Glossary and Definitions for Military Transgenderism

Note the definition for RLE. That means the male or female in their original sex as born, as created by God, may be sleeping, bathing, toileting with members of the other sex before taking hormones or surgery. The example I was reading was what the commanding officer does when HE becomes pregnant if he hasn't completed, or begun, the transition. This apparently is why we have birthing persons.

DoDI 1300.28, April 30, 2021 Change 1, December 20, 2022

GLOSSARY

G.1. ACRONYMS. ACRONYM MEANING

AC Active Component

BCA body composition assessment

DEERS Defense Enrollment Eligibility Reporting System

DHA Defense Health Agency

DoDI DoD instruction

DSM-5 American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition

DTP Delayed Training Program

ETP exception to policy

HIPAA Health Insurance Portability and Accountability Act

MPDATP Military Personnel Drug Abuse Testing Program

MTF military medical treatment facility

PHI protected health information PII personally identifiable information

PRT physical readiness testing

RC Reserve Component

RLE real life experience

ROTC Reserve Officer Training Corps

SCCC Service Central Coordination Cell

TRICARE Military Health Care

USCG United States Coast Guard

USD(P&R) Under Secretary of Defense for Personnel and Readiness



G.2. DEFINITIONS.


These terms and their definitions are for the purpose of this issuance.


TERM                                              DEFINITION
cross-sex hormone therapy The use of feminizing hormones in an individual assigned male at birth based on traditional biological indicators or the use of masculinizing hormones in an individual assigned female at birth. A common medical treatment associated with gender transition.
DTP A program established by the Secretary of the Army to provide a personnel accounting category for members of the Army Selected Reserve to be used for categorizing members of the Selected Reserve who have not completed the minimum training required for deployment or who are otherwise not available for deployment.
gender dysphoria A marked incongruence between one’s experienced or expressed gender and assigned gender of at least 6 months’ duration, as manifested by conditions specified in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5), page 452, which is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning.
gender identity An individual’s internal or personal sense of gender, which may or may not match the individual’s biological sex.
gender marker Data element in DEERS that identifies a Service member’s gender. Service members are expected to adhere to all military standards associated with their gender marker in DEERS and use military berthing, bathroom, and shower facilities in accordance with the DEERS gender marker.
gender transition is complete A Service member has completed the medical care identified or approved by a military medical provider in a documented medical treatment plan as necessary to achieve stability in the self-identified gender.
gender transition process Gender transition in the military begins when a Service member receives a diagnosis from a military medical provider indicating the Service member’s gender transition is medically necessary, and concludes when the Service member’s gender marker in DEERS is changed and the Service member is recognized in the self-identified gender.
human and functional support network Support network for a Service member that may be informal (e.g., friends, family, co-workers, social media.) or formal (e.g., medical professionals, counselors, clergy).
medically necessary Health-care services or supplies necessary to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms, and that meet accepted standards of medicine.
mental health provider A medical provider who is licensed, credentialed, and experienced in the diagnosis and treatment of mental health conditions and is privileged at a Military MTF (in the direct care system). Private care sector civilian TRICARE authorized mental health providers may be involved in a specific Active Duty Service member’s care. These providers are credentialed through the managed care support contractors.
military medical provider Any military, government service, or contract civilian health care professional who, in accordance with regulations of a Military Department or DHA, is credentialed and granted clinical practice privileges to provide health care services within the provider’s scope of practice in a Military MTF.
non-urgent medical treatment The care required to diagnose and treat problems that are not life or limb threatening or that do not require immediate attention.
PHI Individually identifiable health information (as defined in the HIPAA Privacy Rule) that, except as provided in this issuance, is transmitted or maintained by electronic or any other form or medium. PHI excludes individually identifiable health information in employment records held by a DoD covered entity in its role as employer. Information that has been de-identified in accordance with the HIPAA Privacy Rule is not PHI.
PII Information that can be used to distinguish or trace an individual’s identity, either alone or when combined with other information that is linked or linkable to a specific individual. Defined in OMB Circular No. A-130.
RLE The phase in the gender transition process during which the individual begins living socially in the gender role consistent with their self-identified gender. RLE may or may not be preceded by the commencement of cross-sex hormone therapy, depending on the medical treatment associated with the individual Service member, cadet, or midshipman’s gender transition. The RLE phase is also a necessary precursor to certain medical procedures, including gender transition surgery. RLE generally encompasses dressing in the new gender, as well as using self-identified gender berthing, bathroom, and shower facilities.
SCCC Service-level cell of experts created to provide multi-disciplinary (e.g., medical, legal) advice and assistance to commanders regarding service by transgender Service members, cadets, or midshipmen and gender transition in the military.
self-identified gender The gender with which an individual identifies.
stable in the self-identified gender The absence of clinically significant distress or impairment in social, occupational, or other important areas of functioning associated with a marked incongruence between an individual’s experienced or expressed gender and the individual’s biological sex. Continuing medical care including, but not limited to, cross-sex hormone therapy may be required to maintain a state of stability.
transgender Service member Service member who has received a medical diagnosis indicating that gender transition is medically necessary, including any Service member who intends to begin transition, is undergoing transition, or has completed transition and is stable in the self-identified gender.
transition Period of time when individuals change from the gender role associated with their sex assigned at birth to a different gender role. For many people, this involves learning how to live socially in another gender role. For others, this means finding a gender role and expression that are most comfortable for them. Transition may or may not include feminization or masculinization of the body through cross-sex hormone therapy or other medical procedures. The nature and duration of transition are variable and individualized.

