Name

Age

Email

1.- What are your initials?

2.- Tell me about how you identify from a perspective of gender and sexual orientation.

3.- Do you ever experience gender dysphoria or questions about your biological gender and/or gender expression?

4.- Tell me about your sexual desires. Have you actualized any of these desires?

5.- What kind of sexual imagery do you like?

6.- In what ways would you like to work on and/or address your sexuality in your treatment at The SAT Project?

The next section is an opportunity to tell me about your sexual history.

7.- When did you first become aware of sexuality, sexual interest, and desire?

8.- What were your earliest sexual experiences like?

9.- What type of sexual imagery were you first exposed to?

10.- How has your sexuality developed over your life? Tell me about feelings, thoughts and experiences related to your sexuality at different points in your life.

11.- How would you describe your sexuality today?

Now let’s explore some more in-depth questions about your sexuality.

12.- Which parts of your sexuality do you celebrate and embrace?

13.- Which parts of your sexuality do you have negative feelings about? Are there aspects of your sexuality that remain hidden from others?

14.- What is your relationship to your body? What parts of your parts of your body do you feel pleased with? What parts of your body do you wish were different?

15.- What was your most pleasurable sexual experience? Why?

16.- What was your least pleasurable sexual experience? Why?

17.- Do you believe you have body and/or sexual shame? If so, describe what that is.

18.- Have you experienced any involuntary or unwelcome sexual experiences? If so, please share as much detail about the experience(s) as you are comfortable doing (i.e., what was the experience? When did it occur? Who was involved? What are the feelings associated with the encounter? etc.)

19.- Sometimes our sexual behavior is different from our sexual fantasies. Sexual fantasies are important aspects of who we are and what we desire and wish for in our lives. What sexual fantasies have been part of your life, both historically and currently?

20.- Was there any information and/or sexual education that your received from your parents, friends, educators, etc.? If so, at what point in your life did you have those conversations?

21.- Sometimes our sexuality can be shamed by caretakers, family members and/or peers. If you had this experience, how did this manifest and what were the aftereffects?

22.- Were there any sexual feelings and/or experiences between you and a family member? If so, please share as much detail about the feelings and experiences as you are comfortable doing (i.e., What was the experience? When did it occur? Who was involved? What are the feelings associated with the encounter? etc.)

23.- Do you know much about your caretakers’ sexuality? If not, do you make up something about what you think their sexual connection was like?

24.- Sometimes we are drawn to the sexual imagery in magazines, videos, written materials, etc.? What was your relationship to sexual imagery in the past? What is your relationship to sexual imagery today?

25.- Masturbation and solo sexuality are often a part of a person’s sexual expression. How would you describe your relationship to masturbation?

26.- Do you engage in sexual behavior when you are highly emotional? Is it most common to seek out sex when you are lonely, sad, angry, fearful, or happy? How do you understand the connection between your emotions and your sexuality? Do you want that relationship to be different in any way?

In the final section

using the scale provided as guide, indicate how much you agree or disagree with the following statements by selecting the corresponding number.

Select: if you: STRONGLY DISAGREE	Select: if you: MODERATELY AGREE
Select: if you: MODERATELY DISAGREE	Select: if you: STRONGLY AGREE
Select: if you: NEITHER DISAGREE NOR AGREE

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