQ+ Teachers in the U.S.
    Educational Researcher
    (link)
    Using the ACS and the Census Pulse we describe the prevalence of LGBTQ+ teachers in the United States.

12. Mann, S. Campbell, T. & Nguyen, D, C. (2024) Gender Affirming Care and Transgender Health: Evidence from Medicaid Coverage
    Honorable Mention at 2022 Discrimination and Disparities Workshop
    American Journal of Health Economics
    (link)
    We provide the first causal evidence of the effect of gender affirming care (GAC) on transgender health, exploiting differential coverage of GAC under Medicaid programs across states. We use State Drug Utilization Data (SDUD) to document that Medicaid coverage of GAC significantly increases take up of GAC among Medicaid beneficiaries. Using data from the Behavioral Risk Factors Surveillance Systems we demonstrate that Medicaid coverage of GAC significantly improves the mental health of low-income transgender population.

13. Backman, M Carpenter, C, Dujeancourt, E, and Mann, S., (2024) Sexual Orientation, Entrepreneurship, and Firm Success
    Small Business Economics
    (link)
    We use Swedish population register data matched to business registry data to analyze the entrepreneurship and firm success disparity between heterosexuals and sexual minorities. We find that while female sexual minorities are more likely to be entrepreneurs, there is no significant difference in the success of sexual minority owned firms, compared to heterosexual owned firms. 

14. Campbell, T. Mann, S. Tran, N, & Rodgers, Y., (2024) Mental Health of Transgender Youth Following Gender Identity Milestones by Level of Family Support
    JAMA Pediatrics
    (link)
    We use a retrospective panel analysis to document the relationship between gender identity development milestones and mental health as well as the moderating role of family support.
    Covered by: Tradeoffs.
    Summary in: The Conversation.

15. Feir, D. Mann, S. (2024) Temporal Trends in Mental Health in the US by Gender Identity
    American Journal of Public Health
    (link)
    Using data from the BRFSS we show that the transgender-cisgender mental health disparity has worsened over time. 

16. Nettuno, L. Mann, S. & Gonzales, G. (2024) The Sexual Orientation Based Health Disparity in Chile
    PLoS ONE
    (link)
    Using newly available nationally representative data from the Chilean Socio-Economic Characterization Survey (CASEN) we explore sexual orientation-based disparities in self-rated health, health insurance coverage, and healthcare utilization in Chile for the first time.

17. Campbell, T. Mann, S. Rodgers, Y. & Tran, N. (2024) Family Matters: The Receipt of Gender-Affirming or -Denying Practices Following Gender Identity Milestones
    American Economic Association Papers and Proceedings
    Summary in: The Conversation.
    Using retrospective panel data from the 2015 U.S. Transgender Survey, we find that transgender youth reaching gender-identity milestones in supportive families are more likely to access hormone therapy and less likely to experience conversion therapy, while the opposite pattern emerges in unsupportive families.

18. Mann, S, Ryan, J, and Barbee, H., (2024) Age Profiles of Suicide Attempt Among Sexual Minorities
    American Journal of Preventative Medicine
    (link)
    We describe the age profiles of suicide attempt among sexual minority youth and in doing so identify the critical age period when suicide attempt risk begins to increase among sexual minorities.

19. Mann, S. McKay, T. & Gonzales, G. (2024) Climate Change and the Health of LGBTQ+ Populations
    The Journal of Climate Change and Health
    (link)
    Climate change poses a significant threat to human health. We hypothesize (and argue) that this threat may be larger for LGBTQ+ populations, given that LGBTQ+ populations will be more exposed to climate change, more susceptible to its impacts, and have fewer resources to recover from its harms. 

20. Tran, N. Mann, S. Cortez, M. Nettuno, L. & Harrell, B., (2023) Association Between Adverse Childhood Experiences and Mental Health Among Gender Minority Adults
    (link)
    Preventative Medicine
    We document disparities in exposure to ACEs across gender identity as well as the differential effects of ACEs on mental health across gender identity. We show that transgender individuals are more likely to be exposed to ACEs. Among populations not exposed to ACEs there is no transgender mental health disparity. The transgender mental health disparity arises due to greater exposure to ACEs and disproportionate negative impacts of ACEs.
    Cited by: CDC.

21. Campbell, T. Mann, S. Nguyen, D, H. Rodgers, Y, M. (2023) Hormone Therapy, Suicidal Risk, and Transgender Youth in the U.S.
    American Economic Association Papers and Proceedings.
    Summary in: The Conversation.
    Using retrospective panel data from the 2015 U.S. Transgender Survey and a stacked event-study design, we find that initiating hormone replacement therapy at ages 14–17 is associated with a 5.7-percentage-point (14.4%) reduction in the risk of ever attempting suicide.

22. Mann, S., (2023) Pre-Exposure Prophylaxis and HIV Incidence 

B.E. Journal of Economic Analysis and Policy
(link)
Using panel data from 40 European countries I study the effect of countries adopting WHO recommendations to make PrEP available to citizens. I demonstrate that in the years after PrEP is made available there are 15-20% fewer new HIV infections.

