Transgender Teen Wins DMV Lawsuit

Transgender and gender-nonconforming individuals in South Carolina will now be allowed to take license photos that reflect their everyday appearance, following a settlement announced this morning in a lawsuit filed by transgender teen Chase Culpepper.

The seventeen year old filed the federal lawsuit last September, accusing the South Carolina Department of Motor Vehicles of sex discrimination and violating her free speech. In the spring of 2014, she arrived at the DMV office in Anderson, S.C. wearing mascara and eye shadow, ready to take her driver’s license photo. She says department officials promptly told her she had to remove the cosmetics before taking the photo because they were a “disguise.” Culpepper, who now identifies as a transgender young woman but used male pronouns at the time, says she often wore makeup and women’s clothing.

Under the terms of the settlement, the South Carolina Department of Motor Vehicles agreed to change its policy to allow people seeking drivers’ licenses to be photographed as they regularly present themselves, even if their appearance does not match the officials’ expectations of how the applicant should look. The department also promised to send Culpepper a written apology and train its employees in how to treat transgender and gender-nonconforming individuals in professional settings. The changes to policy are scheduled to go into effect in May.

Exploring Vascular Diseases Part II (Aneurysms)

Vascular disease is any condition that affects the circulatory system and ranges from diseases of your arteries, veins, and lymph vessels to blood disorders that affect circulation.  With every beat of our hearts, oxygen rich blood is pumped through blood vessels called the circulatory system to every part of the body.  Arteries carry blood away from the heart to the rest of our body while veins return it.  When any part of the circulatory system is weakened by disease, there is a loss or shortage of blood flow to various parts of the body which can lead to anything from pain in the legs to aneurysms or loss of limbs.  Seventy percent of all amputations are not due to diabetes or trauma but because of some form of vascular disease.  We’re going to explore the numerous conditions that fall under the category of vascular diseases, the effects, and causes and how to avoid or treat them.

An aneurysm can occur in the blood vessels of the heart (aortic) or the brain (cerebral) and is an abnormal bulge in the wall of a blood vessel.  They usually develop at branching points of arteries and are caused by constant pressure from blood flow. They often enlarge slowly and become weaker as they grow, just as a balloon becomes weaker as it stretches.  There are two types of aortic aneurysms; a thoracic aortic aneurysm (part of aorta in the chest) and an abdominal aortic aneurysm.  Aortic aneurysms most commonly occur in the aorta -the main blood vessel is leaving the heart.  Small aneurysms lead to an increased risk for atherosclerotic plaque (fat and calcium deposits) at the site of the aneurysm, an increase in the aneurysm size which will cause it to painfully press on other organs, a blood clot may form at the site and dislodge leading to stroke or heart attack and an aneurysm rupture; because the artery wall thins and is fragile at the site of an aneurysm and may burst under stress which can also be life threatening.  They may run in families, but people are rarely born with a predisposition for aneurysms.  They usually develop after the age of forty.

It is difficult to detect an aneurysm early since smaller aneurysms usually don’t have symptoms and smaller ones don’t generally pose a threat.  When an aneurysm grows and ruptures- it can become fatal.  Aortic aneurysms are more common in men and those over the age of 65.  They were the primary cause of 10,597 deaths in 2009.  Aortic aneurysms often cause no symptoms at all but if present, symptoms are a tearing pain in chest, abdomen, and/or middle of the back between the shoulder blades.  Thoracic aneurysms may cause shortness of breath, hoarseness, cough (due to pressure on the lungs and airways), and difficulty swallowing (pressure on the esophagus).  Rupture of an aneurysm can cause loss of consciousness, stroke, shock, or a heart attack.

Risk factors for aortic aneurysms include atherosclerosis (hardening of arteries), high blood pressure, stress, excessive weight, local injury to the artery, smoking, aging and untreated syphilis.  Some congenital abnormalities can cause aortic aneurysms such as Marfan syndrome or bicuspid aortic valves which are present at birth and can cause weakness of the artery walls.

An estimated 6 million (1 in 50) people in the United States have an unruptured brain aneurysm.  The annual rate of rupture is approximately 8 – 10 per 100,000 people or about 30,000 people in the United States.  There is a brain aneurysm rupturing every 18 minutes in the U.S.   Brain aneurysms are more common in women.  Ruptured brain aneurysms are fatal in about 40% of cases.  Of those who survive, about 66% suffer some permanent neurological deficit.

A brain aneurysm is usually located along the major arteries deep within brain structures.  Some aneurysms are due to infections, drugs such as amphetamines and cocaine that damage the brain’s blood vessels, or direct brain trauma from an accident.  They may be associated with other types of blood vessel disorders, such as fibromuscular dysplasia, cerebral arteritis or arterial dissection, but these are very unusual. As an aneurysm enlarges, it can produce headaches or localized pain. As it grows larger, it may produce pressure on the normal brain tissue or adjacent nerves.  This pressure can cause difficulty with vision, numbness or weakness of an arm or leg, difficulty with memory or speech and seizures.

Risk factors of developing a brain aneurysm include older age, high blood pressure, smoking, arteriosclerosis, drug abuse, particularly the use of cocaine or methamphetamines, stress, head injury, heavy alcohol consumption, certain blood infections and lower estrogen levels after menopause.

As with most diseases of the human body, eliminating risk factors will cut your chances of such diseases developing.  While you can’t control all risk factors for an aneurysm; lifestyle changes such as quitting smoking, avoiding drug and heavy alcohol use and controlling high blood pressure will cut your risk.

Other ways to help prevent an aneurysm include maintaining a healthy diet and regular exercise.  Many foods contain vitamins and minerals that help keep us healthy and control stress.  Choose a diet with a variety of fruits, vegetables, whole grains, lean meat and non-meat protein sources. Avoid excess fats, cholesterol, sodium and sugar. Eat smaller portions and consider eating several smaller meals throughout the day, rather than two or three big ones.  Maintaining good cardio health and doing some light strength training to maintain a healthy body weight.  Exercising at least 30 minutes every day will help you avoid an aneurysm or prevent one from rupturing.  Regular exercise is also a great stress reliever.

If you experience any symptoms of an aneurysm, seek medical care immediately.  If you have a family history of aneurysms, discuss regular screening with your doctor.