Of note, sex differences in the expression of CCR5, DTX1, and NR4A1 (genes that were significantly altered between cisgender men and cisgender women who did not have juvenile-onset SLE, were affected by gender affirming treatment hormones in transgender individuals and were associated with SLE by open target analysis), were absent in patients with juvenile-onset SLE (figure 5D). Here, NR4A1 is linked to systemic lupus erythematosus.