E-Cigarette Users Often Believe Devices Will Help Them Quit Tobacco

By Dennis Thompson
HealthDay Reporter

THURSDAY, June 4, 2015 (HealthDay News) — E-cigarette users are much more hopeful that the devices will help them quit smoking than the general public is, including people who just smoke traditional tobacco cigarettes, according to a new French survey.

“Vapers” (people who use e-cigarettes) also are much less concerned about how possible toxins in e-cigarette vapors might affect them and those around them, said lead study author Dr. Sebastien Couraud, a doctor of respiratory medicine and thoracic oncology at Lyon Sud Hospital and Lyon University Cancer Institute in France.

“E-cigarette users appear to have a different view of reality, compared with everyone else,” Couraud said. “Their reality is elsewhere.”

Couraud presented his findings Monday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

Electronic cigarettes are battery-operated products designed to create an aerosol that delivers nicotine, flavor and other chemicals when inhaled by the user.

Couraud said that the public opinion his team captured appears to mirror ongoing expert debate over whether e-cigarettes can actually help people quit smoking and whether e-cigarette vapors might contain toxic chemicals.

About 69 percent of e-cigarette users believe the devices can help a person quit tobacco smoking, compared with just 31 percent of the general population, researchers found.

Many e-cigarette users genuinely appear to want to quit smoking tobacco, Couraud said. They are more likely to be worried about dying from lung cancer than people who only smoke tobacco, he suggested. E-cigarette users are also more likely to think that using e-cigs will reduce their risk of lung cancer death, the survey revealed.

The findings from this survey highlight why regulation of e-cigarettes from the U.S. Food and Drug Administration is needed as soon as possible, said ASCO spokesperson Dr. Jyoti Patel, an associate professor of hematology and oncology at Northwestern University Feinberg School of Medicine in Chicago.

“For people who are addicted to nicotine, e-cigarettes don’t help,” said Patel. “They are still addicted, and they use a lot. It’s not a bridge to abstinence. It’s a way for them to stay addicted in a restaurant or an airplane, where they are unable to smoke.”

And, indeed, users of e-cigarettes tend to be much more dependent on nicotine than traditional cigarette smokers, based on a standard test of nicotine addiction, Couraud said. About 58 percent of e-cigarette users registered as very or highly addicted, compared with 46 percent of people who only smoked tobacco.

In January, ASCO issued a call for regulation of e-cigarettes and other electronic nicotine delivery systems, in conjunction with the American Association for Cancer Research, Patel noted.

For the study, Couraud and his colleagues surveyed nearly 1,500 residents of France. Ninety-three (6 percent) of those surveyed were e-cigarette users, and 74 of them also still smoked tobacco cigarettes, according to the survey.

About 33 percent of e-cigarette users in the survey believed that the devices are effective in reducing deaths from lung cancer, compared with 18 percent of smokers and 12 percent of the general population.

E-cigarette users also parted ways with popular opinion over whether they should worry about toxins in the vapor they inhale.

About 68 percent of current e-cigarette users in the study said that e-cig vapors are less harmful than cigarette smoke for the user, and 87 percent said the vapors pose less of a threat to those around them than secondhand cigarette smoke would.

By comparison, around 40 percent of the general French public felt that e-cigarette vapor is less harmful than cigarette smoke for the user, and about 55 percent were less concerned about e-cig vapors than cigarette smoke.

“Probably they aren’t completely wrong, because we know that e-cigarettes are less toxic than traditional cigarettes,” Couraud said. “But there still is some toxicity, and they have a low awareness of that.”

Couraud and Patel both said that American opinions of e-cigarettes likely are similar to those found in this French survey.

Dr. Gregory Masters said he completely understands conflicted public opinion over e-cigarettes.

“I do have safety concerns for e-cigarettes because nicotine is bad for you, and we don’t know all of the risks with e-cigarettes,” said Masters, an oncologist at the Helen F. Graham Cancer Center in Newark, Del.

“But I struggle when I get asked by patients, should I use e-cigarettes? I don’t want to condone e-cigarettes as a healthy alternative, but could it be a less dangerous alternative? It could be,” he added.

According to the U.S. Food and Drug Administration, e-cigarettes haven’t been fully studied, so consumers don’t know:

• the potential risks posed by the devices,
• how much nicotine or other potentially harmful chemicals are being inhaled,
• whether there are any benefits to be gained from the products.

