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Advanced Neurology Sexual behavior and multiple sclerosis

sex behaviors, and up to 30% of individuals engaging in Funding
same-sex behaviors may identify as heterosexual . The
[19]
ICD-10 codes utilized may also underestimate the true None.
risk, as codes are entered manually by providers and may Conflict of interest
be neglected in some cases.
The authors have no conflicts of interest to disclose.
Our findings advance the understanding of MS risk in a
unique patient population known to be at risk for negative Author contributions
health outcomes [15,19] . Early identification is a crucial
factor in the evolution of MS and can enable patients to Conceptualization: Matthew Kennis, Elijah W. Hale
experience a longer time without debilitating symptoms . Data curation: All authors
[20]
It is our hope that these findings could enable health-care Formal analysis: All authors
providers to suspect and diagnose MS earlier in patients Investigation: All authors
who might otherwise go unnoticed. Future study should Writing – original draft: All authors
seek to rectify the absence of sexuality-focused research in Writing – review & editing: All authors
the field of MS, with an eye toward ensuring better patient Ethics approval and consent to participate
outcomes and promoting health-care equity.
This study only utilized aggregated, deidentified patient
5. Conclusion data and thus was exempted from review by the COMIRB.
In conclusion, our study uncovered a novel correlation Consent for publication
between same-sex sexual behavior and an elevated risk
of MS, underscoring the importance of exploring this Not applicable.
association further. Both male and female individuals
engaging in same-sex behavior demonstrated a notably Availability of data
higher likelihood of MS diagnosis compared to those with The original contributions presented in the study are
opposite-sex behavior, emphasizing the need for targeted included in the article; further inquiries can be directed to
research in this understudied area. the corresponding author.
However, it is crucial to acknowledge the limitations of
our study. The use of de-identified, aggregate data restricted Further disclosure
the detailed exploration of individual characteristics and The abstract of this paper has previously been presented
socioeconomic factors, potentially influencing the observed at the 2023 American Academy of Neurology Annual
results. Additionally, the complexity of sexual behavior and Meeting in Boston, Massachusetts on April 27, 2023.
identity suggests that the ICD-10 codes used may not fully
capture the nuanced experiences of individuals. References
Moving forward, future investigations should delve 1. Owens B, 2016, Multiple sclerosis. Nature, 540: S1.
deeper into the impact of adverse childhood experiences https://doi.org/10.1038/540s1a
related to same-sex behavior, shedding light on potential 2. Abdollahpour I, Nedjat S, Mansournia MA, et al., 2018,
stress-related mechanisms underlying the increased Lifestyle factors and multiple sclerosis: A population-
MS risk. Moreover, there is a pressing need for research based incident case-control study. Mult Scler Relat Disord,
focusing on disease progression and treatment responses 22: 128–133.
in individuals engaging in same-sex behavior, ensuring https://doi.org/10.1016/j.msard.2018.03.022
that health-care providers can tailor interventions
effectively. Addressing these gaps will not only enhance 3. Abdollahpour I, Sormani MP, Nedjat S, et al., 2021, The
our understanding of MS in this specific population but role of nutritional factors during adolescence in multiple
also pave the way for more inclusive and equitable health- sclerosis onset: A population-based incident case-control
study. Nutr Neurosci, 24: 500–507.
care practices.
https://doi.org/10.1080/1028415X.2019.1647689
Acknowledgments 4. Kågesten A, van Reeuwijk M, 2021, Healthy sexuality

The authors would like to acknowledge Jessica Solomon development in adolescence: Proposing a competency-
Sanders, M.D (University of Colorado Anschutz Medical based framework to inform programmes and research. Sex
Campus) for her guidance in the preparation of this Reprod Health Matters, 29: 1996116.
manuscript. https://doi.org/10.1080/26410397.2021.1996116

Volume 2 Issue 4 (2023) 5 https://doi.org/10.36922/an.1383