Joe Biden worsens the danger for children--Why do Democrats support him?

 " . . . when a school strives to create a “safe, welcoming, and inclusive” environment for transgender-identified students, it greatly increases the chance that children who might otherwise go through a temporary stage of identity exploration or confusion will reject their bodies in favor of a risky experimental medical protocol."

The School-to-Clinic Pipeline | City Journal (city-journal.org)

Health problems for trans people

 Before someone with gender dysphoria decides he needs to be a she to solve his problems, he might take a look at the health problems, either before or after, listed by Cleveland Clinic Transgender Health Services.  To the casual observer, it would seem the first step is to fix the problem before cutting off body parts. And after all that "screening" is finished (see below), then what? 

Metabolic conditions: These conditions, such as high blood pressure (hypertension), diabetes (glucose intolerance), liver dysfunction, and high cholesterol (dyslipidemia), can develop as a result of long-term hormone therapy (both estrogen and testosterone).

Obesity and heart disease: Transgender men and women have a slightly higher rate of obesity. Compounded with their long-term hormone use and higher rate of tobacco use, routine screening for heart disease is necessary.

Cancer: Transgender women (male-to-female) should have cancer screening for cancers of the breast, prostate, and anus. Screening for cancer of the reproductive organs should also be done for all symptomatic transgender men. Transgender men (female-to-male) should also need cancer screening for cancers of the breast, cervix, and anus, depending upon anatomy and stage of transition.

Alcohol and illicit substance abuse: Population studies have shown that the rate of substance abuse is higher in the transgender community than in the general population, and patients should routinely be screened for alcohol and illicit substance abuse. As such, patients should also be offered counseling and education regarding substance abuse and risk-taking behaviors.

Tobacco use: Population studies also show that transgender men and women have higher rates of tobacco use than the general population, and patients should be screened for this and provided with counseling and education about smoking cessation.

Depression, anxiety disorders, and post-traumatic stress disorder (PTSD): These medical illnesses occur at higher rates among transgender and non-binary individuals, often because of poor social supports, trauma, and challenges accessing affirming and knowledgeable providers. These conditions should be screened for regularly and be addressed by medical providers.

Sexually transmitted infections (STIs), including HIV and AIDS: Individuals who use drugs and other substances and have condomless sex are at risk for sexually transmitted infections, including HIV and AIDS. Patients who present with these risk factors should be screened for these infections and offered HIV Pre-Exposure Prophylaxis (PrEP) if medically appropriate.

