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LGBT health care for the Veteran you are

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Millye is an Army veteran who served in the early 1960s. Cynthia served in the Navy in the 1970s and 80s. Tracey served in the Army, Army National Guard, and Army Reserve through the 1990s and early 2000s.

These veterans, who have served in different branches of service for different decades, appear on the surface just to share their service experience. But if we look further, we can see that there is more to know about these veterans.

Millye and Cynthia identify as transgender and Tracey identify as lesbian. Along with those who identify as gay or bisexual, these identities form LGBT. LGBT stands for lesbian, gay, bisexual and transgender.

These veterans chose health care through the VA Health System. You have found inclusive and high quality care from supportive providers in VA.

A million veterans

More than a million veterans identify as LGBT or related identities. Many felt pressured to hide their identities, were stigmatized, or felt unsafe when they got out. These situations can increase stress levels and increase the risks to mental health and physical well-being.

Veterans with an LGBT or related identity have higher rates of:

  • Smoking, alcohol problems and drug use.
  • Anxiety, Trauma, and Depression.
  • Sexually transmitted diseases, including HIV infection.
  • Some cancers.

VA encourages veterans to speak to their providers about all aspects of their lives, including their sexual orientation and gender identity.

Conversations and the information you share with your VA provider are confidential, and the information can help your provider tailor their recommendations, ensure you receive all appropriate screenings and exams, and provide you with the best possible care.

Additionally, VA is working to include gender identity and sexual orientation on medical records so that providers can understand the concerns and needs of veterans who identify as LGBT or related identities.

You can also ask staff not to include this information on your medical record. Medically necessary information, such as a doctor’s diagnosis or an anamnesis, must, however, be included.

LGBT care at VA Women’s Health

Women’s Health is dedicated to VA’s mission to be the leader in health care for veterans who identify as LGBT or a related identity and to provide quality care in a respectful environment.

Each VA facility has an LGBT Veteran Care Coordinator (VCC) as well as a Women Veterans Program manager. They help veterans find providers and health services, answer questions, and solve problems they may encounter.

Other resources available are:

  • Virtual Psychiatry: Veterans can connect to a VA mental health provider from the convenience of their home or their nearest VA health facility using a computer or mobile device.
  • Sex-Confirming Hormone Therapy: VA offers sex-affirming hormone therapy and treatment.
  • Substance Use / Alcohol Treatment: VA offers treatment options for substance use problems, including therapy, group programs, and medication.
  • Prevention / Treatment of Sexually Transmitted Infections: VA encourages all veterans of all gender identities to get tested for HIV and other STIs.
  • Cancer screening exams: VA offers all recommended age-appropriate cancer screening examinations.
  • VA Smoking Cessation Resources: VA offers a variety of resources and programs to help veterans quit tobacco.
  • Intimate Partner Violence Support: Female Veterans Program Managers can connect veterans to the resources they need.
  • Infertility: VA is committed to helping veterans overcome challenges that can arise from problems with fertility and conception of a child.

VA encourages veterans who identify as LGBT or related identities to schedule an appointment with their provider or contact the LGBT Veteran Care Coordinator or Women Veterans Program Manager at their local VA Medical Center.

You can hear the stories of Millye, Cynthia, Tracey, and other veterans on Make the Connection.

Alexis Matza is the associate director of the LGBT health program, VA Patient Care Services.

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Women’s Health

Report calls out gaps in women’s heart disease research, care |

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American Heart Association News

Women continue to be underrepresented in research for heart disease, and extensive changes are needed in how women’s heart health is studied, taught and treated, a new report says.

The report, published Monday as a presidential advisory from the American Heart Association in its journal Circulation, seeks to address problems that range from the way basic science is conducted to how women receive care.

“We are losing ground on key indicators of cardiovascular health among women, including blood pressure control, weight management and diabetes,” advisory co-author Dr. Véronique L. Roger said in a news release. Roger is a senior investigator at the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health.

Some heart disease risk factors are specific to women, the advisory said. For example, risks are higher for women who start their menstrual cycle younger than 11 or enter menopause younger than age 40.

Women also face risks related to high blood pressure or diabetes during pregnancy, as well as from oral contraceptive use and hormone replacement therapy. Depression and anxiety are associated with heart disease more frequently and at younger ages in women than in men.

Women also are disproportionately affected by inflammatory and autoimmune disorders such as lupus, rheumatoid arthritis and scleroderma, which are associated with increased risk of heart inflammation, heart and valve disease and heart attacks. And women face heart risks related to treatment for breast, uterine or ovarian cancer.

Despite all that, women continue to be underrepresented in research, leading to gaps in knowledge and understanding of how heart disease affects women.

“Comparing data from women with data from men inherently positions data from men as the gold standard,” said Roger. “For example, the belief that women having a heart attack will present more often with atypical symptoms carries an undertone that women present in the ‘wrong way.'”

Using data specific to women could improve diagnosis and treatment for heart disease, the advisory said. But nearly 7 out of 10 post-graduate medical trainees reported little to no training regarding gender-based medical concepts. Only 22% of physicians and 42% of cardiologists said they felt prepared to adequately assess heart disease specific to women.

“We must urgently address the pervasive gaps in knowledge and health care delivery to reduce gender-based disparities and achieve equity,” said report co-author Dr. Nanette K. Wenger, emeritus professor of medicine in the division of cardiology at Emory University School of Medicine in Atlanta.

The advisory said that declining heart health among US women who are considering pregnancy, and less-than-optimal levels of heart health among pregnant women, was particularly worrisome. Heart problems may lead to pregnancy challenges for the mother and health risks or complications for her and her children.

Solving that will take cooperation from experts in several fields, Wenger said. “We recommend cardiologists, primary care physicians and obstetricians and gynecologists work together to quantify and reduce the risks of cardiovascular disease throughout a woman’s life.”

According to AHA statistics, heart disease is the leading cause of death for US men and women, and 44% of women age 20 years and older between 2015 and 2018 had some form of cardiovascular disease, including high blood pressure.

But awareness among women, which rose before 2009, is slipping. In 2019, only 44% of women understood that heart disease was women’s leading cause of death.

The advisory recommended several actions, such as:

‒ launching new, culturally sensitive heart health awareness campaigns that emphasize the benefits of prevention and education.

‒ conducting more research studies focused on women, especially women from diverse racial and ethnic backgrounds, and at younger ages.

‒ collecting and analyzing data to help deliver more effective health care.

Affordable health insurance coverage and out-of-pocket costs are the two most important factors affecting whether people get health care, the advisory said, noting that under the Patient Protection and Affordable Care Act, signed into law in 2010, women between the ages of 19 and 64 saw the largest coverage gain of any demographic group.

In recent years, Medicaid coverage expansion through the ACA has been shown to increase coverage and health care among low-income women of reproductive age.

“We need to help women develop a ‘lifetime approach’ to their health, where they are empowered to proactively manage their heart disease risk in every life stage,” said Wenger.

If you have questions or comments about this American Heart Association News story, please email editor@heart.org.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News.

Other uses, including educational products or services sold for profit, must comply with the American Heart Association’s Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

HEALTH CARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and experiencing a medical emergency, call 911 or call for emergency medical help immediately.

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Photos: Aspen Democrats rally in support of women’s rights

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A woman wearing a “my body, my choice” sign listens to the speakers during a pro-women’s rights rally put on by the Pitkin County Democrats on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

The Pitkin County Democratic Party hosted a rally on Saturday afternoon at Aspen’s Paepcke Park in support of women’s reproductive rights. The event was in response to the leak of Supreme Court Justice Samuel Alito’s draft decision on Roe v. Wade, which could potentially take away a woman’s right to an abortion at the federal level.

The organization said the event was “in support of a woman’s constitutional right to make her own reproductive health decision without a Republican in her uterus.”

The speakers included the Pitkin County Democrats’ own Howard and Betty Wallach, as well as current Aspen City Councilwoman Rachel Richards. Numerous women also took to the stage to share their stories and feelings when the microphone was opened up to the audience.

Next on the schedule for the Pitkin County Democrats is a town hall session at the Aspen Public Library on Monday from 5 to 6 pm with Colorado State House of Representatives District 57 Democratic candidates Elizabeth Velasco and Cole Buerger. The two candidates are seeking to run against District 57 incumbent Perry Will, a Republican from New Castle.

The entire Roaring Fork Valley, including Aspen and Basalt, will be part of District 57 next year as part of recent redistricting.

Monday’s event is not a debate, and will largely be Howard Wallach asking questions to the two candidates.

