Yesterday, March 31st, the world celebrated International Transgender Day of Visibility. It was a day to celebrate and support the people in our lives who have come out as transgender—a term used to define those whose gender identity differs from the sex assigned to them at birth.

“Transgender people come from all walks of life,” the Human Rights Campaign website reads. “We are your coworkers, family and neighbors. We are 7-year-old children and we are 70-year-old grandparents. We are a diverse community representing all racial and ethnic backgrounds, as well as faith backgrounds.”

RELATED: 5 Things Everyone Gets Wrong About Transgender People

And social media was full of inspiring photos from the day. Some people posted about their personal journeys, others posted selfies, and others still just posted messages of support—all with the hashtag #TransDayOfVisibility.

RELATED: Being Transgender Was Considered a Mental Illness by the World Health Organization—But That's Finally Changing

According to the Human Rights Campaign, transgender visibility has doubled since 2014. A 2016 survey revealed that 35% of likely voters in the U.S. “personally know or work with someone who is transgender.” In 2014, only 17% of likely voters answered the same. And while this doesn’t mean that trans people are experiencing less discrimination, these numbers show a positive step toward inclusivity.

Of course, trans visibility shouldn’t just be a single day of the year—transgender people should be acknowledged, included, and respected every day. So let’s appreciate how far we’ve come—while continuing to work toward a better, more inclusive future.

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

Do I have body dysmorphia?

It’s 2015, and that question is rattling around my head. I’m a sophomore in college, and I’m skipping class today because I can’t find anything to wear.

I’d also be skipping my friend’s birthday dinner that night and calling in sick to work the next morning. I’d spend the day contemplating whether or not to break up with my then-boyfriend so I’d have one less reason to go out and do things.

My distorted body image was affecting my school, my job, my relationships, and my health. I was suffering from a horrific restrict-binge-purge-restrict eating cycle that stemmed from my body image issues. I often skipped social activities to hit the gym instead or simply because I was scared of the food that would be there.

I missed class because I felt so uncomfortable in my body that I couldn’t stomach the idea of walking through campus. I’d ignore phone calls and texts because I was too preoccupied trying on last summer’s swimsuits and analyzing every last detail on my body, particularly the ones I hated.

Eventually, I asked the internet if I had BDD. Body dysmorphic disorder (BDD), also called body dysmorphia, is a mental health condition that involves an unhealthy and excessive preoccupation with one’s physical appearance. It’s estimated that as many as 10 million people in the U.S. struggle with BDD, according to the International OCD Foundation. BDD is technically a sub-classification of obsessive-compulsive disorder, and research suggests that many people with BDD also have an anxiety disorder.

But I didn’t fit the BDD bill. Because my obsession was with my whole body—not one specific trait—I didn’t “qualify” for BDD. Currently, the diagnostic criteria for BDD involves a preoccupation with singular features, such as the nose, hands, or mouth. Whole-body dissatisfaction is technically not considered BDD, so when I was researching, I thought, “Well, that’s not what I have.” And because my dysfunctional eating habits didn’t warrant an eating disorder diagnosis, that was out too. Without a “real” issue to solve, I didn’t think that getting help would, well, help. It wasn’t until 2017 that I sought help.

RELATED: 10 Body-Positivity Moments of 2018 That Were Major Wins for All Women

Who experiences body dysmorphic disorder?

Scenarios like mine occur all too often, Elyse Resch, RDN, an eating disorder therapist and one of the originators of intuitive eating, tells Health.

According to the American Psychiatric Association, BDD is thought to affect 2.5% of women and 2.2% of men, and the disorder can show up at any age, though most people begin to exhibit symptoms during adolescence. The undiagnosed and misdiagnosed population probably skyrockets above those estimates, Resch says.

No single cause for BDD has been identified yet, but some research suggests that genetics might influence a person’s risk for BDD, and brain structure may also make a difference.

Exposure to “perfect” bodies on social media, television, movies, ads, and magazines is known to contribute to body image issues and may also be linked to BDD, Resch says. Constant media consumption puts people at risk of an altered sense of what’s real, and she encourages people to “cleanse” their social media feeds of body-negative accounts.

I traced my body image issues back to the innate perfectionist within me. With the help of my therapist, I was able to find correlations between my eating and exercise habits and other behaviors, like my desire to earn perfect straight As in school.

RELATED: 7 Things You Shouldn't Say to Someone Who's Had an Eating Disorder

How do you know if you have body dysmorphia?

Anyone can experience body dissatisfaction. But not everyone who experiences that dissatisfaction has body dysmorphic disorder. It’s important to note that BDD is a mental health diagnosis that involves an obsessive preoccupation with one or more specific body parts, usually around the head.

Common BDD focus areas include the ears, nose, skin, hair, and mouth or teeth. But people with BDD may obsess over other areas of the body, such as the knees, hands, or thighs, as well. Over the course of their suffering, most people with BDD will focus on five to seven different areas, says Jennifer Greenberg, PsyD, a Harvard Medical School assistant professor and director of translational research for the OCD and Related Disorders Program.

Up to 30% of people with BDD have concerns with their body shape or weight as well, Greenberg adds. And while someone with BDD can have coexisting preoccupations—i.e., their nose and their arms—as clinicians, she says, when they see someone who is obsessed with their stomach, thighs, hips, and other weight- or shape-related features, they need to check for eating disorder symptoms as well.

RELATED: 4 Women Share How Being in a Relationship Changed the Way They Eat

Symptoms of body dysmorphia

BDD causes an unbearable amount of distress for people with the disorder, which can lead to avoidance of social interaction, skipping class or work, and ignoring other obligations. Sometimes BDD makes it difficult to even leave the house or get out of bed, which is part of the reason it’s often misdiagnosed as depression or anxiety.

People with BDD often exhibit the following signs and symptoms:

• Skin picking
• Hair pulling
• Excessive use of makeup or other cosmetics, like self-tanner
• Wearing large or baggy clothes to hide certain features
• Wearing only pants and long sleeves to hide features
• Changing body positions frequently
• Excessive grooming
• Checking their appearance in the mirror repetitively
• Over-emphasizing other body parts in an attempt to draw attention away from the features they don’t like

A telltale symptom of BDD is that people with the disorder seek excessive reassurance from the people around them about the trait or body part they don’t like. For example, someone who struggles with BDD about their nose might say things like:

• “I hate my nose.”
• “Can’t you see how big my nose is?”
• “I wish I could change my nose.”

If you think someone you know may be suffering from BDD, it’s important not to agree or disagree if you find yourself in this situation, Resch says. You shouldn’t reinforce their beliefs one way or another. Instead, gently let them know that maybe their nose isn’t the problem after all, and they should consider finding someone safe to talk to about their self-image.

When I spoke to Resch, I mentioned that I look nearly the same as I did two years ago. Neither then nor now was my body outside of society’s definition of attractive. I would constantly say things like, “Ugh, I feel so fluffy,” and “I hate my cellulite” when, in fact, I was not fluffy and had very little cellulite (which is normal, by the way).

I still say those things sometimes, but the difference is that now—after a few bouts of therapy—I understand the underlying reasons behind my body image issues and can silence my inner mean girl.

RELATED: 9 Ways to Help a Friend With an Eating Disorder

Diagnosing BDD

Mental health professionals use these three criteria to officially diagnose someone with body dysmorphia, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).

Preoccupation with appearance. The focus of your attention is on a slight imperfection, which is either barely noticeable by others or fabricated. To be considered “preoccupied” with the trait, you must spend at least one hour each day thinking about the trait.

Repetitive attempts to "fix" the trait. For example, constantly picking at the skin, pulling hair, changing body positions, and checking the mirror are all repetitive behaviors that someone with BDD might engage in.

The obsessive thoughts and repetitive behaviors must be clinically significant. The perceived flaw must result in so much distress that your quality of life is impaired. Relationships, obligations, and other areas of life are significantly impacted because of the preoccupation.

RELATED: The Common Habit That Could Totally Warp Your Body Image

Body image vs. body dysmorphia

Whereas a person with BDD has an unhealthy fixation on particular body parts, a person with distorted or poor body image tends to be unhappy with their whole body.

Feeling uncomfortable in a swimsuit is “normal,” though everyone should work on self-acceptance, Resch says. Feeling so uncomfortable in a swimsuit that you refuse to wear one and avoid going to the beach with friends might warrant some deeper self-questioning. Feeling uncomfortable in everyday clothes and experiencing apprehension toward leaving your house warrants professional help.

Personal dissatisfaction is present in both conditions, and this type of thinking exists on a spectrum, says Carla Korn, an eating disorder therapist in Conejo Valley, California. “Oftentimes, the progression from ‘normal’ to ‘disordered’ can occur so quickly that one might not even be aware of the problem,” she says.

The question shouldn’t be, “Do I have body dysmorphia?” Resch says. Instead, she wants people to ask themselves, “Do I need help?”

“We place too much emphasis on whether or not someone actually falls into the clinical definition of this diagnosis, and that leaves so many people without proper help,” she says.