23. Tran, N. Mann, S. & Gonzales, G. (2023) Sexual Orientation, High-Deductible Health Plans, and Financial Barriers to Health Care.
    Health Affairs
    (link)
    We analyze differential uptake of High-Deductible Health Plans and Health Savings Accounts across sexual orientation and socio-economic status. We then document health access disparities that arise due to differential take up, demonstrating the importance of insurance design in ameliorating or exacerbating health disparities for LGBTQ+ people. 

24. Mann, S. Carpenter, C. Gonzales, G. Harrell, B. & Deal, C., (2023) Effects of the Affordable Care Act’s Medicaid Expansion on Health Insurance Coverage for Individuals in Same-Sex Couples.
    Health Services Research.
    (link)
    We provide the first evidence on the relationship between state Medicaid expansions under the Affordable Care Act (ACA) and health insurance coverage among sexual minority adults. We find that Medicaid expansion significantly increased health insurance coverage among low-income men and women in same-sex couples. 

25. Mann, S. O'Leary, N. Blackaby, D., (2022) Sexual Orientation, Political Trust, and Same-Sex Relationship Recognition Policies: Evidence from Europe.
    Public Choice.
    (link)
    We use data from the European Social Survey to analyze the impact of same-sex relationship recognition policies on the political trust of sexual minorities. We show that same-sex relationship recognition policies increase the trust that sexual minorities have in actors and institutions integral to the policy change. 

26. Mann, S., (2021) Transgender Employment and Gender Marker Laws.
    Labour Economics
    (link)
    I exploit state variation in the timing of the removal of surgical requirements to change a gender marker within a triple difference framework to analyze the causal impact of these removals on the employment of transgender people. I demonstrate that these relaxations increase the employment of transgender men but have no effect on transgender women.
    Cited in: Montana State District Court.

27. Mann, S. O'Leary, N. Blackaby, D., (2019) Sexual Identity and Wellbeing : A Distributional Analysis.
    Economic Letters
    (link)
    We explore the relationship between sexual identity and wellbeing within an unconditional panel quantile setting to document how the sexual orientaiton wellbeing disparity varies over the distribution.
    Summary in: The Conversation.

28. Bridges, S. Mann, S., (2019) Sexual Orientation, Legal Partnerships and Wages in Britain.
    Work, Employment and Society.
    (link).
    We examine the effect of being in a same-sex legal partnership on wages. We demonstrate that gay cohabitees and lesbians face a wage premium compared to their heterosexual counterparts. Decomposition results demonstrate that the reasons for these differentials differ by gender.

Reports 

1. Matthews, P., Barnett, C., Formby, E., Gregory, L., Lambert, P., and Mann, S. (2024) LGBT+ Welfare and Assets in Great Britain.
   Nuffield Foundation Report. 

2. Karney, B. Zaber, M. Smith, M. Mann, S. AlFakhri, M. Coe, J. Ryan, J. Gadwah-Meaden, C. Mallory, C. Sears, B. & Garber, C., (2024) 20 Years of Legal Marriage for Same-Sex Couples in the U.S.
   RAND Report: RR-A2912-1
   Covered by: Wall Street Journal, CBS, Good Morning America, among others

3. Karney, B. Zaber, M. Smith, M. Mann, S. AlFakhri, M. Coe, J. Ryan, J. Gadwah-Meaden, C. Mallory, C. Sears, B. & Garber, C., (2024) Legalizing Marriage for Same-Sex Couples Did Not Harm Family Formation in the United States: Twenty Years of Evidence.
   RAND Brief: RB-A2912-1

4. Karney, B. Zaber, M. Smith, M. Mann, S. AlFakhri, M. Coe, J. Ryan, J. Gadwah-Meaden, C. Mallory, C. Sears, B. & Garber, C., (2024) Legalizing Marriage for Same-Sex Couples Benefited LGBT Individuals and Their Children: Twenty Years of Evidence.
   RAND Brief: RB-A2912-2

Working Papers (available on request) 

1. "Hybrid Entrepreneurship and Sexual Orientation" with Lucia Naldi and Erwan Dujeancourt
   Revised and Resubmitted to Entrepreneurship Theory and Practice
   We identify disparities in engagement in hybrid entrepreneurship across sexual orientation and explore the underlying mechanisms for differential engagement in this form of entrepreneurship. 

2. “Cannabis Use Modality, Indicators of Risk, and Cessation Behavior” with Michael Dunbar, Dan Sicinolfi, Anthony Rodriguez, Rachana Seelam, and Elizabeth D’Amico.
   Revised and Resubmitted to Drug and Alcohol Dependence
   Using repeated annual survey data from a longitudinal cohort of young adults (2018–2024), this paper shows that cannabis use patterns are highly heterogeneous across modes and that multi-modal use is common and strongly associated with more frequent use. Even after accounting for use frequency and other covariates, modality profiles remain meaningfully linked to indicators of risk and cessation behavior

3. "Sexual Victimization in Young Adulthood and Mental Health Outcomes" with Anthony Rodriguez, Eric Pederson, Wendy Troxel, Daniel Siconolfi, and Elizabeth D’Amico.
   Revised and Resubmitted to JAMA Network Open
   We examine how mental health changes around the first experience of sexual victimization. We show that anxiety and depression increase sharply around the time of victimization, with some effects persisting over time, and that these consequences are not limited to forced sexual activity alone. The findings highlight the importance of broader screening and early, trauma-informed intervention following sexual victimization.

