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Genetic factors in conjunction with environmental triggers lead to breach of immune tolerance and a phase of clinically silent autoimmunity that can last for years

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1 Some, but not all, transgender individuals choose to pursue gender-affirming care, which can include surgical procedures and/or gender-affirming hormone therapy (GAHT), ideally supported by a multidisciplinary care team

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(Normal serum folate levels are above 3 ng/mL.) (7) If youre low in both, B-complex vitamins might help