1. Introduction and Informed Consent

Thank you for agreeing to participate in this study on psychological and physical health among LGBT individuals. You will be asked to answer questions about a wide range of topics, including your mood, coping strategies, and experiences as an LGBT individual. Please try to answer every question honestly. If a question or answer does not pertain to you, please try to answer the question as if you were in that situation or it does pertain to you. Please read the informed consent message below, which describes the study and provides information about your rights as a participant.

This Informed Consent will explain about being a participant in a research study. Please read this material carefully and then decide if you wish to be a volunteer.

PURPOSE:  The purpose of this study is to better understand the psychological and physical health among LGBT individuals in the United States.

PROCEDURE and DURATION: You will be asked to complete an online survey of about 200 questions which will take approximately 30-45 minutes of your time.   Your survey results are confidential. There will be no way to identify you or your answers on the survey.

ALTERNATIVE PROCEDURES: There are no alternative procedures; however, you may choose not to participate in the study.

VOLUNTARY PARTICIPATION: Participation in this research experiment is voluntary.  You may refuse to participate.  You can stop the survey at any time. 

POSSIBLE RISKS/DISCOMFORTS: If you should feel uncomfortable or distressed after completion of this survey, please contact Dr. Hirsch [(423) 439-4463; hirsch@etsu.edu]. In addition, please see the attached community resources available for mental health assessment and treatment.

POSSIBLE BENEFITS: Some people may gain satisfaction by completing surveys that offer some personal insight. Results may provide a better understanding of the physical and mental health issues and concerns of LGBT individuals, with implications for the development of targeted interventions to improve well-being.

FINANCIAL COSTS: There are no costs to you as a participant in this research study, other than your time to complete the survey.  

CONTACT FOR QUESTIONS: If you have questions about this research project, you may call Dr. Hirsch at (423) 439-4463 or Andrea Kaniuka by email at kaniuka@goldmail.etsu.edu.  You may call the Chairman of the Institutional Review Board at (423) 439-6054 for any questions you may have about your rights as a research subject.  If you have any questions or concerns about the research and want to talk to someone independent of the research team or you can’t reach the study staff, you may call an IRB Coordinator at (423) 439-6055 or (423) 439-6002.

CONFIDENTIALITY: Every attempt will be made to see that your study results are kept confidential.  A copy of the records from this study will be stored in Dr. Hirsch’s office in the Department of Psychology, for at least 6 years after the end of this research.  The results of this study may be published and/or presented in group data format at meetings without naming you as a participant.  


Suicide Prevention Lifeline
1(800) 273-TALK (8255)

Help Finding a Therapist
1-800-THERAPIST (1-800-843-7274)

Mental Health America
Website: http://www.mentalhealthamerica.net

Mental Health InfoSource
(800) 447-4474

National Institute of Mental Health
(800) 421-4211

National Alliance on Mental Illness Helpline
(800) 950-NAMI

Question Title

* 1. Check this box to acknowledge that you are 1) at least 18 years of age; and, 2) have read and understand what will occur during your participation.