Transgender and Gender Nonconforming Needs Assessment

Please complete the survey below. It will be completely annonymous and help us better understand your needs as a transgender or gender nonconforming individual and thus work to address them. Additionally, we aim to use the collected information to build an accessible and thorough network of resources for members of the transgender and gender nonconforming communities

If you fully complete the survey you will have the opportunity to enter into a drawing for one of ten $50 Visa Gift Cards!

It will take 15-20 minutes and must be done in one sitting, so please make sure you have appropriate time or you will have to start over.

Thank you!

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INFORMATION SHEET
NEEDS ASSESSMENT OF THE TRANSGENDER AND GENDER NONCONFORMING COMMUNITY IN WESTERN NEW YORK
Principal Investigator: John P. Cullen, PhD

This form describes a research study that is being conducted by Dr. John Cullen of the University of Rochester, Susan B. Anthony Center. The purpose of this study is to identify the issues facing the transgender and gender nonconforming population of Western New York so that their needs can be better understood and addressed. In order to do this, we are conducting an online needs assessment survey of the transgender and gender nonconforming community in Western New York.

If you decide to take part in this study, you will be asked to complete 1 survey that will take about 15-20 minutes to complete. The survey will ask questions about your needs and experiences as a transgender or gender nonconforming individual, specifically in terms of health care needs. We estimate that approximately 1,000 subjects will take part in this study. You will not be asked to enter any personal information by which you could be identified.

Risks to subjects include the following: Based on a subject's responses, the subject may discover the possibility that they have depression, have been victims of domestic violence, or show signs of substance abuse. Some of the survey questions may be upsetting or make you feel uncomfortable. You can skip any of the questions you do not want to answer. If you no longer wish to participate in the study you may exit the survey at any time. All of the information we collect will be stored in a secure manner and only study team members will have access to it. You will not be paid for participating in this study. Upon completion of the survey, you will be directed to a webpage that will display a list of local and national resources that may be helpful. On this webpage there will be a prompt asking if you wish to enter into a drawing to win one of ten $50 Visa gift cards (chances of winning estimated to be 1 in 100). If you choose to enter you will be redirected to a second site where you will enter your contact information. Survey data cannot be linked to contact information for the gift card drawing.

SUSAN B. ANTHONY CENTER TRANSLATING RESEARCH INTO POLICY
The University of Rochester makes every effort to keep the information collected from you private. In order to do so, we will utilize REDCap to disseminate the survey. REDCap is a secure, web-based application designed to support data capture for research studies.

Your participation in this study is completely voluntary. You are free not to participate or to withdraw at any time, for whatever reason. No matter what decision you make, there will be no penalty or loss of benefits to which you are otherwise entitled.

If you are a University of Rochester student participating in this study will not affect your class standing or grades at the University of Rochester.

You will not be offered or receive any special consideration if you take part in this research.
If you are a University of Rochester employee taking part in this research is not a part of your University duties, and refusing will not affect your job. You will not be offered or receive any special job-related consideration if you take part in this research.

For more information or questions about this research you may call Dr. John Cullen at (585) 273-5253. Please contact the University of Rochester Research Subjects Review Board at 265 Crittenden Blvd., CU 420628, Rochester, NY 14642, Telephone (585) 276-0005 or (877) 449-4441 for the following reasons:
 You wish to talk to someone other than the research staff about your rights as a research subject;
 To voice concerns about the research;
 To provide input concerning the research process;
 In the event the study staff could not be reached.

RSRB Case Number: 00067017 Date: 04/03/2017
This study has been approved by the IRB of the University of Rochester.

All of this information is attached as a pdf with the IRB watermark for your personal download.

Attachment:WNY Transgender Information Letter.pdf

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.