Howard Wallach of the Pitkin County Democrats talks during a rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

Josie Brands, who was among a group of middle school students raising money for the Jackson Women’s Health Organization, at an abortion clinic in Mississippi, accepts a donation during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspen .
Austin Colbert/The Aspen Times

People gather to take a photo with their signs after a pro-women’s rights rally put on by the Pitkin County Democrats on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

Aspen city councilwoman Rachel Richards talks during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

People gather to listen to the speakers during a pro-women’s rights rally put on by the Pitkin County Democrats on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

Eleanor Carroll, right, and Josie Brands were among a group of local middle school students raising money for the Jackson Women’s Health Organization, at an abortion clinic in Mississippi, during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspens.
Austin Colbert/The Aspen Times

Betty Wallach of the Pitkin County Democrats talks during a rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

A sign for the Pitkin County Democrats was on display during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

Eleanor Carroll was among a group of middle school students raising money for the Jackson Women’s Health Organization, an abortion clinic in Mississippi, during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

acolbert@aspentimes.com

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Women’s Health

How the Chicago group known as ‘Jane’ helped women get abortions before Roe v Wade

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Jeanne Galatzer-Levy opened the door of a South Side Chicago residence around lunchtime on May 3, 1972, expecting to see a friend who was dropping off food. Instead, she recalled, she sized up a six-foot-five Chicago homicide officer standing in doorway, looking for the abortion doctor.

The Janes were being raided.

For roughly three years, an underground organization in Chicago its members called “the Service” had helped women safely access abortion, which at the time was generally illegal in all but four states. The women behind the group were collectively known under a code name: If people found themselves with an unwanted pregnancy, a friend in the know might advise them to “call Jane.”

When the police raided one of the houses used by the Janes, officers came looking for what they presumed was the male doctor behind the operation.

“We remember the cops walking around saying, ‘Where’s the doctor? Where’s the abortionist?’ Because all the people inside were women,” said Martha Scott, now 80, who was among the seven Janes arrested that day.

In a flurry of confusion as police swept the apartment, Scott and other women considered tossing their medical instruments out the window as they hurried to obscure telltale signs of their activities. Other Janes grabbed notecards filled with patient info and slipped them into their purses — or their mouths. Galatzer-Levy credited her fellow Jane, Sheila Smith, with a better improvisation.

“Sheila said that we only had to eat the name and addresses, which was a great relief,” Galatzer-Levy said.

‘Pregnant? Don’t want to be? Call Jane.’

Everyone in the home was hauled down to the Chicago police station at 11th and State streets, including about a half-dozen young children who came to the house with their mothers, who were patients. The children were eventually released, while the seven Janes spent the night in jail on charges of abortion and conspiracy to commit abortion.

Less than seven months later, all charges against the Janes were dropped when the Supreme Court on Jan. 22, 1973, handed down the landmark decision in Roe v. Wade that legalized abortion throughout the country.

The long-standing ruling is now in jeopardy after a draft Supreme Court decision that leaked on May 2 showed the court’s conservative majority was prepared to strike down Roe v. Calf.

“It’s like going backwards,” said Eileen Smith, a former Jane. “All this hard work with slow steps forward and backward — but basically going forward — seems like it’s all wiped away.”

Supreme Court is ready to strike down Roe v. Wade, leaked draft shows

Smith, now 72, first learned of the Janes as a 21-year-old with an unplanned pregnancy. She had quit school and was working a dead-end job and living in a $90-a-month studio apartment with her boyfriend whom she knew she didn’t want to stay with. She knew few people in the city, having moved to Chicago less than a year earlier.

“I read articles in the newspaper about women dying from botched abortions, but I knew I couldn’t have a baby then,” Smith recalled. “I wanted to have kids, but this wasn’t the right time.”

Then she saw an ad in an alternative newspaper called the Chicago Seed with a simple message: “Pregnant? Don’t want to be? Call Jane.”

Smith called a number, asked for Jane, and waited for a call back.

The Janes service began in 1969 as an outgrowth of the civil rights and feminist movements that had swept much of the country, including Chicago.

The Janes knew their work wasn’t met with universal approval, and they sometimes encountered counter-protesters at abortion rights rallies. But Scott said, “The antiabortion people, it wasn’t nearly as organized as it was now.”

Laura Kaplan, a former Jane who wrote the group’s history in the 1995 book “The Story of Jane: The Legendary Underground Feminist Abortion Service,” said it was not the group’s finding that was unique.

“How we evolved was unique, and we started like a lot of other women’s liberation groups around the country, deciding we wanted to do something to help women navigate the illegal abortion world,” she said.

The group organized to suss out abortion providers who were competent and willing to perform an illegal procedure and — as Kaplan said in a recent interview with Post Reports — weren’t going to exploit women sexually or financially. The Janes helped prepare women for the experience via counseling, and they helped raise money for a procedure that at the time was too expensive for many women.

“I often say to people, the average illegal abortion was about $500 and you could rent a decent apartment in Chicago for about $150,” Kaplan said.

Martha Scott, one of the arrested Janes, said patients in the early days of the Service tended to be either older, premenopausal women who already had children or young girls.

“It initially was a lot of affluent people. Over time, the clientele was not so affluent,” Scott said. “By the time we stopped, the people coming to us tended to be younger, and Black and Latino women,” who often had fewer resources to travel to states where abortion was legal.

In most of the country, abortion remained illegal, and often dangerous. Eileen Smith, who first came to the service seeking an abortion and later volunteered with the Janes, recalled how Cook County Hospital in Chicago had a septic abortion ward — an entire unit full of people who each at some point had an illegal abortion.

Allan Weiland, who worked in the ward as a medical student at the time, recalled in a 2019 essay for BuzzFeed the range of injuries he saw in the 40-person ward.

“I saw chemical burns, as well as perforations of the bladder, vagina, uterus, and rectum,” he wrote. “Some women came in with overwhelming infections or in septic shock.”

The war closed the year after the Roe decision.

The Janes, who were a mix of stay-at-home mothers, students and working women, often relied on tactics that would be more at home in a spy thriller: code names, covered callbacks from public pay phones, unassuming “front houses” where patients would go before transferring to an abortion site, and blindfolded car rides with side-street stopovers to let money change hands.

“People called [the Janes’ number], and they got a recording that said, ‘This is Jane from Women’s Liberation. If you need assistance, leave your name and number and someone will call you back,’” said Kaplan, the Jane historian.

One of the Janes had an early version of an answering machine that was kept in someone’s closet on a reel-to-reel. Once a Jane collected the number, she would call back and say, “This is Jane, how can I help you?”

“We always wanted the woman to say what she wanted rather than for us to, you know, suggest it,” Kaplan said. “We weren’t foisting abortion on anyone. We wanted it to be, from the minute she called, everything we did was to underline the fact that what she was making a decision about her life.”

When Smith called the number as a scared 21-year-old, her callback Jane explained the process.

A callback Jane would find out what the patient wanted and get basic information to write on notecards, including the woman’s age, how far the pregnancy had progressed, whether she had health problems, and what she could afford. Then a “Big Jane” would schedule the appointment and pass the patient cards around at meetings, where counselors could pick who they wanted to counsel.

The counselors would explain to the patient what happens during the abortion procedure, what it would feel like and how they would be taken from a front location to the actual home where the abortion would be performed.

Smith said she went to her counselor’s house for the session; the woman’s young children crawled on Smith as the counselor explained how Smith would go to a home and would wait with several women before being taken to another location for the abortion. She would be blindfolded before the doctor came in.

“She explained it to me in real detail,” Smith said. “It was real concrete information, and it was reassuring.”

The Jane who ended up driving Smith from one front house to the next was eight months pregnant, Smith said.

“It made me feel so good, because she’s eight months pregnant and here I was. And she’s taking a risk for me not to have a kid right now,” she said.

As time went on, Janes themselves learned to perform abortions and didn’t always rely on doctors. Scott, one of the Janes, said they always disclosed to women that the procedure was illegal, and they would tell patients if the person helping them was not a medical professional.

After Smith’s abortion, the woman who counseled her called to make sure she was taking antibiotics and didn’t have any complications.

“I was so impressed, but she had an ulterior motive — she wanted to know if I’d babysit for her because her kids really liked me,” Smith said, laughing. Smith babysat while the counselor was off “doing Jane things.” The woman’s home phone would sometimes ring, and a woman on the other end would ask, “Is my counselor there? I’m bleeding.”

The woman had a pile of copies of the book “Women and Their Bodies” — later retitled “Our Bodies, Ourselves” — which Smith would consult to help answer women’s questions. She eventually quit babysitting and became a Jane herself, assisting in the abortion procedures.

Smith and her fellow Janes — many of whom remain in their core group of friends 50 years on — think something like the Service will return if Roe is ultimately overturned. Abortion will remain more widely legal in the United States than it was in the pre-Roe era, thanks to at least 16 states that have preserved reproductive rights at the state level.

“It will be very different. There’s the abortion pill, and that will change everything,” Smith said. “And because it’s just human nature, there will be people who will figure out how to help people.”

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