Informed Consent Statement

I state that I am over 18 years of age, in good physical and mental health, and wish to participate in the research being conducted by the Maryland Commission for LGBTQIA+ Affairs in partnership with the University of Maryland Eastern Shore. Protocol #09-2025-007

The purpose of this project is to explore the perceptions and experiences of LGBTQIA+ individuals living in Maryland and participants are being asked to complete a brief questionnaire in order to share your opinions.
• You can take this survey or not. Participation is your choice.
• The purpose of this study is to understand the characteristics and experiences of
· LGBTQIA+ people living in the State of Maryland so that state officials can create informed policies.
• To participate in this study, you will need to complete an online questionnaire, which
· should take you about 15-20 minutes.-
• Some questions in the study may make you feel uncomfortable to answer. You don’t have to answer any questions you don’t want to answer.
· Sharing your information can help the Maryland Commission for LGBTQIA+ Affairs and the state government better understand the experiences of our community.

Survey participation is anonymous. You will not be asked any identifying information nor will your email or IP address be collected.

No compensation will be provided. There are no significant direct or indirect risks or benefits to participation.

We will ask you a number of questions about your identity in this survey. Responding to these questions is optional.

I understand that I can ask questions at any time during my participation and that I can withdraw from the study at any time without penalty.

In the event of upset or injury resulting from participation in this is study, I understand that immediate medical treatment is available at my nearest hospital. However, I understand that the University of Maryland Eastern Shore does not provide any medical or hospitalization insurance coverage for participants in the research study nor will the University of Maryland Eastern Shore provide any compensation for any injury sustained as a result of participation in this research study except as required by law. If any questions in this survey have prompted negative thoughts, such as thoughts of self-harm, please reach out immediately to the following free support line: 988 Suicide & Crisis Lifeline: Call or text 988 – available 24/7/365. The Veterans Crisis Line can be reached by dialing 988 then Press 1, or by text via 838255. The Trevor Project can be reached at (866) 488-7386 or via text at 678678 and is the leading national organization providing crisis intervention and suicide prevention services to LGBTQIA+ young people ages 13-24. The Trans Lifeline has specially trained operators available at 1-877-565-8860. Sage Lifeline for older LGBTQ+ adults is available 24/7 in English and Spanish at 1-877-360-LGBT (1-877-360-5428). The Gay, Lesbian, Bisexual and Transgender National Hotline: can be reached at (888) 843-4564.

You are making a decision whether or not you will participate in this study. If you click yes to this consent form, you are agreeing to participate based on your reading and understanding of this form. If you have questions regarding the study, please speak with Dr Nicole Hollywood the principal investigator, who can be reached at 917-854-7408 or nahollywood@umes.edu If you have questions regarding your rights as a research subject, please contact the Chair of the Institutional Review Board at the University of Maryland Eastern Shore, Dr. Jennifer Bobenko by calling 443-614-9226 (cell) or via email at JCBobenko@gmail.com

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* 1. I consent to continue

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* 2. Are you 18 years old or older?

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* 3. Do you live in/reside in the State of Maryland?

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* 4. Are you an LGBTQIA+ person (lesbian, gay, bisexual, transgender, queer, Two-Spirit, asexual, intersex, agender, or a related identity)?

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* 5. What is your age?

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* 6. To what extent do you feel connected to an LGBTQIA+ community (or communities) in MD?

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* 7. Which best describes how available LGBTQIA+ resources are to you in MD (for example, LGBTQIA+ centers, support groups, social groups)?

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* 8. Have you changed or attempted to change any of the following while living in MD? Select all that apply

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* 9. If you answered that you changed or attempted to change your birth certificate at Q8, how was your experience changing the sex or gender on your Maryland birth certificate?

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* 10. If you answered that you changed or attempted to change your Maryland driver’s license, state identification card, or learner's permit at Q8, how was your experience?

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* 11. If you answered that you changed or attempted to change your legal name at Q8, how was your experience changing your legal name through the Maryland court system?

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* 12. How familiar are you with the state policies and legal protections for LGBTQIA+ Marylanders?

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* 13. Would you like to learn more about state policies and legal protections that impact LGBTQIA+ Marylanders?

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* 14. The following questions are about your use of medical care.

Please select any of the following forms of medical care that you have used in MD.

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* 15. If you selected gender-affirming medical care at Q14, which gender-affirming medical care did you access? Select all that apply

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* 16. Have you ever faced an obstacle or delay in receiving health care in Maryland

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* 17. Please select any types of medical care that you have tried to use but have been unable to access while living in MD Select all that apply

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* 18. Which of the following best describes your primary health insurance coverage? Select all that apply

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* 19. While living in MD, have you encountered barriers to obtaining insurance coverage for gender-affirming treatment?

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* 20. Do you tend to avoid obtaining medical care because you expect to experience discrimination (that is, unfair or prejudicial treatment) in medical settings?

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* 21. Do you feel that you have experienced discrimination in a medical setting in MD based on any of your identities or characteristics listed below? Select all that apply

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* 22. These are questions about suicidal thoughts and behaviors. Talking about suicidal thoughts or behaviors sometimes brings up difficult emotions. If you experience any difficult emotions because of these questions we encourage you to get help from someone you trust or call one of the anonymous helplines listed at the bottom of this section.

