How gender-affirming care improves trans mental health

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In recent years, a growing number of states have passed laws restricting or banning gender-affirming care for transgender people, particularly minors. As conversations about gender-affirming care increase, so do false narratives about it, with some opponents falsely suggesting that it’s harmful to mental health.

Despite widespread attacks against gender-affirming care, research clearly shows that it improves mental health outcomes for transgender people.

Read on to learn more about what gender-affirming care is, how it benefits mental well-being, and how you can access it.

What is gender-affirming care?

Gender-affirming care describes a range of medical interventions that help align people’s bodies with their gender identities. While anyone can seek gender-affirming care in the form of laser hair removal, breast augmentation, erectile dysfunction medication, or hormone therapy, among other treatments, most conversations about gender-affirming care center around transgender people, whose gender identity or gender expression does not conform to their sex assigned at birth.

Gender-affirming care for trans people varies based on age. For example, some trans adults seek hormone replacement therapy (HRT) or gender-affirming surgeries that help their bodies match their internal sense of gender.

Trans kids entering adolescence might be prescribed puberty blockers, which temporarily delay the production of hormones that initiate puberty, to give them more time to figure out their gender identities before deciding on next steps. This is the same medication given to cisgender kids—whose gender identities match the sex they were assigned at birth—experiencing early puberty.

What is gender dysphoria?

Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity. This can lead to a range of mental health conditions that affect their quality of life

Some trans people may manage gender dysphoria by wearing gender-affirming clothing, opting for a gender-affirming hairstyle, or asking others to refer to them by a name and pronouns that authentically represent them. Others may need gender-affirming care to feel at home in their bodies.

Trans people who desire gender-affirming care and have not been able to access it experience psychological distress, including depression, anxiety, self-harm, and suicidal ideation. The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People found that roughly half of trans youth “seriously considered attempting suicide in the past year.”

A grid shows 10 drawings of people in black and white. Seven of the people are highlighted in purple squares. Text on the image reads,

How does gender-affirming care improve mental health?

For trans adults, gender-affirming care can alleviate gender dysphoria, which has been shown to improve both short-term and long-term mental health. A 2018 study found that trans adults who do not undergo HRT are four times more likely to experience depression than those who do, although not all trans people desire HRT.

Extensive research has shown that gender-affirming care also alleviates gender dysphoria and improves mental health outcomes in trans kids, teens, and young adults. A 2022 study found that access to HRT and puberty blockers lowered the odds of depression in trans people between the ages of 13 and 20 by 60 percent and reduced the risk of self-harm and suicidal thoughts by 73 percent.

Both the Endocrine Society—which aims to advance hormone research—and the American Academy of Pediatrics recommend that trans kids and teens have access to developmentally appropriate gender-affirming care.

How can I access gender-affirming care?

If you’re a trans adult seeking gender-affirming care or a guardian of a trans kid or teen who’s seeking gender-affirming care, talk to your health care provider about your options. You can find a trans-affirming provider by searching the World Professional Association for Transgender Health directory or visiting your local LGBTQ+ health center or Planned Parenthood.

Some gender-affirming care may not be covered by insurance. Learn how to make the most of your coverage from the National Center for Transgender Equality. Find insurance plans available through the Marketplace that cover gender-affirming care in some states through Out2Enroll.

Some states restrict or ban gender-affirming care. Learn about the laws in your state by visiting the Trans Legislation Tracker.

Where can trans people and their families find mental health support?

In addition to working with a trans-affirming therapist, trans people and their families can find mental health support through these free services:

  • PFLAG offers resources for families and friends of LGBTQ+ people. Find a PFLAG chapter near you.
  • The Trevor Project’s hotline has trained counselors who help LGBTQ+ youth in crisis. Call the TrevorLifeline 1-866-488-7386 or text START to 678-678.
  • The Trans Lifeline was created by and for the trans community to support trans people in crisis. You can reach the Trans Lifeline hotline at 1-877-565-8860.

