We are glad to see your interest in our study. We know that this is a challenging time for everyone, with massive restrictions on personal life. This not only affects health care, but also vulnerable groups in particular. The health care of trans people is, as we expect, part of this. With this study, we would like to learn from you how you are personally affected by the situation around COVID-19 and what consequences this has for your physical and mental health.

Why this study?
COVID-19 is a lung infection caused by the coronavirus SARS-CoV-2. The current COVID-19 pandemic poses new and massive challenges for health systems around the world. It is causing massive restrictions in the provision of medical care. These inevitably affect trans people whose access to health care was already restricted before the COVID-19 pandemic and is now expected to be further impaired. Moreover, studies on experiences with previous pandemics (Leung et al., 2009) and the COVID-19 pandemic (Wang et al., 2020) show the negative impact of such events on the mental health of the general population and vulnerable subgroups, such as health care professionals (Li et al., 2020). Up to now, the impact of the COVID-19 pandemic on both health care services for and the health of trans people can only be assessed based on anecdotal information, e.g., blog posts or individual reports (Loggins, 2020). However, these provide hints of specific negative impacts for trans people as a result of limited access to medical and psycho-social care due to the COVID-19 pandemic.
What does the survey ask?
The survey contains a set of questions about yourself, your current living situation, your health care needs, and your physical and mental health. Most questions are multiple choice questions, and for some questions, you will also find the possibility to add further information in a free text that you consider important. Please take the chance to write to us! Participation in the study is completely voluntary and anonymous. It will take about 20 minutes to answer the questionnaire. You can cancel your participation at any time without giving reasons and without incurring any disadvantages. Participation in the study should not be associated with certain health risks. You are only asked to report on your personal experience of the current COVID-19 pandemic. The participation is free of charge for you. However, we cannot pay any compensation for expenses. All the information we collect in the study will be treated confidentially and used exclusively for scientific purposes.
Who can take part in this survey?
We recognise the heterogeneity of the trans population, and this survey is open to anyone who identifies, experiences and/or describes themselves as transgender, as long as they are at least 16 years of age. We use the term trans here as an umbrella term that includes many other terms, such as transgender, non-binary, genderqueer, gender-non-conforming, trans men, trans woman, etc. You are able to specify the specific genders you identify with in the survey.
Who is the research team and is there ethical approval?
The research team consist of Andreas Koehler & Timo Nieder from the University Medical Center Hamburg-Eppendorf, Germany and Joz Motmans from Ghent University Hospital, Belgium. Leo Mulió Alvarez of Transgender Europe (TGEU) also contributed to the development of the survey. On the survey for Australia and New Zealand, David Azul from the La Trobe University, Australia, also provided helpful feedback. There is no funding for this survey. The study received ethical approval from the Local Psychological Ethics Committee (LPEK) at the Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (No.: LPEK-0130, date: 01/04/2020), as well as from Ghent University Hospital (BC-07607, date: 15/04/2020).
How have trans people been involved in this study design?
Part of the research members are trans–identified persons. Additional consultation has been sought in the construction of the questionnaire by two German trans organisations (Bundesverband Trans*, dgti e.V.,) and European organisations such as TGEU, and EPATH. The research team wants to thank all persons who have reviewed the questionnaire, and takes all responsibility for remaining faults. We did not receive a financial compensation for this work. We recognise that the survey was constructed under huge time pressure, but we tried to be sensible and use respectful language. We welcome your feedback for improving the survey.
What will happen with the results?
Because we consider the impact of the COVID-19 pandemic on trans health and health care a time-sensitive issue, we will analyse preliminary results of the study, particularly at state level. We will provide information based on the preliminary results to both local trans organizations and health care providers, and we hope they get informed on what trans people need in this COVID-19 pandemic. When the online survey is completed, the final results will be made available again to the participating trans-organisations and published in scientific journals, preferably with open access.