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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.

Original publication




Conference paper

Publication Date





1759 - 1762


Multiple sclerosis, epidemiology, risk factor, sex hormones, testosterone, transgender, Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Comorbidity, Female, Gender Dysphoria, Humans, Male, Middle Aged, Multiple Sclerosis, Sex Reassignment Procedures, Young Adult