ZAMBOANGA DEL NORTE NATIONAL HIGH SCHOOL-TURNO

Senior High School Department

Turno, Dipolog City

Dear Respondents,
Good day!
We are pleased to inform you that you have been chosen as one of our respondents for our
research entitled “Blah blah blah.” Kindly answer the survey questionnaire to the highest level
of your honesty. Your honest responses to this survey will definitely be very vital to create
policies and programs that will help and benefit you and other learners in this institution.
Rest assured that your responses will be held with utmost confidentiality.
Thank you and God bless.

Truly yours,

PRETTY ABEGAIL C. PACILAN

PRETTY ABEGAIL C. PACILAN
PRETTY ABEGAIL C. PACILAN
PRETTY ABEGAIL C. PACILAN
Researchers

I. DEMOGRAPHIC PROFILE

Direction: Please indicate your responses by checking the answer to the information
being asked for.

1. Name : (optional) _________________________________________________

2. Age : ( ) Below 16 years old

( ) 16 – 18 years old
( ) 19 – 20 years old
( ) 21 years old and above

3. Gender : ( ) Heterosexual (Straight Male/Straight Female)

( ) Homosexual (Gays/Lesbian)
( ) Bisexual
( ) Transexual
4. Annual Family Income
: ( ) P 500,000.00 above
( ) P 200,000.00 – P 499,999.00
( ) P 150,000.00 – P 199,999.00
( ) P 100,000.00 – P 149,999.00
( ) P 80,000.00 – P 99,999.00
( ) P 79,999.00 below

5. Religion
( ) Roman Catholic
( ) UCCP
( ) CAMACOP
( ) Seventh Day Adventist
( ) Islam
( ) Church of Christ in the Latter Days Saints
( ) Others, please specify ___________________

6. Course:
( ) Bachelor of Science Criminology
( ) Bachelor in Elementary Education
( ) Bachelor in Secondary Education
( ) Bachelor of Science in Hotel and Restaurant Management
( ) Bachelor of Science in Tourism
( ) Bachelor of Science in Nursing
( ) Others, please specify ___________________________

II. EXTENT OF SOCIAL MEDIA ENGAGEMENT

Directions: Please indicate your responses based on the following scale.

Legend:
5- Always
4- Often
3- Occasionally
2- Rarely
1- Never

A. Psychological Effect 5 4 3 2 1
1. Feels discriminated by my classmates.

2. Feels that the community hates my

presence.
3. Feels rejected by my neighbors.
4. Feels other treat me negatively.
5. Want to express my gender identity and
do not care if others will reject me.
6. Feel that I get rid of my depression
through cross dressing.
7. Feels that cross dressing cause
destructive actions that may harm my
being.
8. Want to feel what is like to cross dress.
9. Feels comfortable and contented with
 how the community treat me.
10. Feels liberated when I cross dress.
B. Moral Effect.
1. Feels that I am unaccepted by the
Church.
2. Feels that I break the law of God.
3. Feels people considered me as deviant.
4. Feels being unaccepted as member of
my Church.
5. Fears being branded as unscrupulous by
religious leaders.
6. Feels that I am immoral.
7. Fears that I am unchaste.
8. Feels being excommunicated by my
religion.
9. Feels that I am being akin to an animal.
10. Feels I am being akin to uncivilized
individual.