For more information, talk to your health care provider.

If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

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    While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.

    Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of both type 1 and type 2 diabetes.

    More people became aware of this condition after Lance Bass, best known for his role in the iconic American pop band NSYNC, recently revealed he has it.

    So, what is type 1.5 diabetes? And how is it diagnosed and treated?

    Pixel-Shot/Shutterstock

    There are several types of diabetes

    Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually more than ten types of diabetes, but the most common are type 1 and type 2.

    Type 1 diabetes is an autoimmune condition where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.

    Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need insulin medication daily. Type 1 diabetes usually appears in children or young adults.

    Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to overcome this resistance. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.

    Type 2 is more common in adults but is increasingly seen in children and young people. Management can include behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.

    A senior man applying a device to his finger to measure blood sugar levels.
    People with diabetes may need to regularly monitor their blood sugar levels. Dragana Gordic/Shutterstock

    How does type 1.5 diabetes differ from types 1 and 2?

    Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin immediately because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within five years of diagnosis, while those with type 1 typically require it from diagnosis.

    Type 1.5 diabetes is usually diagnosed in people over 30, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.

    Type 1.5 diabetes shares genetic and autoimmune risk factors with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as obesity and physical inactivity which are more commonly associated with type 2 diabetes.

    What are the symptoms, and how is it treated?

    The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following symptoms:

    • increased thirst
    • frequent urination
    • fatigue
    • blurred vision
    • unintentional weight loss.

    Typically, type 1.5 diabetes is initially treated with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.

    When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are no universally accepted management or treatment strategies for type 1.5 diabetes.

    A young woman taking a tablet.
    Type 1.5 diabetes might be managed with oral medications, at least initially. Dragana Gordic/Shutterstock

    Type 1.5 diabetes is often misdiagnosed

    Lance Bass said he was initially diagnosed with type 2 diabetes, but later learned he actually has type 1.5 diabetes. This is not entirely uncommon. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes 5–10% of the time.

    There are a few possible reasons for this.

    First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special antibody tests (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.

    Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).

    Third, people with type 1.5 diabetes often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.

    Finally, because type 1.5 diabetes has symptoms that are similar to type 2 diabetes, it may initially be treated as type 2.

    We’re still learning about type 1.5

    Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in non-European populations. In 2023, it was estimated type 1.5 diabetes represented 8.9% of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.

    Overall, there has been a limited awareness of type 1.5 diabetes and unclear diagnostic criteria which have slowed down our understanding of this condition.

    A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.

    Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce diabetes distress. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.

    Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Overcome Front-Of-Hip Pain

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    Dr. Alyssa Kuhn, physiotherapist, demonstrates how:

    One, two, three…

    One kind of pain affects a lot of related things: hip pain has an impact on everything that’s connected to the pelvis, which is basically the rest of the body, but especially the spine itself. For this reason, it’s critical to keep it in as good condition as possible.

    Two primary causes of hip stiffness and pain:

    • Anterior pelvic tilt due to posture, weight distribution, or pain. This tightens the front muscles and weakens the back muscles.
    • Prolonged sitting, which tightens the hip muscles due to inactivity.

    Three exercises are recommended by Dr. Kuhn to relieve pain and stiffness:

    • Bridge exercise:
      • Lie on a firm surface with your knees bent.
      • Push through your feet, engage your hamstrings, and flatten your lower back.
      • Hold for 3–5 seconds, relax, and repeat (10–20 reps).
    • Wall exercise with arms:
      • Stand with your lower back against the wall, feet a step away.
      • Tilt your hips backwards, keeping your lower back in contact with the wall.
      • Alternate lifting one arm at a time while maintaining back contact with the wall (10–20 reps).
    • Wall exercise with legs:
      • Same stance as the previous exercise but wider now.
      • Lift one heel at a time while keeping your hips stable and your back against the wall.
      • Practice for 30–60 seconds, maintaining good form.

    As ever, consistency is key for long-term relief. Dr. Kuhn recommends doing these regularly, especially before any expected periods of prolonged sitting (e.g. at desk, or driving, etc). And of course, do try to reduce, or at least break up, those sitting marathons if you can.

    For more on all of this plus visual demonstrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    How To Stop Pain Spreading

    Take care!

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  • What does it mean to be transgender?

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    Transgender media coverage has surged in recent years for a wide range of reasons. While there are more transgender television characters than ever before, hundreds of bills are targeting transgender people’s access to medical care, sports teams, gender-specific public spaces, and other institutions.

    Despite the increase in conversation about the transgender community, public confusion around transgender identity remains.

    Read on to learn more about what it means to be transgender and understand challenges transgender people may face.

    What does it mean to be transgender?

    Transgender—or “trans”—is an umbrella term for people whose gender identity or gender expression does not conform to their sex assigned at birth. People can discover they are trans at any age.

    Gender identity refers to a person’s inner sense of being a woman, a man, neither, both, or something else entirely. Trans people who don’t feel like women or men might describe themselves as nonbinary, agender, genderqueer, or two-spirit, among other terms.

    Gender expression describes the way a person communicates their gender through their appearance—such as their clothing or hairstyle—and behavior.

    A person whose gender expression doesn’t conform to the expectations of their assigned sex may not identify as trans. The only way to know for sure if someone is trans is if they tell you.

    Cisgender—or “cis”—describes people whose gender identities match the sex they were assigned at birth.

    How long have transgender people existed?

    Being trans isn’t new. Although the word “transgender” only dates back to the 1960s, people whose identities defy traditional gender expectations have existed across cultures throughout recorded history.

    How many people are transgender?

    A 2022 Williams Institute study estimates that 1.6 million people over the age of 13 identify as transgender in the United States.

    Is being transgender a mental health condition?

    No. Conveying and communicating about your gender in a way that feels authentic to you is a normal and necessary part of self-expression.

    Social and legal stigma, bullying, discrimination, harassment, negative media messages, and barriers to gender-affirming medical care can cause psychological distress for trans people. This is especially true for trans people of color, who face significantly higher rates of violence, poverty, housing instability, and incarceration—but trans identity itself is not a mental health condition.

    What is gender dysphoria?

    Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity, or their internal sense of gender. A 2021 study of trans adults pursuing gender-affirming medical care found that most participants started experiencing gender dysphoria by the time they were 7.

    When trans people don’t receive the support they need to manage gender dysphoria, they may experience depression, anxiety, social isolation, suicidal ideation, substance use disorder, eating disorders, and self-injury.

    How do trans people manage gender dysphoria?

    Every trans person’s experience with gender dysphoria is unique. Some trans people may alleviate dysphoria by wearing gender-affirming clothing or by asking others to refer to them by a new name and use pronouns that accurately reflect their gender identity. The 2022 U.S. Trans Survey found that nearly all trans participants who lived as a different gender than the sex they were assigned at birth reported that they were more satisfied with their lives.

    Some trans people may also manage dysphoria by pursuing medical transition, which may involve taking hormones and getting gender-affirming surgery.

    Access to gender-affirming medical care has been shown to reduce the risk of depression and suicide among trans youth and adults.

    To learn more about the trans community, visit resources from the National Center for Transgender Equality, the Trevor Project, PFLAG, and Planned Parenthood.

    If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Heal Your Stressed Brain

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    Rochelle Walsh, therapist, explains the problem and how to fix it:

    Not all brain damage is from the outside

    Long-term stress and burnout cause brain damage; it’s not just a mindset issue—it impacts the brain physiologically. To compound matters, it also increases the risk of neurodegenerative diseases. While the brain can indeed grow new neurons and regenerate itself, chronic stress damages specific regions, and inhibits that.

    There are some effects of chronic stress that can seem positive—the amygdalae and hypothalamus are seen to grow larger and stronger, for instance—but this is, unfortunately, “all the better to stress you with”. In compensation for this, chronic stress deprioritizes the pre-frontal cortex and hippocampi, so there goes your reasoning and memory.

    This often results in people not managing chronic stress well. Just like a weak heart and lungs might impede the exercise that could make them stronger, the stressed brain is not good at permitting you to do the things that would heal it—preferring to keep you on edge all day, worrying and twitchy, mind racing and body tense. It also tends to lead to autoimmune diseases, due to the increased inflammation (because the body’s threat-detection system as at “jumping at own shadow” levels so it’s deploying every defense it has, including completely inappropriate ones).

    Notwithstanding the “Heal Your Stressed Brain” thumbnail, she doesn’t actually go into this in detail and bids us sign up for her masterclass. We at 10almonds however like to deliver, so you can find useful advice and free resources in our links-drop at the bottom of this article.

    Meanwhile, if you’d like to hear more about the neurological woes described above, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • 100 No-Equipment Workouts – by Neila Rey

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    For those of us who for whatever reason prefer to exercise at home rather than at the gym, we must make do with what exercise equipment we can reasonably install in our homes. This book deals with that from the ground upwards—literally!

    If you have a few square meters of floorspace (and a ceiling that’s not too low, for exercises that involve any kind of jumping), then all 100 of these zero-equipment exercises are at-home options.

    As to what kinds of exercises they are, they each marked as being one or both of “cardio” and “strength”.

    They’re also marked as being of “difficulty level” 1, 2, or 3, so that someone who hasn’t exercised in a while (or hasn’t exercised like this at all), can know where best to start, and how best to progress.

    The exercises come with clear explanations in the text, and clear line-drawing illustrations of how to do each exercise. Really, they could not be clearer; this is top quality pragmatism, and reads like a military manual.

    Bottom line: whatever your strength and fitness goals, this book can see you well on your way to them (if not outright get you there already in many cases). It’s also an excellent “all-rounder” for full-body workouts.

    Click here to check out 100 No-Equipment Workouts, and find the joy and freedom in not needing anything at all for full-body training!

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  • How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

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    Each Monday, we’re going to be bringing you cutting-edge research reviews to not only make your health and productivity crazy simple, but also, constantly up-to-date.

    But today, in this special edition, we want to lay out plain and simple how to see through a lot of the tricks used not just by popular news outlets, but even sometimes the research publications themselves.

    That way, when we give you health-related science news, you won’t have to take our word for it, because you’ll be able to see whether the studies we cite really support the claims we make.

    Of course, we’ll always give you the best, most honest information we have… But the point is that you shouldn’t have to trust us! So, buckle in for today’s special edition, and never have to blindly believe sci-hub (or Snopes!) again.

    The above now-famous Tumblr post that became a meme is a popular and obvious example of how statistics can be misleading, either by error or by deliberate spin.

    But what sort of mistakes and misrepresentations are we most likely to find in real research?

    Spin Bias

    Perhaps most common in popular media reporting of science, the Spin Bias hinges on the fact that most people perceive numbers in a very “fuzzy logic” sort of way. Do you?

    Try this:

    • A million seconds is 11.5 days
    • A billion seconds is not weeks, but 13.2 months!

    …just kidding, it’s actually nearly thirty-two years.

    Did the months figure seem reasonable to you, though? If so, this is the same kind of “human brains don’t do large numbers” problem that occurs when looking at statistics.

    Let’s have a look at reporting on statistically unlikely side effects for vaccines, as an example:

    • “966 people in the US died after receiving this vaccine!” (So many! So risky!)
    • “Fewer than 3 people per million died after receiving this vaccine!” (Hmm, I wonder if it is worth it?)
    • “Half of unvaccinated people with this disease die of it” (Oh)

    How to check for this: ask yourself “is what’s being described as very common really very common?”. To keep with the spiders theme, there are many (usually outright made-up) stats thrown around on social media about how near the nearest spider is at any given time. Apply this kind of thinking to medical conditions.. If something affects only 1% of the population (So few! What a tiny number!), how far would you have to go to find someone with that condition? The end of your street, perhaps?