More information

For more on e-cigarettes, visit the U.S. Food and Drug Administration.

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Fewer Young Men Fathering Children Outside of Marriage: CDC

By Alan Mozes
HealthDay Reporter

THURSDAY, June 4, 2015 (HealthDay News) — Fewer unmarried American men are becoming first-time fathers, U.S. health officials reported Thursday.

Thirty-six percent of first-time fathers younger than 44 had a child out of wedlock during the first decade of the 2000s, officials said.

“This represents a decline from the previous two decades,” said report author Gladys Martinez, of the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

In the 1980s, she said, 42 percent of first-time fathers were unmarried, as were 40 percent in the 1990s.

The national survey also found a larger proportion of unmarried first-time fathers living with the mother and child than in the past.

The report is good news, given prior research indicating that “having a father involved positively with his child benefits the child and the family on a number of outcomes,” said Dr. Craig Garfield, an associate professor of pediatrics at Northwestern University Feinberg School of Medicine in Chicago.

“This [benefit] is across the age spectrum,” said Garfield, who wasn’t involved with the new research. “For infants, having an involved father results in improved breast-feeding initiation and duration, toddlers have improved language development, and teenagers engage in less delinquent behaviors.”

The trend largely reflects changing patterns among black fathers, the study authors said.

To gain insight into fatherhood trends over the last 30 years, Martinez sifted through information collected by the National Survey of Family Growth in three time frames: 1980-1989, 1990-1999 and 2000-2009. Surveys involved interviews with men and women between the ages of 15 and 44.

Besides the decline in unmarried first-time fathers over the three decades, the report noted more first births in cohabiting relationships: 24 percent in the 2000s, up from 19 percent in the 1980s.

Martinez reported the trends in the June edition of the CDC’s National Center for Health Statistics Data Brief.

While no notable drop was seen among unmarried white or Hispanic fathers, the percentage of unmarried black men having kids for the first time dropped from 77 percent during the 1980s to 66 percent during the 2000s, the report said.

First births for black fathers in cohabiting relationships also became more common over time, increasing from 23 percent to nearly one-third.

In the 2000s, unmarried men with a first birth were less likely to be black (21 percent) than Hispanic (33 percent) or white (39 percent), the report said.

The survey also showed that dads in the 2000s who did have a first child outside of marriage tended to be older than their peers during the 1980s and 1990s.

The survey focused on the numbers, and did not set out to explain what is driving the changing trends.

That said, Garfield said future research should focus on the long-term implications of fathering children in a cohabiting, but unmarried, context.

He noted that despite initial intentions to marry eventually, most cohabiting couples never do. And it remains unclear how such relationships might affect child development, he said.

“Nevertheless, from my perspective as a pediatrician working with moms and dads to take care of their child, I am excited by the optimism that new dads bring, married or not, to being involved and participating in the care of their new baby,” Garfield said.

More information

Boston Children’s Hospital has information for teen fathers.

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Artichoke and lentil salad

This is another quick and easy salad recipe that is best prepared the morning of your lunch or dinner to allow optimal chilling for the best flavour.

 

Ingredients

• 3 cups pre-cooked lentils*

• 400 g can artichoke hearts, drained and quartered 

• 2⁄3 cup red pepper (diced)

• 1⁄3 cup black olives (chopped)

• 1/4 cup red onion (chopped)

• 1/4 cup fresh parsley (chopped)

• 7 g fresh mint leaves (chopped)

• 3/4 tsp dried basil

• 1⁄3 cup olive oil

• 1/4 cup red wine vinegar

• Salt and pepper, to taste
  

*Requires a pre-cooked ingredient

What you’ll do

In a large bowl, combine the lentils, artichoke hearts, red pepper, olives, red onion, parsley, mint, and basil.

In a jar or small bowl, combine oil and vinegar; shake together or mix well. Pour oil and vinegar over the salad, and toss to coat.

Season with salt and pepper to taste before serving. 

Recipe from fitness model Andrea Albright.

Want to lose weight? Find out your ideal weight, browse low-fat recipes and choose a healthy eating plan.

