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Sexual Activity of People with Physical Disabilities
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What i your age?
Your answer
What is your gender
Choose
Male
Female
Other
What is your Sexual Orientation
Choose
Heterosexual (attracted only to the opposite gender)
Gay/Lesbian (attracted only to the same gender)
Bisexual (attracted to both genders)
Asexual (attracted to neither gender)
Omnisexual/Pansexual (attracted to person regardless of gender presentation
Other
What is your disability?
Your answer
Is it congenital (were you born with it?
yes
no
Is your partner disabled
Yes
No
Not Applicable
If Yes, what is their disability
Your answer
Is their disability congenital
yes
no
Clear selection
What isyour current relationship status (check all that apply)
Single, never in relationship
Single, have had previous relationships
Partnered
Married
Divorced
Separated
Widow(er)
What is your current living situation?
Choose
Alone
With parents
With other family members
With non-family members
With significant other
College housing
Residential setting (group home/nursing home/other)
Correctional Institute
Transitional Housing
Currently without permanent housing
What sexual activities have you participated in? (mark all that apply)
Hugging
Kissing
(Giving) Oral Sex
(Receiving) Oral Sex
(Giving) Anal Intercourse
(Receiving) Anal Intercourse
(Giving) Vaginal Intercourse
(Receiving) Vaginal Intercourse
Mutual Masturbation
(Giving) Digital Stimulaion
(Receiving) Digital Stimulation
(Giving) Using Sex Toys
(Receiving) Using Sex Toys
(Giving) Scat/Watersports
(Receiving) Scat/Waterspors
(Giving) BDSM
(Receiving) BDSM
Role Playing
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