{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:28:19Z","timestamp":1788413299625,"version":"build-2803163510"},"reference-count":11,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"NIH","award":["K12 AR084222"],"award-info":[{"award-number":["K12 AR084222"]}]},{"name":"NIH","award":["U54 AG044170"],"award-info":[{"award-number":["U54 AG044170"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Gender-affirming hormone therapy (GAHT) may increase multiple sclerosis (MS) risk, yet MS disease course among transgender and gender-diverse (TGD) individuals remains understudied. We aimed to evaluate the disease course in TGD individuals with MS (TGD-MS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Seventeen TGD-MS were identified. Ten TGD-MS on GAHT (five transgender women with MS (TW-MS) and five transgender men with MS (TM-MS)) were investigated further for MS outcomes of symptomatic (clinical)\/asymptomatic (radiological) disease activity and progressive MS (PMS) onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>TW-MS (mean = 54.5 years, range = 35.1\u201366.3) were older than TM-MS (39.2 years, range = 29.6\u201347.2) at last follow-up. MS onset was later in TW-MS (31.5 years, range = 25.1\u201339.1) than in TM-MS (21.0 years, range = 15.0\u201329.8). Three patients (one TW-MS, two TM-MS) experienced symptomatic activity after GAHT initiation (8\u201310 months); in two patients (one TW-MS, one TM-MS), this marked symptomatic MS onset. Seven patients (four TW-MS, three TM-MS) had \u2a7e1 clinical\/radiological disease activity. Four had PMS; all were TW-MS. In three, GAHT initiation preceded PMS onset (1\u20135 years). Disability was higher in TW-MS than in TM-MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>MS disease course may be modified by GAHT and may differ between TW-MS and TM-MS, highlighting the need for larger long-term studies to overcome disparities in MS care. Comprehensive GAHT history, timely management, and closer follow-up are warranted in TGD-MS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585251341174","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T02:41:55Z","timestamp":1750819315000},"page":"1672-1677","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Gender-affirming interventions and prognosis in multiple sclerosis"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2959-4271","authenticated-orcid":false,"given":"Nur","family":"Neyal","sequence":"first","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"},{"name":"Department of Radiology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6446-1146","authenticated-orcid":false,"given":"Nabeela","family":"Nathoo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"},{"name":"Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J","family":"Cathcart-Rake","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Center, Mayo Clinic, Rochester, MN, USA"},{"name":"Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhun H","family":"Kantarci","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"},{"name":"Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2270-9868","authenticated-orcid":false,"given":"Burcu","family":"Zeydan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"},{"name":"Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA"},{"name":"Department of Radiology, Mayo Clinic, Rochester, MN, USA"},{"name":"Women\u2019s Health Research Center, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/26895269.2022.2100644"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.101440"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515627205"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2019.0070"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-024-01042-x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2007.07.003"},{"issue":"5","key":"e_1_3_2_8_2","first-page":"347","article-title":"Gender change and its impact on the course of multiple sclerosis","volume":"113","author":"Reske D","year":"2006","unstructured":"Reske D, Haupt WF, Petereit HF. Gender change and its impact on the course of multiple sclerosis. Acta Neurol Scand 2006; 113(5): 347\u2013349.","journal-title":"Acta Neurol Scand"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-023-06838-1"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12491"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2017.02.001"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2023.105089"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585251341174","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585251341174","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585251341174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:18:33Z","timestamp":1777695513000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585251341174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":11,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/13524585251341174"],"URL":"https:\/\/doi.org\/10.1177\/13524585251341174","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,3]]}}}