 

 

 

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Many Skin Bacteria Are Dead or Inactive, Study Finds

WEDNESDAY, June 3, 2015 (HealthDay News) — The many different types of bacteria that live on your skin are your first line of defense against dangerous germs, but the protection they provide may be reduced by exposure to ultraviolet light and lack of nutrients and moisture, researchers say.

These challenging conditions cause some bacteria to die and others to become dormant, according to study author Sarah Cummins from Indiana University in Bloomington, and her colleagues.

The researchers looked at the activity of different types of skin bacteria (the skin microbiome) from three different areas of the body: the upper back, the forearm and behind the knee. Overall, about 90 percent of the bacteria were either dead or inactive. But, there was significant variation depending on the location.

The upper back had the highest amount of active bacteria (11 percent). The upper back also had the highest amount of dead bacteria (67 percent). The forearm had the most dormant bacteria (55 percent). Activity levels of bacteria collected from behind the knee were somewhere between those of the upper back and the forearm.

The researchers also found that as people grow older, skin bacteria become less active.

Results from the study were to be presented this week at the annual meeting of the American Society for Microbiology in New Orleans. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

“We developed two main hypotheses to explain these results,” Cummins said in a society news release.

“The first is that the lack of nutrients and moisture on our skin creates a harsh environment for the cells, and they are not able to breathe and grow at full capacity, if at all, with this lack of nutrition. The differences in nutrient availability (e.g., oil, sweat) on each skin site accounts for the differences in activity levels,” she explained.

“The second hypothesis is that our immune system causes the cells to have a low level of activity,” Cummins said.

A low activity level may be a way for bacteria on the skin to avoid detection and destruction by the immune system. And, if that’s true, Cummins said, these findings could impact the treatment of skin-associated diseases.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about skin health.

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Tight Blood Sugar Control Helps the Heart in Type 2 Diabetes

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, June 3, 2015 (HealthDay News) — Strictly controlling blood sugar levels appears to keep people with type 2 diabetes from developing heart problems, a new study finds.

Tight control of blood sugar reduces the odds of heart attack, stroke, heart failure or amputation by about 17 percent, according to the study.

But controlling blood sugar alone won’t prevent deaths from heart disease or other causes. For that, lowering blood pressure and cholesterol are also needed, the researchers suggested.

“In addition to regular exercise, a good diet and not smoking, people with diabetes can dramatically reduce their risk of strokes and heart attacks by taking a statin, keeping their blood pressure under control and getting their average blood sugar at least to moderate control with an A1C of about 8,” said lead researcher Dr. Rodney Hayward. He is a senior research scientist at the VA Center for Clinical Management Research and University of Michigan in Ann Arbor.

The A1C test — an important tool in diabetes management — is a blood test that estimates a person’s average blood sugar levels for the past two or three months. A normal A1C for someone without diabetes is below 5.7, according to the American Diabetes Association. Prediabetes ranges from an A1C of 5.7 to 6.4, and diabetes is usually diagnosed when the A1C is 6.5 and above, according to the diabetes association.

In general, the diabetes association guidelines recommend an A1C of 7 or lower, but the group also recommends that patients discuss with their doctor whether or not that is the right goal for them. It’s important to avoid serious reactions from low blood sugar, Hayward said.

The new report was published in the June 4 issue of the New England Journal of Medicine.

For the study, Hayward’s team collected follow-up data on nearly 1,800 people enrolled in the Veterans Affairs Diabetes Trial. In that trial, people with type 2 diabetes were randomly assigned to have their blood sugar strictly controlled or not as tightly controlled.

The A1C in the intensive blood sugar control group was 6.9, on average. For those on standard care, the A1C average was 8.4, according to the study.

Over an average follow-up of almost 10 years, those who had their blood sugar strictly controlled had a significantly lower risk of heart attack, stroke, new or worsening heart failure, or amputation of feet or legs, compared with people whose blood sugar wasn’t as strictly controlled.

Deaths from heart problems or other causes, however, were not reduced with strict blood sugar control, the researchers noted.

“This finding reinforces the importance of combining good blood sugar control with control of other cardiovascular risk factors for a combined effect, especially controlling cholesterol and blood pressure,” Hayward said.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, said, “Even after the study was stopped, there was a legacy of tightly controlling blood sugar that reduced the risk of heart attack and stroke in subsequent years.”

