Section Topic Area | Specific Content |
---|---|
Socio-demographics | Age; Race/Ethnicity; Education; Employment status; Income; Relationship status; Children; Housing stability; Zip code; Cross streets |
Transgender History & Gender Affirmation | Sex assigned at birth; Gender identity; Pronouns; Childhood gender behavior/feelings; Ages of transgender first awareness, gender affirmation, disclosure; Legal gender affirmation status (i.e., legal documents); Internalized stigma; Physical gender affirmation status (i.e., binding, testosterone, surgery); Access to gender-affirming care |
General Healthcare Access (for routine care not related to transition) | Insurance; Barriers to accessing care; Healthcare satisfaction; Healthcare avoidance; Experiences of discrimination in healthcare; Anticipated stigma in healthcare |
General Sexual Health | Age of menarche; Gender(s) of sexual partners (lifetime); Age at first intercourse; History of contraception, pregnancy, and childbirth; Parenting desires; Beliefs about cervical Pap tests; Pap testing history; HPV vaccine and testing history; HPV risk beliefs; HIV testing history; PrEP knowledge and use; STI testing, diagnosis, treatment, and partner notification history; Libido and sexual satisfaction; STI knowledge and beliefs; Anticipated acceptability of and comfort with self- and provider-collection methods |
Sexual Risk Activity | Sexual orientation; Gender(s) of sexual partners (past 36Â months); Unprotected sexual contact (past 36Â months); Partner-level sexual activity (3 most recent partners in past 12Â months) âž” Gender of partner; Relationship type; Sexual activities (e.g., oral-genital performed/received, receptive and/or insertive vaginal or anal sex) and barrier use frequency; Partner HIV/STI status |
Trauma, Victimization & Resilience | Childhood abuse/trauma (prior to 18Â years of age); Adult abuse/trauma; Intimate Partner Violence (lifetime and past 12Â months); Victimization and attribution; Physical symptoms due to victimization; Stress recovery/Resilience; Social support |
Mental Health & Substance Use | Mental health treatment (lifetime and current); Depression (CESD-10); Anxiety (BSI-18); Self- and community-acceptance; Suicide attempts (lifetime and past 12Â months); Non-lethal self-injury (lifetime and past 12Â months); Alcohol, tobacco, and other drug use (past 6Â months) |
Other | Cancer history (self and family); BMI; Weight description; Weight management; Body consciousness; Nutrition; Exercise |