Health, Wealth, and Representation: Three Essays on LGBTQ+ Policies and Politics in the U.S. States

Queerness is political in the United States. Yet, despite the queer liberation movement igniting many political and policy gains for the lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) community, queer individuals are underrepresented in policies, political institutions, and policy research. What is more, the LGBTQ+ community is frequently marginalized by policy and possesses distinctive policy needs. In my three-essay dissertation, I study how LGBTQ+ identities and populations interact with state politics and policy in various domains: health policy, economic policy, and representation in state legislatures. In the first empirical chapter, I study the accessibility of pre-exposure prophylaxis (PrEP), a preventative medication mitigating the transmission of HIV, across the United States. I use the Integrated Two-Step Floating Catchment Area (I2SFCA) method to identify what I refer to as PrEP deserts across all 50 states in 2020 and 2023. Using the I2SFCA allows me to elucidate areas where populations gained and lost access to PrEP providers in each state. Despite many states expanding PrEP access for their populations, I find some demographic groups with disproportionate rates of HIV like Black and American Indian/Alaskan Native individuals failed to realize the same level of gains in access as other populations. In the second empirical chapter, I assess the health effects of state Earned Income Tax Credits (EITCs) for sexual minority recipients. I exploit the variation in adoption timing and benefit generosity to quantify the differential effects for sexual minority recipients relative to their heterosexual counterparts. Using a difference-in-difference-in-differences (DDD) approach, I find that, in the aggregate, EITCs do not differentially affect the health of sexual minority recipients. However, when considering the intersections of race, gender, and sexual minority status, I find modest differential effects for certain subgroups within the LGBTQ+ community, particularly along dimensions of self-reported mental health measures. In the third empirical chapter, I evaluate the characteristics of state legislative districts most likely to elect LGBTQ+ representatives to office, which I call queer-friendly districts. Using latent profile analysis (LPA), I find that districts with lower proportions of racial and ethnic minorities, a high proportion of the population college educated, a high median income, lower levels of professionalism in state legislatures, lean more liberal, and have low religious adherence elect openly-LGBTQ+ individuals at higher rates.Doctor of Philosoph