When patients with type 2 diabetes are diagnosed, they need to be treated aggressively from the start, said Zonszein, who was not involved with the study. “That is going to prevent complications,” he said.

“When patients feel well and healthy is when there is much more benefit from aggressive treatment that will last for many years,” Zonszein said. “The earlier we treat and the more aggressive we are then, the better.”

More information

For more information on type 2 diabetes, visit the American Diabetes Association.

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International Panel Finds Only ‘Limited’ Evidence for Mammograms in 40s

By Amy Norton
HealthDay Reporter

WEDNESDAY, June 3, 2015 (HealthDay News) — Adding to the debate about the benefits of mammography screening before age 50, a new research review finds “limited” evidence that screening prevents breast cancer deaths among women in their 40s.

The results come from the International Agency for Research on Cancer, which asked experts from 16 countries to look at the latest evidence on breast cancer screening.

What they found largely confirmed what experts have long said: For women ages 50 to 75, routine mammograms reduce the risk of dying from breast cancer.

For women in their 40s, however, the agency found only limited evidence of such a benefit.

Still, one panel member said that conclusion was far from unanimous.

“The group was split down the middle, at least when it came to women ages 45 to 49,” said Robert Smith, vice president of the American Cancer Society. “Half of us thought the data were sufficient to say [screening mammography] reduces breast cancer mortality. Others were not persuaded.”

The report, published in the June 4 issue of the New England Journal of Medicine, reflects a longstanding debate.

In 2009, the U.S. Preventive Services Task Force ignited a controversy when it changed its recommendations on mammograms — which had long advised women to have screening every one to two years, starting at age 40.

The revised guidelines now say routine screening should begin at age 50 and be done every two years. The panel said women in their 40s should discuss the pros and cons of mammography screening with their doctors, then make an informed decision.

However, the cancer society and the American College of Obstetricians and Gynecologists still urge women to get yearly mammograms, starting at age 40.

The problem, the task force said, is that breast cancer screening can cause harm, so there should be strong evidence that the benefits outweigh those risks.

The risks include false-positive results that trigger further, sometimes invasive tests, and needless anxiety. But the bigger concern, experts say, is over-diagnosis and overtreatment.

Mammography catches tiny tumors, some of which may never progress to the point of threatening a woman’s life. But because there is no way to predict which tumors are dangerous, women almost always go through treatment.

Smith stressed all women should be fully informed of the downsides going into screening. But as far as the cancer society is concerned, he said, the evidence of benefit to women in their 40s is sufficient.

“Across the world, people interpret the data differently,” Smith noted. “And that’s partly based on the resources available for mammography screening [in a given country].”

It is true that screening carries less benefit for women in their 40s versus older women, Smith said.

That’s largely because their risk of breast cancer is lower. The average 40-year-old has a 1.5 percent chance of developing the disease in the next 10 years, while a 60-year-old has a 3.5 percent chance, according to the U.S. Centers for Disease Control and Prevention.

Age alone should not determine whether a woman undergoes mammography screening, said Joni Avery, a spokesperson for Susan G. Komen, the Dallas-based nonprofit organization that funds breast cancer education and research.

“Any screening recommendations must account for an assessment of an individual’s risk,” said Avery.

“In our opinion,” she said, “women should be talking to their doctors about screening well before their 40s, to find out if they have a high risk of developing breast cancer, or have other personal health issues that may require a specialized screening program.”

That specialized screening may include yearly MRI scans in addition to mammograms. The cancer society recommends that approach for women at high risk of breast cancer because of mutations in the BRCA1 or 2 genes, or a very strong family history of breast cancer.

In its current review, the agency for research on cancer said there is “inadequate” evidence that enhanced screening benefits high-risk women.

But that, Smith stressed, was based on a lack of randomized clinical trials. Such studies would require researchers to randomly assign high-risk women to undergo the screening regimen or not — which would be ethically impossible.

“A trial like that is never going to happen,” Smith said.

More information

The American Cancer Society has more about breast cancer screening.

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You Need to Read Sheryl Sandberg’s Moving Statement About Her Husband’s Death

Recent Hospitalization Might Raise Blood Infection Risk, Study Says

WEDNESDAY, June 3, 2015 (HealthDay News) — A routine hospital stay may put older adults at risk for a potentially deadly condition called sepsis, according to a new study.

