Julia Pakpoor1, Clare J Wotton1, Klaus Schmierer2, Gavin Giovannoni2, Michael J Goldacre3. 1. Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 2. Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK; Department of Neurology, Barts Health NHS Trust, The Royal London Hospital, London, UK. 3. Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK michael.goldacre@dph.ox.ac.uk.
Abstract
BACKGROUND: An altered balance of gonadal hormones in males with gender identity disorders (GIDs) may increase multiple sclerosis (MS) risk both inherently and secondary to treatment in undergoing male-to-female conversion. OBJECTIVE: We investigated any association between GIDs and MS through analysis of record-linked hospital statistics. METHOD: Analysis of English Hospital Episode Statistics, 1999-2012. RESULTS: The adjusted rate ratio (RR) of MS following GIDs in males was 6.63 (95% confidence interval (95% CI) = 1.81-17.01, p = 0.0002). The RR of MS following GIDs in females was 1.44 (95% CI = 0.47-3.37, p = 0.58). CONCLUSION: We report a strong association between GIDs and MS in male-to-females, supporting a potential role for low testosterone and/or feminising hormones on MS risk in males.
BACKGROUND: An altered balance of gonadal hormones in males with gender identity disorders (GIDs) may increase multiple sclerosis (MS) risk both inherently and secondary to treatment in undergoing male-to-female conversion. OBJECTIVE: We investigated any association between GIDs and MS through analysis of record-linked hospital statistics. METHOD: Analysis of English Hospital Episode Statistics, 1999-2012. RESULTS: The adjusted rate ratio (RR) of MS following GIDs in males was 6.63 (95% confidence interval (95% CI) = 1.81-17.01, p = 0.0002). The RR of MS following GIDs in females was 1.44 (95% CI = 0.47-3.37, p = 0.58). CONCLUSION: We report a strong association between GIDs and MS in male-to-females, supporting a potential role for low testosterone and/or feminising hormones on MS risk in males.
Authors: Stefan M Gold; Anne Willing; Frank Leypoldt; Friedemann Paul; Manuel A Friese Journal: Semin Immunopathol Date: 2018-10-25 Impact factor: 9.623