He was the lead guitarist, singer and songwriter of Anti-Flag, a punk rock band formed in 1988 in Pittsburgh, Pennsylvania that was known for its left-wing political views.

On March 4, 2009, Sane jumped into the crowd at a concert at the LCR in Norwich to stop a scuffle which broke out and landed awkwardly, breaking his collar bone.

[9] Publications including Stereogum and Us Weekly linked the breakup to sexual assault allegations made on a podcast against an anonymous "singer in a political punk band", believed to be Sane.

[9][10][11] On July 21, the mental health nonprofit organization Punk Rock Saves Lives severed ties with Sane.

[12] On July 26, Sane denied the accusations as "categorically false" through a statement on his reactivated Instagram account.

In a separate statement, his bandmates said Anti-Flag broke up as Sane's alleged behavior contradicted the band's values.

[13] On September 5, Rolling Stone published an exposé revealing twelve more women and girls, the youngest at 12 years old, who accused Sane of predatory behavior, sexual assault, and statutory rape in alleged incidents dating from the 1990s to 2020.