Sepsis is a catastrophic, whole-body response to infection, according to the researchers.

The study looked at data from nearly 11,000 older Americans. Over 12 years, there were 43,000 hospitalizations. The researchers found people were three times more likely to develop sepsis within three months after leaving the hospital than at any other time.

The analysis also showed that the risk of sepsis three months after a hospital stay was 30 percent higher for those who received care for any type of infection. The risk of sepsis three months after hospitalization was 70 percent higher for those who had an intestinal infection caused by Clostridium difficile (or C. difficile) bacteria, the study revealed.

One in 10 C. difficile infection survivors developed sepsis within three months of a hospital stay, according to the study.

However, the study did not prove a cause-and-effect relationship between the hospitalization and later sepsis. It only showed an association between those factors.

Findings from the study were published online in the American Journal of Respiratory and Critical Care Medicine.

There is increasing evidence that antibiotics and other infection treatments disrupt the body’s microbiome — the natural community of bacteria and other microbes that are vital for healthy body function. And it’s known that hospital patients with a disrupted intestinal microbiome are at increased risk for C. difficile infection, according to the researchers.

“Our findings could mean that disruption to the microbiome in the hospital may predispose older people to get sepsis later, which is different from what we already know about the acute and chronic effects of microbiome disruption,” study lead author Dr. Hallie Prescott, a critical care physician and health care researcher at the University of Michigan, said in a university news release.

“While more work is needed to explore this further, it also opens the possibility that we might be able to prevent sepsis — by doing something as simple as helping the microbiome recover rapidly from a hospitalization,” she added.

According to the U.S. Centers for Disease Control and Prevention, sepsis is a response to an infection in which the immune system releases chemicals into the blood to fight the infection. The chemicals sometimes cause body-wide inflammation, which can lead to blood clots and leaky blood vessels.

Sepsis may affect as many as 1.1 million hospital patients in the United States each year, according to the CDC.

The condition kills one in six people who develop it. More people die from sepsis than from prostate cancer, breast cancer and AIDS combined, according to the researchers.

“The implications of this paper are big,” said study senior author Dr. Theodore Iwashyna in the news release. He is a physician-scientist at the University of Michigan and the Veterans Affairs Ann Arbor Center for Clinical Management Research.

“We know that a major cause of microbiome disruption is antibiotic use. This study hints — it does not prove, but it hints — that profligate use of antibiotics might not just be bad because of antibiotic resistance. Profligate use of antibiotics might also, via the microbiome, put patients at increased risk of both all kinds of other infections, and to having a particularly bad response [sepsis] to those infections,” he explained.

More information

The U.S. Centers for Disease Control and Prevention has more about sepsis.

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Rise in Deaths Even When Smog Is Below EPA Standard: Study

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, June 3, 2015 (HealthDay News) — Death rates among people older than 65 appear to be affected by air pollution, even when the air they breathe meets current standards, researchers say.

In the study, Harvard researchers looked at Medicare recipients in the New England region. The investigators found that death rates among seniors were linked to levels of a type of air pollution called “fine-particulate matter” — even in places where air pollution levels were below those recommended by the U.S. Environmental Protection Agency (EPA).

No evidence exists for a “safe” level of pollution, said senior report author Joel Schwartz, a professor of environmental epidemiology at the Harvard School of Public Health in Boston. Instead, “we need to focus on ways that lower exposure everywhere all the time,” he cautioned.

The report was published online June 3 in the journal Environmental Health Perspectives.

Particulate matter (PM) is the term for particles found in the air, including dust, dirt, soot, smoke and liquid droplets. Particles less than 2.5 micrometers in diameter (PM2.5) are referred to as “fine” particles and are believed to pose the greatest health risks. Because of their small size (approximately 1/30th the width of a human hair), fine particles can lodge deeply into the lungs.

Sources of fine particles include all types of combustion — from cars, power plants, wood burning and certain industrial processes, according to the EPA.

Earlier studies have linked exposure to PM2.5 with increased deaths from heart disease, high blood pressure and reduced lung function, Schwartz said.

