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LGBTQ+ Family Stories
Thanks for telling us a bit about your family for the WE ARE HERE documentary series about LGBTQ families throughout the country.
Our mission is to bring to light the discrimination still faced by LGTBQ families along with the love and persistence in face of opposition.
Right now we are focused on families in the Midwest but feel free to reach out to us from wherever you are!
And please only fill out the form if you are willing to share your story on camera.
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Name (First Last)
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Your answer
Email:
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Your answer
Phone:
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Your answer
Where do you live? (City, State)
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Your answer
What do you love most and least about where you live?
Your answer
Which of the following best applies to you:
Gay cisgender man
Gay trans man
Lesbian cisgender woman
Lesbian trans woman
Straight trans man
Straight trans woman
Bi-sexual
Non-binary
Other:
Clear selection
What ethnic group(s) do you most identify with?
Your answer
How many children do you have and what are their ages?
Your answer
Tell me a bit about your family structure i.e. are you single married, co -parent? Are your children biological, adopted, foster, etc?
Your answer
If you parent with a partner, please share a bit about them and your relationship:
Your answer
What have you found the most challenging about parenting as an LGBTQ+ person or couple?
Your answer
What are some specific instances of discrimination you are facing?
Your answer
What are some of the conflicts in your extended family or community such as school, church or on the job?
Your answer
Anything else you'd like to share with us?
Your answer
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