Why did the report omit the T in GLBT? “The short answer is that we didn’t have any data to report,” says Christopher Dyer, Director for the Mayor's Office of GLBT affairs. "[Trans-specific health] is a brand new field of research at the government level."

The District's transgender community has become a lot more visible in recent years. In 2005, the DC Trans Coalition formed to advocate for trans issues in the District; in 2007, Capital Trans Pride was added to the roster of the city's LGBT pride celebrations. But scientific data moves at a slower pace than public consciousness does.

The new LGB health report relies on data from the CDC's Behavioral Risk Factor Surveillance System (BRFSS), which tracks “health conditions and risk behaviors in the United States” via random phone surveys. The BRFSS surveys included in the LGB Health Report were completed in 2005 and 2007, when respondents' sexual orientation was on the CDC's radar—but gender identity wasn't. "There just weren’t questions asked about gender identity anywhere in the country in those years," Dyer says. “We need to add a question about gender identity."

In order to get transgender health data into upcoming BRFSS-based reports, Dyer says the CDC will first have to approve the gender identity question for the District survey. D.C. will have its next opportunity to request the question in January 2011. If it's approved, the random survey will then have to hit upon enough local transgender people for the results to be statistically significant. “The CDC has a requirement that you get 100 responses or more before you can do any kind of comparative analysis,” Dyer says. “There is no baseline data yet on the transgender population in this country, and it might take two to three years to get enough responses to even begin the analysis. It conceivably could be until 2013 or 2014.”

That's a long time to wait for accurate health information on the local transgender community, which often suffers from health disparities—like an increased risk for HIV. Yesterday, District trans activists took issue with the exclusion of trans data from the LGB report, and penned a letter to the Mayor's Office saying so. "[T]he goal of the report was to 'present data and prompt discussion' about how to improve the overall 'health outcomes in the GLBT community living in the District of Columbia,'" the DC Trans Coalition wrote in a press release. So DCTC was "alarmed" by "the report’s very obvious omission of existing research on D.C. trans communities."

The press release faulted the Mayor's Office for failing to look past the BRFSS-specific data to include information from other surveys that do include trans residents—like the District's 2009 Youth Risk Behavior Survey and its 2000 Washington Transgender Needs Assessment Survey. Since the results of the 2009 YRBS haven't yet been released, the ten-year-old Needs Assessment Survey provides the latest publicly-available data on the community. But according to the DCTC, "Acknowledging that the existing survey tools only provide a partial snapshot of the current health of local transgender communities in the report would have added much needed transparency."

The DCTC asked the Mayor's Office to wrangle up funding for a new comprehensive transgender needs assessment to supplement the 2000 report, to draw up a trans health report based on data available now, to add questions that include gender identity to all survey tools, and to show a "commitment to true inclusion." Dyer says he’s currently “exploring other options” for gathering transgender data that works with the population’s small sample size. "I'm personally committed to including transgender health data and making the report as good as possible," says Dyer. “When we do produce the transgender report, we want to make sure it’s the best data possible.”

This week, the District Mayor's Office of GLBT Affairs released the "LGB Health 2010 Report," an examination of everything from smoking habits to sexual behavior in the gay community. This is the District's first report to address the health of lesbians, gays, and bisexuals in the District. But as the report's title makes clear, the transgender community has yet again been excluded from the official conversation on health. Also underrepresented here: African-American men and women under the LGB umbrella.

The methodology of the [study] itself raises questions about the reliability of the data and how it represents the true health of the LGB community, as reflected by the limited number of responses from African American LGBT people. The survey's findings rely on an identity-based rather than a behavioral questionnaire, which may exclude men who have sex with other men (MSM) but do not identify as gay.

And, as always: "the absence of information on transgender health underscores the pressing need for better data on the transgender community in the District," the DC Center writes.

Last week on the Sexist, we payed tribute to the wedding industry's focus on women's "health," as evidenced through its tireless "BIG DAY" diet promotions, its images of women squeezing into too-small white dresses, and its total obsession with brides, not grooms. Commenters weighed in (GET IT?):

Shinobi on what wedding "health" looks like:

I remember one time a friend of mine was eating nothing but special K for two weeks before her wedding. (to fit into her dress, which she had purchased while on weight watchers.) Our conversations were pretty much limited to what she had eaten for the last two days, oh yeah, super interesting. When I failed to be particularly supportive she was all “Don’t you want me to be HEALTHY!?!?!?!?!”

And so I realized the error of my ways. The true road to health is crash dieting to fit into dresses.

Jess on the very healthy double standards of wedding "health":

I am getting married in October, and I cannot believe the amount of pressure I am getting from family and coworkers about my weight. I am a lifetime member of Weight Watchers, having met my goal a long time ago. I am a healthy weight for my height (5′9, 150lbs) and my wedding dress is a size 8. But all my coworkers and some annoying family members are telling me that I really should “tone up” or take off about 10 more lbs. Why? Why am I supposed to starve myself for a freaking wedding?! Not a chance!

Oh, and my fiance is about 25lbs overweight. No one has said a word to him about his weight and the wedding.

juicepockets on the beautiful moments that a focus on wedding "health" inspires between family members:

I was a fat bride three years ago (am still fat), and the amount of guff I got from my mom about it was alternately infuriating and heartbreaking. At one of my dress fittings, my mom looked at my reflection in the mirror and said sadly, “Your arms are so big.” Oh well, I wore the shit out of my sleeveless dress anyway!If you want an antitode to the People piece, take a look at the Museum of Fat Love.

Lesley of Fatshionista.com created the site to document ACTUAL EVIDENCE that fatties can and do find love and even sometimes GET MARRIED WHILE FAT. The gallery is full of adorable fatties in love.

PD on the media's helpful focus on wedding "health":

I was a fat bride two years ago. I’ve gotten fatter since—the back of my dress kept popping open because I’d put on a few pounds right before the wedding, and my husband shed blood trying to pin me back into it. Frankly, I think I looked great on my wedding day, probably better than I ever have in my life including my high school days, when I was definitely at my most fit.

No one who knows me personally—besides my mother, who does it all the time—suggested I try to lose weight in the two years I spent planning my wedding. I was, however, inundated with weight loss advice from the numerous wedding-related magazines and web sites I immersed myself in. Everywhere I looked I saw ads for “GET FIT FOR THE BIG DAY” schemes, and everyone on the internet was really, really invested, apparently, in making sure I was as trim and toned as possible before walking down the aisle. HOW DARE I be fat on my wedding day, when EVERYONE IN THE WORLD would see those pictures FOREVER? How dare I look at those pictures and think about how happy everyone was and what a great time we all had and how great the man I married is instead of focusing on how flabby my arms looked that day?

Listen, I’m like 70 pounds overweight, I know this is not great and it’s not healthy. I’m down with that. I’m also down with my own body—the body my husband has loved for 10 years, from 150 pounds to 230 pounds—even if the rest of the world is not. The wedding weight loss thing is, like pretty much everything else related to weddings, a scam to make money and make women feel like they have to conform to a certain standard of what brides should look like. I’m pretty sure your “bridal white” yoga mat costs twice as much as a regular one because someone screen-printed some doves and “FUTURE MRS. ____” on it or something.

Photo via sylvar, Creative Commons Attribution License 2.0

Earlier this week, I engaged in some light mockery of a People Magazine contest encouraging brides-to-be to lose weight before their wedding days. But yesterday, some commenters pointed out why this is no joking matter: Did you know that these women are, like, fat? And you do know how unhealthy that is, right?

Holy shit, you guys, why didn't you say something earlier? People Magazine is doing women everywhere a public service by worrying so much about our health for us. And to think I almost dismissed this initiative out of hand! Let's take a closer look at this valuable asset that's been gifted to our gender.

Here's how the magazine describes this contest: "For the Next Nine Months, We're Following These Six Women as They Work with a Trainer and a Nutritionist to Get Smaller for Their Big Day." It is illustrated with a photograph of each woman grimacing as she struggles to fit into a dresses that is too small for her.

I'm sure by "smaller," People really means "healthier." And I'm sure by illustrating the piece with a photograph of each woman grimacing as she struggles to fit into a dresses that is too small for her, People really means for us to be seeing visions of crisp apples and unrolled yoga mats and shit. After all, as commenter Kit-Kat writes: "This is not about losing weight for purely aesthetic reasons. These women need to lose weight for health reasons." And they desperately need to do it juuuust before their wedding days, when everyone in their lives will be intently judging how unhealthy they are—in a totally non-aesthetic manner, of course. (As a special gift for their weddings, these loved ones will also conveniently ignore all the ways that diets like this are actually bad for you).

But don't take it from me: let's hear it straight from the dieters themselves:

* "Eager to 'be healthier,' Jones adds, 'I'd want to lose weight whether I was getting married or not.' But the thought of standing before 150 guests at the Biltmore Estate in Asheville, N.C., on her wedding day is 'an extra motivating factor,' she admits. 'I want to enjoy taking pictures—not running from the camera!'"

* "When Councell, 35, tried on wedding dresses for the first time, she was shocked to find out she was a size 16. 'I'll get married in a blanket before I buy a size-16 gown!' says the 5' bride."

* "Now she has a big reason to change her habits: When she exchanges vows with Head, 25, in October, 'I want my dress,' she says, 'to be very fitted.'"

* "Ever since she got engaged last October, one thought has consistently run through Quintero's head: Oh my gosh—I'm going to be a fat bride!"

* "When her high school sweetheart proposed in 2008, Cerrata, 26, was ecstatic—until she saw their engagement photos. 'I was like 'Put them away!' she says."

Well there you have it. This has absolutely nothing to do with appearance, and it certainly is completely unrelated to subtly shaming some women into believing that they are too fat to be loved, like, in public in front of everyone. That's why I'm excited for People to roll out the following health-related wedding promotions:

* People Magazine's Bride-to-Be Cholesterol Reduction Challenge: "I'll get married in a blanket before I get married with a high density lipoprotein level 50 mg/dL!' says the 5' bride."

* People Magazine's Bride-to-Be Wear Your Helmet Every Time You Ride Your Bike Challenge: "Now she has a big reason to change her habits: When she exchanges vows with Head, 25, in October, 'I want my helmet,' she says, 'to be very fitted.'"

* People Magazine's Bride-to-Be Regular Pap Smear Challenge: "When her high school sweetheart proposed in 2008, she was ecstatic—until she saw her irregular pap smear results. 'I was like 'Put them away!' she says."

* People Magazine's Bride-to-Be CPR Training Challenge: "Ever since she got engaged last October, one thought has consistently run through her head: Oh my gosh—I never learned CPR!"

* People Magazine's Bride-to-Be Social Anxiety Disorder Management Challenge: "I want to enjoy taking pictures—not running from the camera!'"

* People Magazine's Groom-to-be Weight Loss Challenge: Haha. JUST KIDDING.

The danger of swine flu in pregnant women has received a great deal of press attention recently. As concerns over the health of pregnant women rise, the abortion debate has slyly emerged as a a central influence in the dialogue.

Yesterday, the New York Times told the story of Aubrey Opdyke, a 27-year-old woman who was pregnant when she contracted swine flu last June. What began as mild symptoms of aches and fatigue turned into a harrowing four month ordeal. Writes reporter John McNeil:

In the four months she was hospitalized, she spent five weeks in a coma, suffered six collapsed lungs and a near-fatal seizure. High-pressure ventilation blew her up like a molten balloon until “she looked like she weighed 400 pounds,” her husband, Bryan, said, and she has stretch marks from her neck to her ankles. Her muscles and lungs are still so weak that she uses a walker.While hospitalized, she missed seeing her 4-year-old daughter, Hope, learn to swim and start pre-school.

And, most important, she lost her baby. Parker Christine Opdyke, almost 27 weeks in the womb, was delivered by emergency Caesarean section on July 18, when her fetal heart rate plummeted during Ms. Opdyke’s third lung collapse. Her airways were too blocked to let a breathing tube in, possibly a side effect of the drugs saving her mother. She lived seven minutes.

In McNeil's profile of Opdyke, losing the baby was "most important"—more traumatic than even falling into the coma, suffering a seizure, temporarily losing the ability to walk, talk, and see her family, and facing death. The trauma of losing a child in the womb is clearly central to Opdyke's experience. But it is still Opdyke's experience—the ordeal is hers, not her baby's. Compare that treatment to a previous profile of Opdyke, which ran in the Scripps Treasure Coast Newspapers. It's worth it to examine the entire lede:

The baby was beautiful, with tufts of long eyelashes—just like her mother.

But she didn’t cry.

Her heart stopped minutes after doctors delivered her from the belly of Aubrey Opdyke, who had swine flu and lay in a medically induced coma.

Aubrey never had the chance to see her.

So the baby’s grandmother, Joanne Felker of Stuart, readied tiny Parker Christine for photographs and a video.

She bathed her and held her.

“She looks like she’s just peaceful,” Felker said of the images, shot by the volunteer group Now I Lay Me Down to Sleep.

One of these days, the family will show the images to Aubrey.

They’ll fill in the blanks about the time she has spent in a coma at Wellington Regional Medical Center, battling a case of H1N1 influenza that took Parker’s life on July 18 — more than two months before she was supposed to be born.

This is a story about a fetus. Opdyke, who endured months of comas, collapsed lungs, and seizure in a fight to stay alive, is introduced in a prepositional phrase: "from the belly of." Joanne Felker is not Opdyke's mother; she is "the baby's grandmother." The loss of Parker Christine is mourned at length, but the fact that Opdyke herself was on the verge of death is never mentioned in the story. Tellingly, Opdyke was not even able to speak at the time this profile was written about her. Given her condition, it's doubtful she had a hand in authorizing the story at all:

Now that doctors have eased her off coma-inducing medication, Aubrey can blink in response to visitors.

She indicated that she recognized her husband, Bryan Opdyke, and can wiggle her toes.

The sources in the story are Opdyke's mother, her former co-workers, and her former Girl Scout troop leader. Opdyke's husband is not quoted in the story. That's too bad, because he provided an extremely interesting insight to the New York Times:

Mr. Opdyke was warned he might have to choose—her life or that of the baby, who was just at the border of survivability outside the womb.

“I said, ‘Save Aubrey,’ ” he said of the woman he married last year. “I can make another baby, but I can’t replace her.”

Her third lung collapse forced the issue. Parker had to be delivered, but she did not survive.

The Times addresses the issue head-on: Losing Parker was a tragedy for the Opdykes, but it may very well have saved a woman's life. Andrea Opdyke wasn't given many choices throughout her horrific ideal. At least, in the New York Times, she's afforded a voice in her own story.

Photo by flickr user Andres Rueda, Creative Commons 2.0

The District's HIV/AIDS Administration estimates the number of known infected D.C. residents at 15,120, a figure which brings D.C. to a rate "higher than West Africa." HIV/AIDS cases have increased 22 percent in the District since numbers were last released in 2006.

The true number of infected residents is probably substantially higher than that. The numbers only reflect those residents who have been tested for HIV, and the study reports that only three out of five people in D.C. are aware of their HIV status.

Increased testing may be partly responsible for the heightened numbers. Reports the Post: "More people are getting HIV diagnoses early, while they are still healthy, as a result of a policy of routine testing implemented by the city in mid-2006." Since then, "Publicly supported HIV testing expanded by 70 percent."

I'll have more on the numbers when the D.C. Department of Health releases its reports today.