Using satellite data, Schwartz and his colleagues determined pollution levels and temperatures for all of the ZIP codes in New England. This let them examine effects of PM2.5 pollution in areas far from monitoring stations. In addition, they analyzed Medicare data on deaths in the same region from 2003 to 2008.

The investigators found that short- and long-term exposure to fine-particle pollution was associated with higher death rates among the study group, even in areas with annual exposures below EPA standards.

Short-term (two-day) exposure led to a 2 percent increase in death rates for each increase of 10 micrograms per cubic meter of air (10 mcg/m3) in concentration of PM2.5. And long-term (one-year) exposure led to a 7.5 percent increase in death rates for each 10 mcg/m3 increase in concentration of PM2.5, the study found.

Janice Nolen, assistant vice president for national policy at the American Lung Association, said, “These findings are not surprising.”

The EPA needs to enact tougher standards to reduce the levels of air pollution even more, she said.

“We have made a lot of progress, but there is still a long way to go,” Nolen added.

Schwartz agreed. “EPA needs to tighten the particle standard further,” he suggested.

“We need to reduce the particles in the air, which we can do with off-the-shelf technologies,” Schwartz said.

“Current regulations still allow some coal-burning power plants to avoid using scrubbers, and that is raising death rates on the East Coast,” Schwartz said.

“Moreover, EPA’s recent wood stove and diesel standards do not require retrofits, and local governments will need to deal with this to reduce these avoidable deaths,” he added.

More information

For more about air pollution and health, visit the U.S. Environmental Protection Agency.

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What You Can Learn About Being True to Yourself From Caitlyn Jenner

Let’s face it: Caitlyn (with a C!) Jenner just broke the Internet (Sorry, Kim). The 65-year old, formally known as Bruce, revealed her identity on the cover of the July issue of Vanity Fair. “I’m so happy after such a long struggle to be living my true self. Welcome to the world Caitlyn. Can’t wait for you to get to know her/me,” Jenner tweeted, shortly after the cover was released online.

And the world has taken note. Jenner gained 1 million Twitter followers within four hours, breaking a record set just two weeks ago by President  Obama.

Another Jenner world record, and at 65? Who'da thought! Humbled & honored to have reached 1M followers in 4 hrs. Thank you for your support.

— Caitlyn Jenner (@Caitlyn_Jenner) June 1, 2015

RELATED: Bruce Jenner Fans Paint Their Nails in Solidarity

Laverne Cox, one of the stars of the critically acclaimed Netflix series Orange Is the New Black, and transgender herself, took to Tumblr to voice her support of Jenner. “I am so moved by all the love and support Caitlyn is receiving. It feels like a new day, indeed, when a trans person can present her authentic self to the world for the first time and be celebrated for it so universally,” Cox wrote.

And with 2.31 million (and growing!) twitter followers, the world is waiting to see what the former Olympic decathlete is going to do now that she is living the life she has always truly wanted. For now, though— or at least until her new E! docu-series I Am Cait begins airing on July 26— we’ll just take a few cues from the equal parts wise and brave gleaned from Jenner’s Vanity Fair debut and the trailer for her new show.

On living authentically

“I wish I were kind of normal. It would be so much more simple… I’m not doing this to be interesting. I’m doing this to live.”

On having no regrets

If I was lying on my deathbed and I had kept this secret and never ever did anything about it, I would be lying there saying, ‘You just blew your entire life…’ ‘You never dealt with yourself,’ and I don’t want that to happen.”

RELATED: A Late-Life Gender Transition Like Bruce Jenner’s Is Full of Challenges and Rewards

On dealing with your issues, no matter what they are

“So many people go through life and never deal with their own issues, no matter what their issues are. Ours happen to be gender identity. But how many people go through life and just waste an entire life because they never deal with themselves and who they are?” she says in a just released promo for I Am Cait.

On the freedom of letting go of a life you don’t want

“Bruce always had to tell a lie. He was always living that lie. Every day he always had a secret from morning to night. Caitlyn doesn’t have any secrets. Soon as the Vanity Fair cover comes out, I’m free.”

On how bravery is contagious

“Honestly, since the Diane Sawyer piece every day it’s exciting to go to the mailbox, because I get letters every day from all these people from all over the world. I’ve gotten a lot from trans women telling their story, and how excited they were to see the Diane piece.”

RELATED: 5 Things You Should Never Say to a Transgender Person

 

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