Clues about the election outcomes

Maybe some clues about the election results.

 
I was listening to Matt Walsh last night and he had some interesting statistics about Gen-Z--both that generation and their lifestyles and voting patterns (born 1996-2015). Overwhelmingly, they voted Democrat--huge spread from other generations. Only 45% of Gen Z report having good mental health--many suffer from anxiety, depression, OCD, PTSD, Bi-polar, etc. and a high percentage have seen a professional or take medication. From Catholics to Lutherans to Bible Only churches, Gen-Z is turned off--but they are instead opting for pantheism, gnosticism and the occult. They are "spiritual" but not religious, so they have no real grounding in faith because those expressions are all interior focused and not based on truth.

And maybe that's a message about where Democrats, and our Democracy, are going. Mentally confused and ungrounded in reality voters reach out for big government to help them survive. This provides a ready made market for Big Pharma which helps to elect more Democrats with its profits. From the time they entered Kindergarten they've been told the world is going to crash and burn unless they do something, anything, like recycle, or stop using plastic, or rush into the streets and scream. They've been taught to look inward for strength, and that their bodies don't matter--that sex is now gender and can all be changed just through wishful thinking, amputating body parts, and making others change their pronouns. Then the lockdown came and they were left to their own company. A perfect storm.

Poor lil Gen-Z. They grew up in a country rich beyond any other generation's dreams and they believe they can/will destroy it, and that God isn't revealed in the Bible or the churches, but they personally will save the world if they just follow some guru or their inner light and swallow some pills.

 
Creepy Joe is just the president they need and want.

How have environmental rule and regs worsened our housing for low income and middle class?

Because our AC died on the hottest day of the summer (95) and current EPA laws on R-22 prevent it being fixed (will have to replace) I was trying to research to what extent our energy and environmental laws have contributed to homelessness or even pricing low income out of real estate wealth or the competition for a good rental. It's only common sense that the constant drum beat of climate change on the building trades and the corresponding greater concern for mother earth than a mother in America has to hit the more fragile in the wallet. Zip, nada, zilch in the research, especially EPA and Energy Star articles. So I'll just continue to know in my gut that saving the environment is throwing a lot of people out of work and out of their homes. Soon, you may be seeing a lot of cars up on blocks as the bidenflation roars ahead.

But my eyes landed on an interesting fact sheet about homelessness in Washington DC. It decreased significantly under the Trump booming economy, but was still higher than most big cities. The January 2018 count (a point in time) showed 3,761 single adults, and 924 families (3,134 people), and 9 minors alone. So I took a closer look at the singles: 51% were chronically homeless, but only 19% of the adults in the families were chronically homeless. I think that was my big takeaway. 50% of the singles had formerly been institutionalized--from jail or hospital to the streets; 19% of the singles had a history of domestic violence, much lower than the family rate; 30% of the singles had chronic substance abuse and 32.7% had a history of mental illness; 24.6% of single homeless adults were chronically ill and 18% were disabled. Median age for the singles was 51 and for family adults 29.

 
I was a librarian not a social worker, so I won't suggest a solution, but I do know that saving families is a big part of the solution of homelessness, and housing is probably the smallest part. Families are a social safety net, and many of our government policies can't answer that need.
https://www.legalclinic.org/wp-content/uploads/2019/04/Fact-Sheet-on-Homelessness-and-Housing-Instability-in-DC.pdf

Is it Covid or the lockdown causing rise in mental problems in children?

Surgeon General alarmed by rise in child suicides triggered by pandemic – HotAir

"U.S. Surgeon General Dr. Vivek Murthy is shedding some light on a growing crisis of child mental health issues brought on by the coronavirus pandemic. The pandemic has produced an epidemic of mental health challenges for young people. As the second year of the pandemic ends, the state of children’s mental health has hospitals, teachers, and health professionals thinking an epidemic has already arrived."

Mike Huckabee has an alternative viewpoint.

