University of Hawai`i-Manoa

John A. Burns School of Medicine

Department of Anatomy & Reproductive Biology

Pacific Center for Sex & Society

1951 East-West Road, Honolulu, Hawai`i 96822 USA

==============================================================

 

PLEASE HELP

 

BODY & MIND_____ (BODY-T)

 

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 University of Hawaii, School of Medicine, 1951 East-West Road, Honolulu, HI 96822, or via the internet to <diamond@hawaii.edu>.

 

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 University of Hawaii Committee on Human Subjects at (808) 956-5007 or on the Internet at <UHIRB@hawaii.edu>.

 

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 University of Hawaii, School of Medicine.

1951 East-West Road, Honolulu, HI 96822. (808) 956-7400, diamond@hawaii.edu

 

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 didnít 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: _______________________________________________________________________

________________________________________________________________________

________________________________________________________________________

 

Many Thanks for Your Cooperation!!!

V/I 2.1

 

Pleased email copy to <diamond@hawaii.edu> †† or snail mail to

Dr. M. Diamond, Univ. of Hawaii, 1951 East-West Road, Honolulu, Hawaii96822USA