I am invited to participate in research, on how the social and political climates, of a particular country, will influence the mental health of the LGBT community. This investigation is the Clinical Research Project equivalent to a Doctorate Dissertation in Clinical Psychology, affiliated with the Illinois School of Professional Psychology, Argosy University, Chicago.
I am invited to participate because I identify myself as an LGBT individual, I am older than 18, and I have been a resident in the U.S.A. for the past five years.
The purpose of this current research is to discover how residency in a particular country, will influence the level of discrimination, of the LGBT citizen, and how this residency influences psychological difficulties amongst LGBT individuals.
All the participants are asked to answer on-line questions which will include some demographics. The participation in this research will take approximately 20 minutes. Risks associated with the participation are minimal. This research excludes all risks except for the possible stress reaction connected with questions about sexual orientation and negative experiences related to discrimination. It is possible that I will find some questions uncomfortable. In the case of stress and other negative symptoms, I am encouraged to contact the Behavioral Health line of the Center on Halsted 773-472-6469, Ext. 460, or e-mail
Participation in this research will allow me to think of my previous social experience that influenced my LGBT identity. My participation will help to understand how negative social and political factors affect the lives of lesbians, gay men, bisexuals, and transgender individuals in whose countries, where hostile attitudes toward them dominate. This knowledge may lead to a positive change in the views of society on LGBT issues.
The current research contains demographic questions. These questions do not include personal data such as name, place of work, address, etc. This research is completely anonymous. All data received during this research will be kept confidential. Only the Primal Investigator Inna Fatkins will have access to data. No personal information will be included in publications.
I have the right inquiry the results of this research. I am aware that my participation in this research is strictly voluntary. My participation will not affect my relationships, if any, with the Center on Halsted. If I decide to participate in this research, I have the right, not to answer uncomfortable questions. I may withdraw from answering the questions without any consequences, and I understand my unfinished questionnaire will not be included in the research.
I may contact Inna Fatkins if I have any questions about this research: 330-319-5045, email@example.com.
I understand that this research has the approval, of the Institutional Research Board of the Illinois School of Professional Psychology, Argosy University, Chicago. I can contact the Head of the Institutional Research Board Dr. Leah Horvath if I have any questions related to current research or the rights of the participants. Dr. Leah Horvath, 312-777-7681, firstname.lastname@example.org
I have read and understood the description of the research. I received the answers to my questions and agreed to participate.
I have a right to obtain a copy of this agreement.
Choosing "I agree" below I give my agreement to participate in this research.
Illinois School of Professional Psychology
Argosy University, Chicago