Consent Form

Midwestern University

STUDY TITLE: Intimacy and Sexual Satisfaction in Same-Sex Couples and Transgender Individuals

RESEARCHERS: Kate L Jansen, Ph.D., Clinical Psychology and Gabrielle Price

We’re inviting you to participate in a research study. Participation is voluntary. If you agree to participate, you can always change your mind and withdraw. There are no negative consequences, whatever you decide.

The purpose of this study is to examine the relationship between intimacy and sexual satisfaction in same-sex couples and transgender individuals in romantic relationships.

The study consists of an online survey. You will be asked to complete a series of questions about intimacy, passion, sexual self-disclosure, internalized stigma, and sexual satisfaction in your romantic relationship. This survey may be completed on any computer with Internet access. You may skip any question that you would prefer not to answer. You may opt out of any questions that you feel uncomfortable answering and may stop the survey at any time. We are not collecting any protected health information and the survey is anonymized.

Emotional and physical risks: Some questions may be personal, upsetting, or cause physical discomfort. You can skip any questions you do not want to answer or stop the survey entirely.
Legal, social, and economic risks: Online data may be hacked or intercepted. You experience this risk any time you provide information online. We are using a secure system to collect this data, but we cannot completely eliminate this risk. Any information you provide will not result in the possibility of being arrested or have an effect on your financial standing.
Breach of confidentiality: There is a chance your data could be seen by someone who should not have access to it. We're minimizing this risk in the following ways:
- Data is anonymous
- we will store all electronic data on a password-protected, encrypted computer.

You will receive no direct benefit or payment from participation in this study, but your participation may help the investigators better understand the relationship between intimacy and  sexual satisfaction in same-sex couples and transgender individuals in romantic relationships.

Participation will take approximately 15-30 minutes.


You will not be paid for being in this research study.


Where will data be stored?

Please note that the survey is being conducted with the help of Survey Monkey, a company not affiliated with MWU and with its own privacy and security policies that you can find at its website. We anticipate that your participation in this survey presents no greater risk than everyday use of the Internet. The data will be stored on the servers using the online survey software from Survey Monkey and on password-protected, encrypted computers. How long will it be kept? For 5 years after the completion of the study

Who can see my data?

·We (the researchers) will have access to your responses. This is so we can analyze the data and conduct the study.

·We may share our findings in publications or presentations. If we do, the results will be aggregate (grouped) data, with no individual results Sharing De-identified Data Collected in this Research De-identified data from this study may be shared with the research community at large to advance science and health. We will remove or code any personal information that could identify you before files are shared with other researchers to ensure that, by current scientific standards and known methods, no one will be able to identify you from the information we share. Despite these measures, we cannot guarantee anonymity of your personal data.


You may refuse to participate before the study begins, discontinue at any time, or skip any questions that may make you feel uncomfortable with no penalty to you. This study has been reviewed and approved by the Midwestern University Institutional Review Board (AZ #1242). If you have questions about this research project and the research subjects’ rights please contact the principal investigator, Kate L Jansen at 623-572-3712 or email You may also contact the Office of Research and Sponsored Programs at (623) 572-3728 or email at



By completing this survey, you agree to participate in the research project described above. If you do not agree to participate, please exit the survey and close the webpage.

Thank you for your consideration.