• We Out Here!

    Developing a snapshot of Black Trans Masculine people's geographical, environmental, and socio-political conditions. First 500 participants will receive $25 gift card  via email with in 30 days.
  • What is your age range?*
  • What is your highest level of education?*
  • Are you a veteran or active duty for the US military?*
  • What is your ethnicity?*
  • What is your gender identity?*
  • What is your sexual orientation?*

  • Health and Wellness

  • What kind of medical care do you currently access? Select all that apply*
  • How often do you receive medical care?*
  • Where and how do you access health care tools? Add names of where people access (non profit orgs, public sexual health clinics*
  • Do you know the patient’s bill of rights for your state?*
  • The currently political climate has had an impact on my (check options)*

  • Reproductive Health

  • Do you have access to birth control options?*
  • Do you have access to abortion/emergency birth termination services?*
  • Do you have access to the type of reproductive services you need for your growing family?*
  • Which type of reproductive services would you like to have access to? Check all that apply*
  • If you should decide to carry a child do you have the support of family or community?*

  • Safety

  • Food

  • Which of the following types of produce do you have access to? Check all that apply*
  • What type of food stores do you have within 2 miles of your current residence? Check all that apply*
  • Have you experienced food insecurities within the past 6 months?’*
  • Do you have access to a local pantry?*
  • How do you store your food? Check all that apply*
  • Do you have access to spaces to grow food?*
  • If yes, which spaces?  Check all that apply*
  • Are you interested in learning about farming, storing foods, etc?*
  • What is your employment status? - freelancer, gig work, self employed*
  • My individual annual income is - below 10k before or after after taxes*
  • Is  your current income enough to meet your basic needs?*
  • Do you have access to resources (monetary, informative) about higher education, training, and or professional development opportunities?*

  • Social Connections

  • I feel connected to the Black community. (pick one)*
  • Are you currently in an intimate partner relationship (e.g., couple, partner, etc.)? Check all that apply*
  • Is the family that raised you affirming of your sexual orientation?*
  • Is the family that raised you affirming of your gender identity?*
  • Are you a member of a chosen family? *chosen family defined as a family outside of family that is of blood relation (examples: adoption, ballroom house, etc.)*
  • Are you a parent?*
  • Are you a caregiver?*
  • Who are you a caregiver for? check all that apply*
  • Should be Empty: