Angelina Jolie has proven time and time again that she isn't afraid to talk about extremely personal health experiences in the interest of educating others, and opening up conversations about important issues that are not often widely discussed.
Most recently, the 44-year-old actress penned an essay for Time on Sunday for International Women's Day and revealed that two of the six kids she shares with ex-husband Brad Pitt, recently had surgery. While Jolie didn't mention any specific names in the article -- only referring to Zahara as her eldest daughter -- ET has learned that 15-year-old Zahara and 13-year-old Shiloh were the two kids who underwent surgery. Jolie and Pitt are also parents to 18-year-old Maddox, 16-year-old Pax as well as 11-year-old twins Knox and Vivienne.
"I have spent the last two months in and out of surgeries with my eldest daughter, and days ago watched her younger sister go under the knife for a hip surgery," Jolie writes. "They know that I am writing this, because I respect their privacy and we discussed it together and they encouraged me to write. They understand that going through medical challenges and fighting to survive and heal is something to be proud of."
Nobody understands this more than Jolie, who has faced her own serious health battles. Jolie stunned fans and fellow celebrities alike when she wrote an op-ed for The New York Times in April 2013, revealing that she underwent a preventive double mastectomy. She came to the decision after doctors told her that she carried a "faulty gene" that increases the chances of breast and ovarian cancer, with an estimated 87 percent risk of breast cancer and 50 percent risk of ovarian cancer.
Jolie has a painful personal history with the disease. Her mother, Marcheline Bertrand, died in 2007 after a years-long battle with ovarian and breast cancer when she was just 56 years old. Her grandmother and aunt also died from cancer.
"On April 27, I finished the three months of medical procedures that the mastectomies involved," she revealed in the NYT piece. "During that time I have been able to keep this private and to carry on with my work. But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people's hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action."
"I wanted to write this to tell other women that the decision to have a mastectomy was not easy," she continued. "But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.”
Jolie's candid op-ed drew plenty of praise from fellow celebs like Kristen Bell, Ann Curry and Mindy Kaling. She later acknowledged all the public support she received at her first public appearance since the piece was published -- her then-husband, Pitt's, World War Z premiere in June 2013.
"I feel wonderful, and I'm very grateful for all the support," the actress told reporters at the time. "It's meant a lot to me. I've been very happy to see the discussion about women's health expanded. That means the world to me, and after losing my mom to these issues, I'm very grateful for it."
Later, Pitt praised Jolie's bravery at the World War Z premiere in Australia.
"It's onwards and upwards... but I'm really touched," he told reporters at the time of Jolie's operation. "The whole thing's heroic to my mind. And how many people are also battling with the same decision and she's just a great example of that, it doesn't have to be a scary thing. You can take control of it."
In an interview with ET in October of that year, the surgeon who performed Jolie's reconstructive surgery, Dr. Jay Orringer, said the Oscar-winning actress was definitely making a difference by speaking out.
"She's a remarkable individual," he said. "She made the brave choice to want to help others."
"She's a ... truly benevolent individual [who] I think really cares about other people," he added. "It made women think, 'Well, maybe I should be gene tested.' We're already seeing women come in and say, 'That saved my life!'"
But Jolie wasn't done yet. In another op-ed for The New York Times in March 2015, she revealed she had her ovaries and fallopian tubes removed as another preventative measure against cancer, and that it would cause her to go into menopause.
"I had been planning this for some time," Jolie wrote of her ovarian excision. "It is a less complex surgery than the mastectomy, but its effects are more severe. It puts a woman into forced menopause."
"Last week, I had the procedure: a laparoscopic bilateral salpingo-oophorectomy," she continued. "There was a small benign tumor on one ovary, but no signs of cancer in any of the tissues. I feel feminine, and grounded in the choices I am making for myself and my family. I know my children will never have to say, 'Mom died of ovarian cancer.'"
She also stressed that her decision was not best for every woman facing higher cancer risks, and encouraged others to seek the best treatment for themselves.
"I have spoken to many doctors, surgeons and naturopaths. There are other options," Jolie explained. "Some women take birth control pills or rely on alternative medicines combined with frequent checks. There is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally."
In November 2015, Jolie wasn't afraid to talk about undergoing the premature onset of menopause.
"I actually love being in menopause," she told The Daily Telegraph. "I haven't had a terrible reaction to it, so I'm very fortunate. I feel older, and I feel settled being older."
"I feel happy that I've grown up," she added. "I don't want to be young again."
Of course, Jolie has also been remarkably open not just about her physical health, but about the mental health of her and her children -- specifically, after undergoing a tough split from 56-year-old Pitt. Jolie filed for divorce from Pitt unexpectedly in September 2016 and has been candid about the traumatic experience.
"We are focusing on the health of our family," Jolie said during an interview that aired on Good Morning America in February 2017 about life after her and Pitt's headline-making breakup. "So we will be stronger when we come out of this because that's what we're determined to do as a family."
