{"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":1788413299615,"version":"build-2803163510"},"reference-count":15,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Foundation CMSC"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A better understanding of MS outcomes in transgender and gender-diverse (TGD) people with MS (PwMS), including those undergoing gender-affirming hormone therapy (GAHT), would improve the clinical care of this underrepresented population and deepen understanding of how exogenous sex hormones may impact MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To characterize a cohort of TGD PwMS, describe changes in MS disease activity and outcomes following GAHT, and identify potential gaps in clinical management or social drivers of health (SDoH) in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multicenter retrospective review was performed on TGD PwMS medical record data to record their relevant demographic, gender identity, and clinical information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-two TGD PwMS were identified, 21 were assigned female at birth (AFAB). They had a wide range of gender identities and reproductive histories. Overall, MS disability was mild: median EDSS score was 1.5 and no individuals required ambulatory assistance. Testosterone as GAHT was not associated with clinical relapses, disability progression, Timed 25-Foot Walk slowing, or new radiologic disease activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The current findings, that a well-educated, well-insured TGD PwMS cohort (primarily AFAB) on high-efficacy disease-modifying therapy (DMT) had overall mild disease, provides reassurance for TGD about their MS disease trajectory and did not detect any concerns regarding exogenous testosterone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585251383330","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T09:39:50Z","timestamp":1759916390000},"page":"1464-1471","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["A multicenter cohort of transgender and gender diverse people with multiple sclerosis"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3202-6921","authenticated-orcid":false,"given":"Alexandra","family":"Balshi","sequence":"first","affiliation":[{"name":"Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talia B","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Neurology, UMass Medical School, Worcester, MA, USA"},{"name":"Department of Neurology, Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7465-5749","authenticated-orcid":false,"given":"John P","family":"Dempsey","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursela","family":"Baber","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara B","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanuja","family":"Chitnis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Katz","sequence":"additional","affiliation":[{"name":"The Elliot Lewis Center for Multiple Sclerosis Care, Wellesley, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Greenawalt","sequence":"additional","affiliation":[{"name":"The Elliot Lewis Center for Multiple Sclerosis Care, Wellesley, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meagan","family":"Harms","sequence":"additional","affiliation":[{"name":"Department of Neurology, UCSF Weill Institute for Neurosciences, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Imitola","sequence":"additional","affiliation":[{"name":"Department of Neurology, UConn Health, Farmington, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Carrizzo","sequence":"additional","affiliation":[{"name":"Department of Neurology, UConn Health, Farmington, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2034-8800","authenticated-orcid":false,"given":"Riley","family":"Bove","sequence":"additional","affiliation":[{"name":"Department of Neurology, UCSF Weill Institute for Neurosciences, San Francisco, CA, 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