Peer Reviewed Journal Publications
Mann, S & Barbee, H., (2025) Rollbacks on Medicaid Coverage of Gender Affirming Care: Public Health and Ethical Risks
JAMA
(link)
We discuss the public health and ethical implications of a recent federal ruling regarding coverage of gender affirming care under Medicaid.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Other Publications and Reports
Matthews, P., Barnett, C., Formby, E., Gregory, L., Lambert, P., and Mann, S. (2024) LGBT+ Welfare and Assets in Great Britain. Nuffield Foundation Report.
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
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
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
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
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.
Working Papers (available on request)
"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.
"Rollbacks on Medicaid Coverage of Gender Affirming Care: Public Health and Ethical Risks" with Harry Barbee
Revise and Resubmit at JAMA
We discuss the public health and ethical implications of a recent federal ruling regarding coverage of gender affirming care under Medicaid.
"A National Randomized Controlled Trial Comparing Two Virtual Culturally Grounded Substance Use Interventions for Urban Native American Emerging Adults" with Elizabeth D’Amico, Daniel Dickerson, David Klein, Anthony Rodriguez, Virginia Arvizu-Sanchez, Kurt Schweigman, Carrie Johnson, David Kennedy, Pierrce Holmes, Alina Palimaru, Ryan Brown, and Nipher Malika.
Under Review
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.
"An Economic Evaluation of a Culturally Centered Opioid 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 opioid prevention intervention relative to opioid education.
“Sexual Identity, Industrial Segregation, and Earnings” with Nigel O’Leary & David Blackaby.
Under Review
Best Paper Award at 2019 Welsh Postgraduate Conference in Business, Management, and Economics
We use data from the UK household longitudinal study to explore the pay of sexual minorities, and the role of industrial segregation. The analysis demonstrates that sexual minorities cluster in industries that are associated with lower pay, but also that the lower earnings of sexual minorities are a result of both within and between industry differentials.
"Coming Out is Associated with Increased Suicide Risk Among Sexual Minorities" with Harry Barbee
Under Review
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.
"Hybrid Entrepreneurship and Sexual Orientation" with Lucia Naldi and Erwan Dujeancourt
Under Review
We identify disparities in engagement in hybrid entrepreneurship across sexual orientation and explore the underlying mechanisms for differential engagement in this form of entrepreneurship.
"Cost-Effectiveness of Acupuncture Needling for Older Adults with Chronic Low Back Pain" with Patricia Herman, Andy Avins, Lynn DeBar, Morgan Justice, Arya Nielsen, Alice Pressman, Katie Stone, Rob Wellman, and Andrea Cook
Under Review
We calculate cost-utility and cost-effectiveness comparing standard and enhanced acupuncture 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.
"Equal Pay Laws and the Gender Pay Gap: Evidence from Swedish Administrative Data" with Lina Aldén, Anne Boschini, and Sara Värn
Using Swedish administrative data and a difference-in-differences approach, 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 occupational segregation, occupational mobility, early vs later career wage growth, and access to male-dominated occupations.
Selected Work in Progress
"Effect of Vaccine Subsidies on Childhood Immunization: Evidence from the Introduction of the Vaccines for Children Program" with Brandyn Churchill and Emily Lawler