I eventually sought help because my life was so impacted by intrusive thoughts. Skipping class and losing friends wasn’t OK with me—I knew I needed help, even if I didn’t meet all of the diagnostic criteria for BDD.

Because my body image issues and dysfunctional eating habits were so closely related, I was eventually officially diagnosed with OSFED, which stands for other specified feeding and eating disorders. OSFED is a catch-all for eating, food, and body image concerns that are serious but don’t meet the criteria for another disorder.

Everyone who has a difficult or dysfunctional relationship with their body should have an opportunity for introspection and reflection around their patterns and behaviors. Social comparison is a significant challenge for many, if not most, of us, and it can be even more challenging when you are suffering from BDD.

“There is damage to the mind, body, and soul when you’re living your life obsessed with these behaviors or with your body,” Resch says. “The behaviors are just the tip of the iceberg, and underneath there is pain and discomfort and anguish.”

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

Two Port Elizabeth patients awaiting life-saving kidney transplants recently received the phone call they had long been praying for. However, they had to be in Cape Town early the following morning to undergo transplant surgery as donor kidneys have to be transplanted within a certain time after becoming available.

Cally Williams had been reliant on dialysis for many years after suffering kidney failure. She had been on the waiting list for a donor kidney since 2013, and when that telephone call finally came, she and her family were overcome with emotion. “For our family, this was nothing short of a miracle,” explains Mercia Heilbron, who is Cally’s primary caregiver.

“After we received the news, we were desperately trying to find a way to get Cally to Cape Town in time or else Cally’s chance to receive this life-saving transplant would be lost.”

Anonymous patient

It was welcome news too for the staff at the National Renal Care (NRC) unit based at Netcare Cuyler Hospital in Uitenhage that Cally, one of the patients who had been dialysing at their unit, would finally receive the kidney transplant she needed. The other patient to receive a donor kidney, who has chosen to remain anonymous, had been undergoing renal dialysis at a state hospital.

Sr Salome Siebritz, who is one of the NRC nurses providing acute dialysis to patients in Port Elizabeth and surrounding areas, has known 25-year-old Cally for some five years. Although Sr Siebritz had never met the state patient before, she was anxious to find out how both patients would find their way to Cape Town at such short notice.

The last flight for the day from Port Elizabeth to Cape Town was due to take off a mere 30 minutes after the patients were contacted, which ruled out air travel as a transport option.

“There was not a moment to lose, and I immediately phoned Cally to make travelling arrangements as I was concerned that she would miss this opportunity, and had decided that I would drive her to Cape Town myself,” Sr Siebritz relates.

Strict timeframe

Sr Siebritz also contacted the other patient who needed to get to Cape Town and her offer to drive her too was gratefully accepted.

The NRC unit expressed their desire to contribute towards the costs of the journey. They spontaneously started a collection, and everyone from the doctors to the cleaning staff, as well as a number of patients were eager to make donations to help the two kidney recipients reach Cape Town in time.

It was critical for both patients that they reached their hospitals (Netcare Christiaan Barnard Memorial Hospital and Groote Schuur) within the strict timeframe for the transplants to be viable. Thanks to the extraordinary efforts of Sr Siebritz and everyone who donated funds towards their travel, they were able to reach the hospital in time.

^{NRC NCBMH: (Left to right) Following the successful kidney transplant for patient Cally Williams, Netcare Christiaan Barnard Memorial Hospital enrolled nurse, Margaret Dankers who cared for Cally in hospital, is pictured with National Renal Care’s Sr Salome Siebritz; the patient’s aunt, Mercia Heilbron; and Netcare’s transplant co-ordinator, Alexia Michaelides.}

The money raised to cover the transport costs far exceeded expectations, and was even enough for Cally to fly home when she had recuperated sufficiently to be discharged. 

Mercia Heilbron adds that she and her family are very grateful for the care and assistance from all concerned, particularly Sr Siebritz and most importantly, the organ donor and the donor’s family.

How to register as an organ donor

Mercia herself is registered as an organ donor with the Organ Donor Foundation, and encourages others to consider doing the same.

Chief executive officer of NRC, Robert Souter, commended Sr Siebritz and her colleagues for going the extra mile to assist their two patients.

“Our staff are always committed to ensuring the well-being of our patients. When a kidney becomes available and is a match for one of our patients, we recognise the importance of the opportunity for them,” he concluded.

According to Alexia Michaelides, one of Netcare’s transplant co-ordinators, there are around 4 000 individuals on the waiting list for donor organs in South Africa, and more than 2 000 awaiting kidney transplants.

To register as an organ donor or for more information contact the Organ Donor Foundation on their toll free number, 0800 22 66 11, or visit https://www.odf.org.za.