4. "Flexible Versus Fixed Incentive Targets for Antiretroviral Adherence Among Youth Living with HIV in Uganda: A Multi-Arm Randomized Controlled Trial" with Crystal Huang, Adeyemi Okunogbe, Barbara Mukasa, and Sebastian Linnemayr.
   Revisions requested at Aids and Behavior
   Using a multi-arm randomized controlled trial among 17–24-year-olds in HIV care in Uganda, we test whether incentives work better when eligibility is tied to a fixed or to a flexible (participant-chosen) threshold. We find that flexible targets increase electronically measured ART adherence by around 11 percentage points relative to usual care (with the biggest gains among youth with low baseline adherence), while the fixed target does not significantly improve adherence. 

5. "Public Insurance and the Spread of Infectious Disease" with Shyam Raman, Katherine Wen, Ben Harrell, and Alex Hollingsworth.
   Reject and Resubmit at Journal of Public Economics
   We analyze the effect of public insurance expansions on the spread of HIV. We demonstrate that Medicaid expansions led to a significant reduction in HIV incidence. We provide estimates from three mechanisms; increases in testing, increases in prevention, and increases in treatment.

6. "An Economic Evaluation of a Culturally Centered Substance-Use Prevention Intervention for American Indian and Alaska Native Young Adults" with Elizabeth D'Amico, Daniel Dickerson, David Klein, Anthony Rodriguez, Pierce Holmes, Rosanna Smart, and Carrie Johnson
   Under Review
   We estimate the cost effectiveness of a culturally centered substance-use prevention intervention. 

7. “Budget Impact Analysis of the Traditions and Connections for Urban Native Americans (TACUNA) Intervention” with Elizabeth D’Amico, Daniel Dickerson, Carolina Barbosa, Olga Khavjou, and Sophia D'Angelo.
   Under Review
   We conduct a budget impact analysis of nationwide implementation of TACUNA, a culturally grounded prevention program for American Indian and Alaska Native emerging adults. We show that TACUNA would reduce binge drinking and cannabis use and generate substantial net public-sector savings over 10 years.

8. "Temporary alcohol abstinence challenges among emerging adults: Participation and prospective outcomes." with Daniel Siconolfi, Eric Pedersen, Michael Dunbar, Anthony Rodriguez, Rachana Seelam, Wendy Troxel, and Elizabeth D'Amico.
   Under Review
   Using longitudinal data we demonstrate how alcohol abstinence challenges associate with prospective outcomes. 

9. "Perinatal Mental Health Care Gaps and Severe Maternal Morbidity: A Longitudinal Cohort Study" with Kandice Kapinos, Rachel Nesbit, Kami Elrich, and Kelly Hyde.
   Under Review
   Using linked electronic health records, pharmacy, vital records, and county social-service data from a large integrated health system in Pennsylvania, we show that mental health encounters during pregnancy are associated with higher odds of severe maternal morbidity.

10. "Investigating predisposing, enabling, and need factors associated with mental health treatment receipt among young adults" with Eric Pedersen, Graham DiGuiseppi, Michael Dunbar, Rachana Seelam, Anthony Rodriguez, Wendy Troxel & Elizabeth D'Amico
    Under Review
    Using longitudinal survey data we find that among young adults with untreated depression or anxiety, nearly half remained symptomatic and untreated one year later. Social and material resources were associated with symptom remission, while demographic characteristics were associated with treatment receipt.

11. "Equal Pay Laws and the Gender Earnings Gap: Evidence from Swedish Administrative Data" with Lina Aldén, Anne Boschini, and Sara Värn
    Using Swedish administrative data and a matched event study design, we analyze the impact of equal pay legislation on women's earnings relative to mens. Our findings provide robust evidence that the law increased women’s earnings relative to men’s. We explore potential mechanisms and demonstrate the role of job mobility, occupational segregation, and access to male-dominated occupations.

12. "Conversion Practices and Suicide Risk Among Sexual Minority Youth: A Retrospective Cohort Study" with Harry Barbee
    We demonstrate that sexual identity change efforts are associated with large increases in suicide intention, planning, and attempts among sexual minority adults, with risk rising around the time of exposure and remaining elevated afterward.

Selected  Work in Progress

1. "Effect of Vaccine Subsidies on Childhood Immunization: Evidence from the Introduction of the Vaccines for Children Program" with Brandyn Churchill and Emily Lawler 

2. "Frictions in Preventive Care Markets: Evidence from PrEP" with Sebastian Tello Trillo and Kathleen McManus

3. "Sexual Victimization and Sleep" with Wendy Troxel, Anthony Rodriquez, Eric Pedersen, Daniel Siconolfi, and Elizabeth D'Amico

4. “Driving and Adolescent Arrests: Evidence from the Minimum Legal Driving Age” with Laura Nettuno, August Morgan, Cathy Xue, and Nicholas Lovett.