At any time in the past 12 months, did you seriously think about trying to kill yourself?

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* 23. During the past 12 months, did you try to kill yourself?

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* 24. At any time in your life, have you seriously thought about trying to kill yourself?

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* 25. At any time in your life, did you try to kill yourself?

If any questions in this survey have prompted negative thoughts, such as thoughts of self-harm, please reach out immediately to the following free support line: 988 Suicide & Crisis Lifeline: Call or text 988 – available 24/7/365. The Veterans Crisis Line can be reached by dialing 988 then Press 1, or by text via 838255. The Trevor Project can be reached at (866) 488-7386 or via text at 678678 and is the leading national organization providing crisis intervention and suicide prevention services to LGBTQIA+ young people ages 13-24. The Trans Lifeline has specially trained operators available at 1-877-565-8860. Sage Lifeline for older LGBTQ+ adults is available 24/7 in English and Spanish at 1-877-360-LGBT (1-877-360-5428). The Gay, Lesbian, Bisexual and Transgender National Hotline: can be reached at (888) 843-4564.

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* 26. How safe do you feel as an LGBTQIA+ person in the state of Maryland?

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* 27. In general, how would you rate your overall mental or emotional health?

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* 28. While living in MD, have you ever been a target of a hate crime (that is, one that is motivated by bias toward a characteristic or identity of a person)?

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* 29. Please select any of the following hate crimes you have experienced while living in MD, regardless of whether you reported the crime or not. Please select all that apply

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* 30. The following questions are about different dimensions of your identity

What best describes your sexual orientation?

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* 31. What best describes your gender identity?

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* 32. Some people are born with variations in sex anatomy, reproductive organs, chromosomes, and/or hormone function. These variations may be known as variations in sex characteristics, differences in sex development, intersex traits, or sometimes by specific medical terms (e.g., Klinefelter Syndrome). To the best of your knowledge, do any of these differences apply to you?

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* 33. Thinking about your LGBTQIA+ identity, are you out (or open about your LGBTQIA+ identity) to all, most, some, or none of the following

  All Most Some None Not applicable
Immediate family members (parents/guardians, siblings)
Extended family members (aunts, uncles, cousins)
Friends
People at your work or school (coworkers, supervisors, classmates, instructors)
Faith community
Neighbors

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* 34. Do you live with a disability?

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* 35. What is the highest level of education you have completed?

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* 36. Have you ever served in the United States military?

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* 37. Which race/ethnicity best describes you? Please check all that apply:

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* 38. Are you an enrolled member of a Native American nation or tribe

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* 39. Do you identify with any of the following religions? (Please select all that apply.)

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* 40. Which of the following categories best describes your employment status?

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* 41. Do you feel that you have experienced discrimination (that is, unfair or prejudicial treatment) in the workplace in MD based on any of your identities or characteristics listed below? Select all that apply.

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* 42. Is English the primary language in your home?

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* 43. The following questions are about your individual and household income.

Which best describes your gross annual individual income (that is, the income
you personally earn in one year before deductions for taxes, benefits, etc)? Please include income from all sources (for example, child support)

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* 44. Which best describes your gross annual household income (that is, the income
your household earns in one year before deductions for taxes, benefits, etc – for example, your income plus your spouse’s income)? Please include income from all sources (for example, child support).

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* 45. Do you believe your LGBTQIA+ identity has affected your career advancement
opportunities?

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* 46. Which best describes your current primary housing? Select all that apply.

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* 47. Have you ever experienced homelessness?

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* 48. Are you a parent?

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* 49. Are there any children currently living in your home?

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* 50. Which of the following best describes your current relationship status?

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* 51. In what county do you live?

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* 52. Do you live in a rural area (that is, an area not immediately surrounding a city; a small town generally surrounded by open land)?

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* 53. How long have you lived in MD? Please report your total time living in MD.

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* 54. We would like to ask you about your immigration status. Your responses are completely anonymous and confidential and will help us understand the characteristics and needs of LGBTQIA+ people across MD.

Are you a citizen of the United States?

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* 55. How inclusive would you rank the community where you reside for LGBTQIA+ people

0 (extremely hostile and not inclusive) 10 (extremely inclusive)
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 56. Next, we would like to ask about your experiences with the criminal justice system. Your responses are completely anonymous and confidential and will help us understand the characteristics and needs of LGBTQIA+ people across MD.

Have you ever been incarcerated in Maryland (either found guilty of committing a crime and sentenced to time in prison or held in pretrial confirnment)?

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* 57. If you answered yes to the last question, did your LGBTQIA+ identity negatively affect your treatment by other incarcerated people or personnel? (If you have not been incarcerated please skip this question)

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* 58. If you have previously been incarcerated, did you have difficulty receiving health care that affirmed your LGBTQIA+ identity while incarcerated?

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* 59. Is there anything else you’d like to share with us about being LGBTQIA+ in MD?

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* 60. Would you like to be contacted if the researchers complete a follow-up study of LGBTQIA+ Marylanders?

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* 61. If you would like to be contacted, please provide us with your email address. Your email address will be stored separately from your responses.

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* 62. What is your favorite thing about living in Maryland?

T