^{Image credit: Supplied}

The reason that humans shifted away from hunting and gathering, and to agriculture — a much more labor-intensive process — has always been a riddle. It is only more confusing because the shift happened independently in about a dozen areas across the globe.

Understanding stock market returns hinges on understanding their volatility. Two simple but competing models have been dominant for decades: the Heston model, introduced in 1993, and the multiplicative model, which dates back to 1990. American physicists recently compared the two models by applying them to the United States stock market and using historical data from two indexes: the S&P500 and Dow Jones Industrial Average.

Scientists at the Sensitive Instrument Facility of the U.S. Department of Energy’s Ames Laboratory achieved real-time atom rearrangement monitoring using aberration-corrected scanning transmission electron microscopy during the synthesis of intermetallic nanoparticles (iNPs).

Many survivors of the 2014–2016 Ebola outbreak in West Africa have ongoing health problems, a new study finds.

More than 28 000 people were infected and more than 11 000 died in the outbreak.

Genetic material in semen

Researchers compared 966 Ebola survivors from Liberia with 2 350 close contacts and sexual partners. They found that survivors were more likely to have increased urinary frequency, headaches, fatigue, as well as neurological and musculoskeletal problems.

Memory loss was reported in 30% of survivors, compared to fewer than 6% of their contacts. Survivors reported twice as much joint and muscle pain.

While 25% of survivors have uveitis – an inflammation of the eye that can lead to blindness – it was also found in 12% of the contacts. Researchers said that suggests Ebola may not be its cause.

They also discovered that Ebola virus genetic material can be found intermittently in the semen of male survivors for more than three years.

“We found many examples where people would test negative twice for Ebola and then later test positive. Some people would go through multiple episodes of this up to 40 months or possibly longer after being infected with Ebola,” study co-leader Cavan Reilly said. He is a professor at the University of Minnesota School of Public Health in Minneapolis.

Lingering health problems

“However, it’s not likely that they’re contagious and can infect other people,” Reilly said in a university news release.

“The findings suggest there’s a great need to provide follow-up care for Ebola survivors to help them deal with lingering health problems,” Reilly added. “The study results could also help improve the response to the current Ebola epidemic underway in the Democratic Republic of the Congo.”

The findings were recently published in the New England Journal of Medicine.

Reilly’s team plans to keep tracking the health of the Ebola survivors at least through 2020. The researchers are also working on a study to evaluate the effectiveness of several treatments for active Ebola infection.

^{Image credit: iStock}

Scientists are looking to an unexpected source in the battle against drug-resistant bacteria: fish slime.

The researchers said that microbes in the protective mucus that coats young fish holds promise in fighting multidrug-resistant bacteria. These include the so-called “superbug” microbes that cause methicillin-resistant Staphylococcus aureus (MRSA) infections.

New compound worth exploring

The slime protects fish from bacteria, fungi and viruses, trapping them before they can cause infections. It is also rich in compounds known to have antibacterial activity, the study authors said.

The study was presented at the American Chemical Society’s (ACS) meeting, in Orlando, Florida. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

“For us, any microbe in the marine environment that could provide a new compound is worth exploring,” principal investigator Sandra Loesgen said in an ACS news release. Loesgen is an assistant professor of chemistry at Oregon State University, in Corvallis.

Molly Austin, an undergraduate chemistry student in Loesgen’s laboratory, said that the mucus is fascinating because the environment in which fish live is complex.

“They are in contact with their environment all the time with many pathogenic viruses,” Austin explained.

The researchers are trying to determine if anything in the fish mucus could help protect people.

Reducing antibiotic use

The slime the investigators are studying is from juvenile deep-sea and surface-dwelling fish caught off the Southern California coast. Young fish have a weaker immune system than adult fish, so they have more protective mucus on their scales. And their mucus could contain a greater concentration of active bacteria than that from adult fish, the researchers added.

So far, the research team has identified 47 different strains of bacteria from the slime. Five bacterial extracts strongly inhibited MRSA, and three inhibited Candida albicans, a fungus that causes infections of the mouth, throat and vagina in people.

A type of bacteria from mucus on a particular Pacific pink perch showed strong activity against MRSA and against a colon cancer cell line, the scientists reported.

Along with the potential for new antibiotics for people, this project could pave the way for drugs that target microbes on certain types of fish, thereby reducing antibiotic use in fish farming, the study authors suggested.

^{Image credit: iStock}

Tiny needles and an electric current may be all surgeons need to quickly reshape a nose, say researchers.

Some women have been left in permanent pain – unable to walk, work or have sex – after having the implants.