    Selection/Sampling Bias

    Diabetes disproportionately affects black people, but diabetes research disproportionately focuses on white people with diabetes. There are many possible reasons for this, the most obvious being systemic/institutional racism. For example, advertisements for clinical trial volunteer opportunities might appear more frequently amongst a convenient, nearby, mostly-white student body. The selection bias, therefore, made the study much less reliable.

    Alternatively: a researcher is conducting a study on depression, and advertises for research subjects. He struggles to get a large enough sample size, because depressed people are less likely to respond, but eventually gets enough. Little does he know, even the most depressed of his subjects are relatively happy and healthy compared with the silent majority of depressed people who didn’t respond.

    See This And Many More Educational Cartoons At Sketchplanations.com!

    How to check for this: Does the “method” section of the scientific article describe how they took pains to make sure their sample was representative of the relevant population, and how did they decide what the relevant population was?

    Publication Bias

    Scientific publications will tend to prioritise statistical significance. Which seems great, right? We want statistically significant studies… don’t we?

    We do, but: usually, in science, we consider something “statistically significant” when it hits the magical marker of p=0.05 (in other words, the probability of getting that result is 1/20, and the results are reliably coming back on the right side of that marker).

    However, this can result in the clinic stopping testing once p=0.05 is reached, because they want to have their paper published. (“Yay, we’ve reached out magical marker and now our paper will be published”)

    So, you can think of publication bias as the tendency for researchers to publish ‘positive’ results.

    If it weren’t for publication bias, we would have a lot more studies that say “we tested this, and here are our results, which didn’t help answer our question at all”—which would be bad for the publication, but good for science, because data is data.

    To put it in non-numerical terms: this is the same misrepresentation as the technically true phrase “when I misplace something, it’s always in the last place I look for it”—obviously it is, because that’s when you stop looking.

    There’s not a good way to check for this, but be sure to check out sample sizes and see that they’re reassuringly large.

    Reporting/Detection/Survivorship Bias

    There’s a famous example of the rise in “popularity” of left-handedness. Whilst Americans born in ~1910 had a bit under a 3.5% chance of being left handed, those born in ~1950 had a bit under a 12% change.

    Why did left-handedness become so much more prevalent all of a sudden, and then plateau at 12%?

    Simple, that’s when schools stopped forcing left-handed children to use their right hands instead.

    In a similar fashion, countries have generally found that homosexuality became a lot more common once decriminalized. Of course the real incidence almost certainly did not change—it just became more visible to research.

    So, these biases are caused when the method of data collection and/or measurement leads to a systematic error in results.

    How to check for this: you’ll need to think this through logically, on a case by case basis. Is there a reason that we might not be seeing or hearing from a certain demographic?

    And perhaps most common of all…

    Confounding Bias

    This is the bias that relates to the well-known idea “correlation ≠ causation”.

    Everyone has heard the funny examples, such as “ice cream sales cause shark attacks” (in reality, both are more likely to happen in similar places and times; when many people are at the beach, for instance).

    How can any research paper possibly screw this one up?

    Often they don’t and it’s a case of Spin Bias (see above), but examples that are not so obviously wrong “by common sense” often fly under the radar:

    “Horse-riding found to be the sport that most extends longevity”

    Should we all take up horse-riding to increase our lifespans? Probably not; the reality is that people who can afford horses can probably afford better than average healthcare, and lead easier, less stressful lives overall. The fact that people with horses typically have wealthier lifestyles than those without, is the confounding variable here.

    See This And Many More Educational Cartoons on XKCD.com!

    In short, when you look at the scientific research papers cited in the articles you read (you do look at the studies, yes?), watch out for these biases that found their way into the research, and you’ll be able to draw your own conclusions, with well-informed confidence, about what the study actually tells us.

    Science shouldn’t be gatekept, and definitely shouldn’t be abused, so the more people who know about these things, the better!

    So…would one of your friends benefit from this knowledge? Forward it to them!

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