Department of Anatomy & Reproductive Biology
==============================================================
If you are a T already or
considering transitioning either from male to female (M2F) or female to male
(F2M) would you please help in our research.
We are trying to determine some of the features that dispose or inhibit
persons from transitioning.
This is an anonymous survey. Participation is voluntary and
you will not be identified in any way. Your name or other identification is not
needed. The survey contains 20 questions
and should only take about 10 minutes or so.
The survey is attached and can be
mailed to us via e-mail or a copy can be sent via snail mail to the address
given.
Your cooperation in providing this
information is appreciated. The more you tell us, the more accurate can be our
interpretation of our results.
Please return this information for
scientific research to Dr. Milton Diamond of the
You can contact me at any of the
numbers or addresses above. If you have any questions about the project or your
rights as a participant you can contact the
Thanks again, for your help and
cooperation.
Mahalo for your kokua!
Aloha,
Milton Diamond,
Ph.D. Professor
BODY & MIND______BODY-T
This
is an anonymous survey. Your name or other identification is not needed. Your
cooperation in providing this information is appreciated. Please return this
information for scientific research, via email or snail mail, to
Dr.
Milton Diamond of the
Please answer all 20 questions to
the best of your ability.
1. Today's Date: ___________ 1.1. Citizen of which Country _________________
2. Date of birth: ________________ 2.1. Your age ______ years
2.2.
Single _____ Married _____ Divorced _____ Unmar/Live w/Partner _____
3. Ethnicity/race:
In the next question our aim is to
get an idea of the type of body category you possess. Some groups are taller/shorter than others or
heavier/lighter and so on.
Please be as informative and helpful
as you can.
a. Mother's ethnicity?
__________________________________________________
b. Father's ethnicity?
__________________________________________________
c. How do you see your own
ethnicity? ___________________________________
4. Sex at birth: Male _____ Female
______
4a. If Intersex, which condition?
_____________________________________
5. How were you raised? as a boy ________ as a girl ________
6. In what year did you change to
live in the gender you do now? _______
Didn't change _____
7. Height now: (as accurate as
possible) ___________ (inches / cms)
8. Weight now: (as accurate as
possible) ___________ (pounds and ounces)
9. Did your height and weight change
since you changed gender? _____
Didn't change _____ If so how ___________________________________
_________________________________________________________________________
10. Gender identity [Please choose
the best single description for yourself]
a. Transsexual (M2F): pre-op _____
post-op _____ non-op _____
b. Transsexual (F2M): pre-op _____
post-op (what?) ____________non-op _____
c. Transgender: _______
i. male with many
feminine traits and behaviors __________
ii female with
many masculine traits and behaviors __________
d. Cross dressing male (male who
enjoys wearing women's clothes) ___________
e. Cross dressing female (female who
enjoys wearing men's clothes) __________
f. Other: Describe
____________________________________________________
_________________________________________________________________________
11. At what age did you first felt
committed to your gender identity? _______
a. Comment:
_______________________________________________________
12. If you transitioned, what most
convinced you to change? If didn’t change, what stopped you?_____________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
13. Handedness: With which hand do
you do the following?
a. For writing: Right _____ Left
____ _ Either/both _____
b. For throwing a ball: Right _____
Left ____ _ Either/both ____
c. For eating: Right _____ Left ____
_ Either/both ____.
Please
continue on next page. Thank you.
BODY & MIND______BODY-T
14. Sexual preference: (from the
list below please select the category/ies
that best describes you; In your
actual current experience.
a. All sexual partners are male
_______
b. Almost all sexual partners are
male but a few are female _______
c. Majority of sexual partners is
male but many are female _______
d. My sexual partners are about
equally male and female _______
e. Majority of sexual partners is
female but more many are male _______
f. Almost all sexual partners are
female but a few are male _______
g. All sexual partners are female.
_______
h. The response above represents a
major change from pre-transition activity _____
i. Have ___ have not _____ been
sexually active since transition.
15. Sexual preference: (from the
list below please select the category
that best describes you; In your
fantasies.
a. All sexual partners are male
_______
b. Almost all sexual partners are
male but a few are female _______
c. Majority of sexual partners is
male but many are female _______
d. My sexual partners are about
equally male and female _______
e. Majority of sexual partners is
female but many are male _______
f. Almost all sexual partners are
female but a few are male _______
g. All sexual partners are female.
_______
16. Do you think your height or
weight influenced you in any way in your decision to shift to your new
gender? Or is it preventing you from
transition? Please comment:
_______________________________________________________________________
________________________________________________________________________
________________________________________________________________________
17.
Do you think your choice in sexual partners influenced you in any way in your
decision to shift to your new gender? _____Or is it preventing you from
transition? _____
Please comment:
________________________________________________________
________________________________________________________________________
________________________________________________________________________
18. On the scale below, please
estimate (circle) how well you "pass" in your own estimation.
Never Pass
Always Pass
0 10 20
30 40 50 60 70
80 90 100%
19. On the scale below, please
estimate (circle) how well you "pass" in other people's estimation.
Never Pass Always Pass
0 10 20
30 40 50 60 70
80 90 100%
20. Do you think your ability to
pass influenced you in any way in your decision to shift to your new gender?
_____ Do you think it inhibits your shift?
_____ Please comment: _______________________________________________________________________
________________________________________________________________________
________________________________________________________________________
V/I
2.1
Pleased
email copy to <diamond@hawaii.edu> or snail mail to
Dr.
M. Diamond,