"That headline, though, needs some rewriting. As Prof. Glenn Reynolds at Instapundit pointed out, all those mental health issues weren’t “triggered by the pandemic,” they were triggered by the government’s authoritarian “lockdown everything” reaction to the pandemic, even when dealing with schools full of kids nearly all of whom are basically immune to the disease.

At least the incredible damage wrought by the “expert” class’s wrongheaded overreaction to COVID is finally starting to be recognized, even by someone from CBS News. It’s too bad that CBS felt it had to censor its own reporter for speaking the truth, but having someone from that network grasp the truth and speak up about it is at least a baby step in the right direction."

CBS Edits Out Own Reporter SLAMMING School Closures Causing Mental Health Crisis | Newsbusters According to this Newsbusters' article Jan Crawford "slammed our elected officials and public health experts for “the crushing impact that our COVID policies have had on young kids and children” and the subsequent mental health crisis."  Her comments were edited out of the Face the Nation panel.

Traumatic Brain Injury

About 35 years ago I applied for a job as the Director of an organization helped victims of TBI, traumatic brain injury. I had some of the qualifications they were seeking, like research and supervising staff, the advanced education, but I didn’t know anything about TBI. So I researched it before the interview. I didn’t get the job, but I never lost my interest in TBI. When I see articles about children’s sports injuries, or NFL brain trauma, or head injuries from auto accidents or falls, I always stop to read them. I’ve known two brilliant women whose careers and lives were devastated in auto accidents during their post graduate college years.

Today I saw an item about a coming conference at OSU, the annual CBI Research Day (Chronic Brain Injury) CBI Research Day | Discovery Themes, The Ohio State University (osu.edu) on March 10. I looked at the qualifications of some of the speakers and for articles they’ve published since I won’t be attending, even virtually. This item about Dr. Christine MacDonald was particularly interesting: Combat concussions worsen over time, not lessen.

“The EVOLVE study, for which she is the lead researcher, found that those who suffer combat concussions worsen over the course of their 1-year and 5-year follow-ups; 80% seek mental health assistance by the 5-year follow-up, and only 19% achieve a “sustained resolution of their symptoms.” The service members had blast or non-blast related concussions, but none had more complex or severe brain injuries.” The Invisible Wounds of War — Concussion Alliance

Electromagnetic controlled cortical impact device for precise, graded experimental traumatic brain injury - PubMed (nih.gov)

Clinical and imaging assessment of acute combat mild traumatic brain injury in Afghanistan (nih.gov)

Cerebellar White Matter Abnormalities following Primary Blast Injury in US Military Personnel (nih.gov)

Amy K. Wagner, MD, Chair for Translational Research at the University of Pittsburgh, is the keynote speaker, and Carrie Lynn Esopenko, PhD, Asst. Professor of Rehabilitation & Movement Sciences at Rutgers is the Spotlight Speaker. 

The database at the University of Pittsburgh, certainly shows some interesting statistics:  Whites (67%) are far more likely to be victims than blacks (19%), an overwhelming number are single--never married, divorced, widowed (67%), males are 73.5%, and 52% of the causes are vehicular crashes.  TBIMS_NationalDB_update.pdf (pitt.edu)

The Right to Fail—PBS

Pro-Publica and Frontline reporting on moving high functioning mentally ill people out of managed homes to supportive “independent” living. The reporter Joaquin Sapien  focuses on Nestor Bunch who at 52 was living on his own for the first time. He was in and out of supported housing, hospital, had roommates, and a 4 hour a day aide.

The complexity of care—and caring—really surprised me.  The reporter had access to boxes of medical records.  Everything was recorded—successes, failures, medications, roommates.

I’ve seen a lot of criticism from Democrats of Ronald Reagan when he was governor of California for signing the law that closed the institutions for the mentally ill, and they say, no accuse, that he is the reason for California’s terrible homeless problem.  However, it was an idea about “rights” for the mentally ill that came from academics.  So I was shocked to see the same reasoning still applies today, as NYC tries to reduce its population of seriously mentally ill from protective, and even locked, housing for many adults, and turn them lose in the name of “right to fail.”

None of the people in this film appear to be “high functioning” to me, however, I don’t know to whom they are compared. They are desperate, lonely,  afraid, wandering the streets, getting into fights, eating poorly, with no socialization. Nestor Bunch was one of the fortunates in that a friend of his deceased mother still cared and looked out for him through the machinations of the huge bureaucracy.

“People with severe mental illness can be difficult to track: some wind up on the street or in psychiatric hospitals; phone numbers often change. After a series of dead ends, I was elated when I found Bunch — until I realized he could not reliably narrate his own life. As he jumbled the timeline of his addresses and experiences, it became clear he had a traumatic story to tell. It involved finding his first roommate naked and dead, landing in the hospital with a serious injury and being sent to the trash-strewed apartment of another roommate who died.”

https://www.pbs.org/video/right-to-fail-fz7iaq/

https://www.pbs.org/wgbh/frontline/article/behind-right-to-fail-a-propublica-frontline-collaboration-to-overcome-roadblocks-and-privacy-restrictions/?

For those who have family with mental health issues

This young lady is the daughter of a friend.  Not sure of her age, but she’s about 19-20. I spent some time with her about 7 years ago when she was in middle school—such a sweet, beautiful child.  We have been praying for her and her mother. Recently she had some serious problems, and today posted this:

“Hi all, I just thought I would share with you what 2019 has held for me so far. I’ve been through some stuff I wouldn’t wish upon my worst enemy. I’ll start with my most recent “adventure”. I’ve struggled with mental health issues for just about as long as I can remember, whether it be anxiety, depression or Bipolar 1. These past 9 days I was hospitalized due to these issues and I would like to share my experience in hopes to help anyone going through something similar.

I was at the lowest of the low. I was unstable, depressed, hopeless, dissociated, anxious you name it. I wasn’t sleeping. I wasn’t eating. I lost 20 pounds in the past month or so. Even though I have a strong support system, I had never felt so alone. I couldn’t describe in words how awful that feeling was.

The first night I was there, I wished that I wasn’t alive. I wished that I had never been born. I wished I could fall asleep and never wake up. Looking back now, I want to tell myself that everything was going to get better with each passing day.

I met some incredible people during my stay in which I hope to keep in touch with for the rest of my days. Hearing people talk about their experiences and being able to relate with you and talk through your problems, is the most amazing way to start your healing process. I cried with them, I laughed with them, but most importantly they taught me that having mental health issues is okay. They taught me so many valuable skills and lessons that I will cherish for the rest of my life. During any future struggles I may have, everything I’ve learned from them will help me come out stronger than before.

Through this experience, I’ve learned not to be ashamed or embarrassed. I’ve talked about my problems, which is totally not my style, but it’s helped immensely. I’m happier, I’m healthier and I have a whole new, positive, outlook on life. I will continue to better myself day by day.

I thought I had no way out. It felt like there was no light at the end of the tunnel. Some of you may be able to relate in your own ways, some of you may not and that’s perfectly okay.  . .

Thank you to my Family, Friends and everyone else who has supported me through my struggles. I appreciate it so very much and I don’t know what I would do without you!”

Are tattoos telling us something?

I kept seeing things float past about tattoos, sex, sleep and mental illness, so I decided to try to track down the research, since none of the summaries gave a definitive source—just something about University of Miami.  Finally found it in the International Journal of Dermatology, “Are tattoos associated with negative health‐related outcomes and risky behaviors?” Jan. 24, 2019  Two of the authors are at the University of Miami.

Abstract (the article is not available on-line)

Background

Tattoos have reached broadening mainstream acceptance. Medical professional societies have noted that tattoos may co‐occur with high risk behaviors.

Methods

Using a variety of statistical models applied to a sample of 2,008 adults residing in the United States via Amazon's Mechanical Turk, we estimate the associations between tattoo characteristics, three health‐related outcomes (overall health status, ever diagnosed with a mental health issue, sleep problems), and three risky behaviors (current smoking, ever spent time in jail or prison, and number of sex partners).

Results

We find that the presence, number, and specific features of tattoos are positively correlated with two of the health‐related outcomes (ever diagnosed with a mental health issue and trouble sleeping) and all three of the risky behaviors (P < .05). Magnitudes are larger for those with multiple, visible, and offensive tattoos.

Conclusions

Our results suggest that individuals with tattoos are more likely to engage in risky behaviors relative to their non‐tattooed counterparts, which may lead to health consequences. Dermatologists, healthcare providers, and public health advocates should recognize that having a tattoo(s) is a potential marker for mental health issues and risky behaviors.

Some will be happy and satisfied, but many won’t

The media is in love with Bruce Jenner and his sex change--or they were until they found out he was a Republican. The research is somewhat limited, but what there is shows a higher mortality rate, higher suicide rate, more mental issues, more criminality, and higher STD/HIV in the post surgical transgendered. I think the news cycle tired of the gay stories (2% of the population) so they moved on to transgender (.01%). If it weren't for the police stories, African Americans wouldn't even get in the media at all. Hispanics can only be in a story if it's about illegal immigration. We have a shallow media.

http://www.ncbi.nlm.nih.gov/pubmed/21364939

http://www.cdc.gov/hiv/risk/transgender/

http://articles.latimes.com/2014/jan/28/local/la-me-ln-suicide-attempts-alarming-transgender-20140127

http://thefederalist.com/2014/11/11/trouble-in-transtopia-murmurs-of-sex-change-regret/

And to this we add pot

I've had conversations with people whose brains were damaged by alcohol and those who have Alzheimer's, and trust me, there's very little difference. Why are people (usually liberals and libertarians) so eager to see the population further downgrade their intelligence?

http://www.biosciencetechnology.com/news/2014/11/long-term-marijuana-use-affects-brain-function-structure

https://www.psychologytoday.com/blog/the-athletes-way/201403/heavy-marijuana-use-alters-teenage-brain-structure

Father of Justine Pelletier tells his story on Glenn Beck—it’s frightening

But this story is from ABC News, just in case you don’t trust Glenn.

“One day Justina Pelletier was a seemingly healthy teenager performing jumps and spirals at a skating show and six weeks later, on Feb. 10, 2013, she was in the emergency room at Children's Hospital in Boston after a severe bout with the flu, refusing to eat and barely able to walk.

Her parents, Lou and Linda Pelletier of West Hartford, Conn., say their daughter was diagnosed and being treated at Tufts Medical Center for mitochondrial disease, a rare genetic disorder with physical symptoms that can affect every part of the body. Justina's sister Jessica, 25, is also being treated for the disease.

But three days later, a team of doctors at Boston Children's said her symptoms were psychosomatic, according to the family. The hospital then filed a complaint with the Massachusetts Department of Children and Families, as required by law, because they suspected the parents of child abuse for subjecting their daughter to invasive medical treatments and denying her mental health therapy.”

http://abcnews.go.com/Health/advocates-fight-teen-justin-pelletier-held-state-pysch/story?id=22312907

http://www.theblaze.com/stories/2014/02/04/the-latest-from-the-parents-of-teen-held-by-hospital-against-their-will-doesnt-look-good-its-scary/

The crisis in mental health beds

Perhaps you watched 60 minutes Sunday night about Austin Deeds, son of Virginia state Sen. Creigh Deeds, who left a Virginia hospital emergency room, went home, stabbed his father, and then killed himself. He was mentally ill, and there were no hospital beds. The implication of the story was that America has failed, won't financially support treatment for the mentally ill. But I was around in the 1970s when there was another "civil rights" movement for the mentally ill, led by former patients of institutions, social workers, academics and church do-gooders. With new drugs, small group homes, counseling, etc., large institutions weren't needed, we were told.

