A music writer for Rolling Stone, MS, the Village Voice, Spin, Newsday and Salon, Gaines is also acknowledged as an international expert on youth suicide and culture. According to a profile in Current Biography, Gaines taught sociology at Barnard College of Columbia University and also at the Graduate Faculty of New School University, in New York City.

Her first book, Teenage Wasteland: Suburbia's Dead End Kids (1991) is widely considered a classic in sociology, described by Newsday's Emily White as a "landmark empathetic look at adolescent anomie." Gaines' second book, A Misfit’s Manifesto: The Sociological Memoir of a Rock & Roll Heart, published by Rutgers University Press in 2007 has been described as "an exploration of relationships between identity formation, popular culture, addiction, and spirituality", hailed by Princeton sociologist Paul DiMaggio as "a new way to do sociology.”