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MN Trans Refuge Data Form

MN Trans Refuge Data Form

36Questions

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  • 1

    This survey is for transgender people and their families who live in Minnesota, have moved to Minnesota or are considering moving here, or travel to Minnesota for gender-affirming care.

    We want to find out more about the impact of the Minnesota trans refuge bill and Executive Order protecting access to gender-affirming care, learning about where people are moving or traveling from. We want to learn about what resources are needed and where there are gaps in support for transgender and non-binary people and their families. 

    The survey results will be used by the MN Trans and Intersex Resource Network to advocate for continued support for trans people and their families in Minnesota, especially for services and resources relating to the Trans Refuge Bill and Executive Order 23-03. We also want to identify what the most needed resources are to help trans people and their families thrive.

    Survey responses are all anonymous, and any demographic information collected will only be reported in aggregate, never attached to your specific response. 

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    This survey has been updated, if you filled it out before we'd love you to fill it out again
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  • 3
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  • 4
    Please Select
    • Please Select
    • Alabama
    • Alaska
    • Arizona
    • Arkansas
    • California
    • Colorado
    • Connecticut
    • Delaware
    • Florida
    • Georgia
    • Hawaii
    • Idaho
    • Illinois
    • Indiana
    • Iowa
    • Kansas
    • Kentucky
    • Louisiana
    • Maine
    • Maryland
    • Massachusetts
    • Michigan
    • Minnesota
    • Mississippi
    • Missouri
    • Montana
    • Nebraska
    • Nevada
    • New Hampshire
    • New Jersey
    • New Mexico
    • New York
    • North Carolina
    • North Dakota
    • Ohio
    • Oklahoma
    • Oregon
    • Pennsylvania
    • Rhode Island
    • South Carolina
    • South Dakota
    • Tennessee
    • Texas
    • Utah
    • Vermont
    • Virginia
    • Washington
    • West Virginia
    • Wisconsin
    • Wyoming
    • Outside of the US
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    Please add as many rows as necessary to capture everyone in your household seeking gender-affirming care
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    Please Select
    • Please Select
    • Alabama
    • Alaska
    • Arizona
    • Arkansas
    • California
    • Colorado
    • Connecticut
    • Delaware
    • Florida
    • Georgia
    • Hawaii
    • Idaho
    • Illinois
    • Indiana
    • Iowa
    • Kansas
    • Kentucky
    • Louisiana
    • Maine
    • Maryland
    • Massachusetts
    • Michigan
    • Minnesota
    • Mississippi
    • Missouri
    • Montana
    • Nebraska
    • Nevada
    • New Hampshire
    • New Jersey
    • New Mexico
    • New York
    • North Carolina
    • North Dakota
    • Ohio
    • Oklahoma
    • Oregon
    • Pennsylvania
    • Rhode Island
    • South Carolina
    • South Dakota
    • Tennessee
    • Texas
    • Utah
    • Vermont
    • Virginia
    • Washington
    • West Virginia
    • Wisconsin
    • Wyoming
    • Outside the US
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    Click next to select a region on the next page.
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    Please add as many rows as necessary to capture everyone in your household seeking gender-affirming care
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  • 15
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  • 16
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  • 17
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  • 18
    Please Select
    • Please Select
    • Alabama
    • Alaska
    • Arizona
    • Arkansas
    • California
    • Colorado
    • Connecticut
    • Delaware
    • Florida
    • Georgia
    • Hawaii
    • Idaho
    • Illinois
    • Indiana
    • Iowa
    • Kansas
    • Kentucky
    • Louisiana
    • Maine
    • Maryland
    • Massachusetts
    • Michigan
    • Minnesota
    • Mississippi
    • Missouri
    • Montana
    • Nebraska
    • Nevada
    • New Hampshire
    • New Jersey
    • New Mexico
    • New York
    • North Carolina
    • North Dakota
    • Ohio
    • Oklahoma
    • Oregon
    • Pennsylvania
    • Rhode Island
    • South Carolina
    • South Dakota
    • Tennessee
    • Texas
    • Utah
    • Vermont
    • Virginia
    • Washington
    • West Virginia
    • Wisconsin
    • Wyoming
    • Outside of the US
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  • 19
    Select which county in the following drop down
    Please Select
    • Please Select
    • Aitkin County
    • Anoka County
    • Becker County
    • Beltrami County
    • Benton County
    • Big Stone County
    • Blue Earth County
    • Brown County
    • Carlton County
    • Carver County
    • Cass County
    • Chippewa County
    • Chisago County
    • Clay County
    • Clearwater County
    • Cook County
    • Cottonwood County
    • Crow Wing County
    • Dakota County
    • Dodge County
    • Douglas County
    • Faribault County
    • Fillmore County
    • Freeborn County
    • Goodhue County
    • Grant County
    • Hennepin County
    • Houston County
    • Hubbard County
    • Isanti County
    • Itasca County
    • Jackson County
    • Kanabec County
    • Kandiyohi County
    • Kittson County
    • Koochiching County
    • Lac qui Parle County
    • Lake County
    • Lake of the Woods County
    • Le Sueur County
    • Lincoln County
    • Lyon County
    • Mahnomen County
    • Marshall County
    • Martin County
    • McLeod County
    • Meeker County
    • Mille Lacs County
    • Morrison County
    • Mower County
    • Murray County
    • Nicollet County
    • Nobles County
    • Norman County
    • Olmsted County
    • Otter Tail County
    • Pennington County
    • Pine County
    • Pipestone County
    • Polk County
    • Pope County
    • Ramsey County
    • Red Lake County
    • Redwood County
    • Renville County
    • Rice County
    • Rock County
    • Roseau County
    • Scott County
    • Sherburne County
    • Sibley County
    • St. Louis County
    • Stearns County
    • Steele County
    • Stevens County
    • Swift County
    • Todd County
    • Traverse County
    • Wabasha County
    • Wadena County
    • Waseca County
    • Washington County
    • Watonwan County
    • Wilkin County
    • Winona County
    • Wright County
    • Yellow Medicine County
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  • 20
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  • 21
    Choose all that apply
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  • 26
    Please enter your response in miles
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  • 34
    1 of 2
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  • 35
    This includes income from all members of your household, except food stamps (SNAP) and WIC
    Please Select
    • Please Select
    • No income
    • 1 to 5,000
    • 5,000 to 7,499
    • 7,500 to 9,999
    • 10,000 to 12,499
    • 12,500 to 14,999
    • 15,000 to 17,499
    • 17,500 to 19,999
    • 20,000 to 24,999
    • 25,000 to 29,999
    • 30,000 to 34,999
    • 35,000 to 39,999
    • 40,000 to 49,999
    • 50,000 to 59,999
    • 60,000 to 74,999
    • 75,000 to 99,999
    • 100,000 to 149,999
    • 150,000 or more
    • Prefer not to say
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  • 36

    Thank you! 

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  • 48
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  • 49
    If you would like to be notified of any services or news related to the Trans Refuge Coalition or more information on the resources you indicated above you can add your email address here and we will let you know if there is anything we think will be helpful! Welcome to Minnesota.
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