Elagabalus' eccentricities, particularly his relationship with Hierocles, have by 221 increasingly infuriated the soldiers of the Praetorian Guard, a significant portion of whom are Illyrians, having distinguished themselves as warriors in the Roman legions.
When Elagabalus’s grandmother, Julia Maesa, perceives that popular support for the emperor is quickly wavering, she decides that he and his mother, who had encouraged his religious practices, have to be replaced.
As alternatives, she turns to her other daughter Julia Avita Mamaea and her son, the thirteen-year-old Severus Alexander.
Persuading Elagabalus to appoint his cousin as his heir, Alexander is bestowed with the title of Caesar and shares the consulship with the emperor this year.
However, Elagabalus reconsiders this arrangement when he begins to suspect that the Praetorian Guard favors his cousin over himself.
Elagabalus' sexual orientation and gender identity are the source of much controversy and debate.
All told, Elagabalus will marry and divorce five women, three of whom are known.
His first wife was Julia Cornelia Paula; the second is the Vestal Virgin Julia Aquilia Severa, but within a year, he abandons her and marries Annia Aurelia Faustina, a descendant of Marcus Aurelius.
It is her beauty and her high prominent imperial ancestry that have attracted Elagabalus to her.
In order to marry her, he orders the execution of her husband, Pomponius Bassus.
After the death of the latter, Elagabalus forbids her to mourn Bassus.
In July 221, Elagabalus takes Faustina as his third wife.
Roman society is more accepting of his marriage to her than of his second marriage to the Vestal Virgin Julia Aquilia Severa.
Through her marriage to Elagabalus, she becomes Empress of Rome.
When she marries Elagabalus, it seems for a time that the Nerva–Antonine dynasty rule has returned to Rome.
He gives her the title of Annia Faustina Augusta and adds the Latin name Julia to her name.
Numismatic and other evidence that have survived of her date from her second, brief marriage, to Elagabalus.
Elagabalus has hoped she will bear him an heir, so that his maternal cousin will not inherit the throne; however, she bears him no children and, towards the end of 221, Elagabalus divorces her; it is not known why.
There are no surviving sources stating how Annia Aurelia Faustina ruled when she was a Roman Empress.
Elagabalus returns to Julia Aquilia Severa, claiming that the original divorce was invalid, and remarries her, as his fourth wife.
Although Elagabalus returns to Severa by the end of the year, according to Cassius Dio, his most stable relationship seems to have been with his chariot driver, a blond slave from Caria named Hierocles, whom he refers to as his husband.
The Augustan History claims that he also married a man named Zoticus, an athlete from Smyrna, in a public ceremony at Rome.
Cassius Dio reported Elagabalus would paint his eyes, epilate his hair and wear wigs before prostituting himself in taverns and brothels, (Cassius Dio, Roman History LXXX.14) and even the imperial palace: Finally, he set aside a room in the palace and there committed his indecencies, always standing nude at the door of the room, as the harlots do, and shaking the curtain which hung from gold rings, while in a soft and melting voice he solicited the passers-by. (Cassius Dio, Roman History LXXX.13)
Herodian commented that Elagabalus pampered his natural good looks by wearing too much make-up.
He was described as having been "delighted to be called the mistress, the wife, the Queen of Hierocles" and was said to have offered vast sums of money to the physician who could equip him with female genitalia. (Cassius Dio, Roman History LXXX.16)
Subsequently, Elagabalus has often been characterized by modern writers as transgender, most likely transsexual.