In July 2017, Jolie gave a candid interview with Vanity Fair and said her kids were "brave" in dealing with their parents' split and still "healing." She also once again opened up about her health and revealed that in addition to hypertension, she developed Bell's palsy, a condition in which the muscles on one side of your face become weak, causing it to droop. She credited acupuncture for her full recovery.
"Sometimes women in families put themselves last, until it manifests itself in their own health," she said.
Jolie shared why she's been so willing to be open about her health issues when she served as a contributing editor for Time magazine's Health Innovation issue in October.
"I'm often asked how my medical choices, and being public about them, have affected me," Jolie wrote. "I simply feel I made choices to improve my odds of being here to see my children grow into adults, and of meeting my grandchildren. My hope is to give as many years as I can to their lives, and to be here for them."
"I have a patch for hormones, and I need to get regular health checkups," she also shared. "I see and feel changes in my body, but I don't mind. I'm alive, and for now I am managing all the different issues I inherited. I feel more connected to other women, and I often have deeply personal conversations with strangers about health and family."
Jolie shared that through her own personal experience, she realized that care is not just about medical treatments, but about the "safety, dignity and support afforded to women" -- whether they're battling cancer or just trying to manage stress -- and passionately advocated for women around the world.
"My mother seemed peaceful when she first knew she had cancer," she recalled. "I now see that in part it was because after many years of stress and struggle, people were forced to be gentle to her. During the highest years of stress in my own life, I developed high blood pressure and needed to be treated for hypertension."
"When we speak of women's equality, it is often in terms of rights withheld, that ought to be given to us collectively," she continued. "Increasingly I see it in terms of behavior that needs to stop. Stop turning a blind eye to the abuse of women. Stop blocking the ability of girls to get an education or access health care. Stop forcing them to marry a person you have chosen for them, especially when they are still children. Help young girls know their value. Help keep women you know safe. And before a woman is in the hospital, dying, and that reality is written on a diagnosis sheet, look into her eyes and consider the life she is living and how it might be with less stress."
A month later, Jolie once again acknowledged that on a personal level, she and her children have gone through some recent tough years in an interview with Harper's Bazaar.
"The part of us that is free, wild, open, curious can get shut down by life. By pain or by harm," she said. "My children know my true self, and they have helped me to find it again and to embrace it. They have been through a lot. I learn from their strength. As parents, we encourage our kids to embrace all that they are, and all that they know in their hearts to be right, and they look back at us and want the same for us."
"My body has been through a lot over the past decade, particularly the past four years, and I have both the visible and invisible scars to show for it," she continued. "The invisible ones are harder to wrestle with. Life takes many turns. Sometimes you get hurt, you see those you love in pain, and you can't be as free and open as your spirit desires. It's not new or old, but I do feel the blood returning to my body."
Most recently, Jolie's essay for Time magazine shed light on her daughters' reactions to their own health issues, once again, turning it into a conversation about the treatment of girls in society.
"I have watched my daughters care for one another," she shared. "My youngest daughter studied the nurses with her sister, and then assisted the next time. I saw how all my girls so easily stopped everything and put each other first, and felt the joy of being of service to those they love. Their brothers were there for them, supportive and sweet. But on this International Women's Day, writing from the hospital, I find myself focusing on my daughters for a moment, and all that I have learned from them and other young girls I have met around the world."
"Someone said to me, when they saw my daughters caring for each other, that 'it comes naturally to girls.' I smiled, but then I thought of how often that notion is abused," she continued. "The little girl is expected to take care of others. The woman she grows up to be will be expected to give, and care for, and sacrifice. Girls are often conditioned to think that they are good only when they serve others, and selfish or wrong if ever they focus on their own needs and desires. Little girls' softness, their openness and instinct to nurture and help others, must be appreciated and not abused. We must do much more to protect them, in all societies: not only against the extreme ways girls' rights are often violated, but also the more subtle injustices and attitudes that so often go unnoticed or excused."
Meanwhile, a source told ET on Monday that Pitt did not attend the 2020 EE British Academy Film Awards last month because he was by his daughter, Zahara's, side as she recovered from surgery. Pitt -- who dedicated his recent Oscar win to his children -- has also been candid about above all, caring for the well-being of his children.
"People on their deathbeds don't talk about what they obtained or were awarded. They talk about their loved ones or their regrets," he told GQ Style in May 2017. "I say that as someone who's let the work take me away."
"Kids are so delicate," he continued. "They absorb everything. They need to have their hand held and things explained. They need to be listened to. When I get in that busy work mode, I'm not hearing. I want to be better at that. I grew up with a father-knows-best/war mentality -- the father is all-powerful, super strong -- instead of really knowing the man and his own self-doubt and struggles. And it's hit me smack in the face with our divorce: I gotta be more. I gotta be more for them. I have to show them. And I haven't been great at it."
For more on the ups and downs of Pitt and Jolie's relationship through the last decade, watch the video below: