SEX SURVEY

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* 1. I am sexually attracted to

Men

Women

Both

Neither

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* 2. My racial /ethnic identity is..? (Select all that apply.)

African-American/Black

East Asian

Hispanic/Latinx

Middle Eastern

American Indian/Alaskan Native

Pacific Islander

South Asian

Southeast Asian

White

Other (please specify)

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* 3. My current age is..

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* 4. I have never liked sex

True

False

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* 5. I no longer have sexual thoughts, dreams or fantasies.

True

False

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* 6. My interest in sex is increasing.

True

False

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* 7. My sexual partner has sexual problems.

Yes

No

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* 8. I don't have a sexual partner.

True

False

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* 9. I enjoy and engage in regular sexual self pleasuring.

Yes

No

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* 10. I am a breast cancer survivor.

Yes

No