In the late 70s we took a friend having a break down to Riverside hospital, he wasn't even a citizen, and he was treated for a week or so, got counseling, drugs, and his life was saved and today is a functioning, healthy person. That couldn't happen today. There are no beds. Take someone to ER today having a breakdown and you might get a few hours of help. And it was liberals, not conservatives, who did this. If the mall shooter of last week in MD had shown signs of his mental illness, his mother would have been helpless, as was the mother of the Sandy Hook shooter. We called it civil rights then; today we call it helpless to save them.

Some bi-polar and schizophrenic people do very well on medication—so well that they decide not to take them any more. But parents can’t always intervene if they are adults, and their hands are tied to get help.  Such a story was told in the December issue of (614) of Adam Helbling who felt a huge let down on medication and he was no long Jesus Christ. We did them no favors when we closed the care facilities in favor of medication.  Both are needed.

 

 http://nation.time.com/2014/01/27/lawmaker-whose-son-attacked-him-faults-mental-health-system/

The Columbia Mall Shooting

They always look for motives. He wasn't poor—a preppy; he graduated from a great pubic high school; he had a job; was environmentally conscientious; liked by others; loved by his family.  But he was suicidal and apparently did want to be known before he left this life. There are common denominators in these tragedies--young and male and mentally troubled. Three dead (including the shooter) and five injured.

http://www.washingtonpost.com/local/crime/2014/01/27/

Darion Marcus Aguilar

Two law enforcement officials, speaking on the condition of ­anonymity because the investigation is ongoing, said Aguilar kept a journal in which he described suicidal thoughts. When the young man’s mother reported him missing Saturday, they said, a police detective was sent to the home. He began reading the journal, but Aguilar’s mother demanded he stop.

Later, after authorities identified Aguilar as the shooter, police seized the journal. In addition to the references to suicide, it contains notes expressing hatred of certain groups, according to the officials, who did not elaborate in detail.

Update: "Howard County police said they have reviewed Aguilar's journal and are examining his cellphone and a home computer, but have found nothing that connects him with the victims. Of the journal, authorities said only that Aguilar "knew he was having mental health issues. . . For more than a year, Aguilar had lived with his mother in the 4700 block of Hollywood Road in College Park — about a half-hour drive from the mall. Before that, Aguilar and his family lived in Silver Spring, about 20 minutes from the mall.

Aguilar did not have a driver's license, according to a Rockville gun shop owner who sold him the shotgun used in the attack. Aguilar used a state learner's permit for identification when he bought the gun Dec. 10." Baltimore Sun

Bi-polar disorder in children

For the general population, a conservative estimate of an individual’s risk of having full-blown bipolar disorder is one percent. Disorders in the bipolar spectrum may affect 4 to 6 percent. When one parent has bipolar disorder, the risk to each child is 15 to 30 percent. When both parents have bipolar disorder, the risk increases to 50 to 75 percent. The risk in siblings and fraternal twins is 15 to 25 percent. The risk in identical twins is approximately 70 percent.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695748/

Not just breast cancer, but also mental health problems

Women don't have choices if they don't have information. They also don't have choices if mama is threatening to put her on the street, and the boyfriend is promising to leave her. Doctors can't do anything about mama or the creepy boyfriend, but they can let women know the mental health dangers of abortion.

"Women who have abortions are 81 percent more likely to experience subsequent mental health problems, according to a new study published by Britain’s Royal College of Psychiatrists. The greatest increases were seen in relation to suicidal behaviors and substance abuse.

The meta-analysis examined and combined results of 22 studies published between 1995 and 2009 and included data on 877,181 women from six countries. All 22 studies revealed higher rates of mental health problems associated with abortion for at least one symptom, and many for more than one symptom." Elliot Institute

Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009, by Priscilla K. Coleman, The British Journal of Psychiatry (2011) 199: 180-186

This review offers the largest quantitative estimate of mental health risks associated with abortion available in the world literature. Calling into question the conclusions from traditional reviews, the results revealed a moderate to highly increased risk of mental health problems after abortion. Consistent with the tenets of evidence-based medicine, this information should inform the delivery of abortion services.