Research Seminars

Until 2013, Sweden required transgender people to undergo surgical sterilization before changing their legal gender. We analyze whether the removal of this requirement led to an increase in the number of legal gender changes. Additionally, we evaluate whether people who changed legal gender with versus without mandated sterilization had different mental health and labor market trajectories during their gender transition. Our analysis uses population-wide administrative data from 2006 to 2020, including information on legal gender changes, medical records, and socioeconomic characteristics. We find that, starting in the first quarter after the requirement was abolished, three to four times as many people changed legal gender, driven by younger people with worse labor market attachment. Approximately 32.6% of trans women and 55.2% of trans men chose not to have surgery when it was not mandated. Despite this, we find negligible differences in earnings, sick leave, or mental health trajectories between people who changed legal gender before and after the abolishment.

We estimate the long-run labor market and health effects of breast cancer among Austrian women. Compared to a random sample of same-aged non-affected women, those diagnosed with breast cancer face a 22.8 percent increase in health expenses, 6.2 percent lower employment, and a wage penalty of 15 percent five years after diagnosis. Although affected women sort into higher quality jobs post-diagnosis, this is offset by a reduction in working hours. We argue that the hours reduction is more likely driven by an increase in the time preference rate, meaning that patients increasingly value the present over the future, rather than by an incapacitation effect or employer discrimination.