Incident Report for Diverse

in Berlin and other States of Germany

Comment about the questions:

The different types of question require the following types of answer:

a) »only one answer« Please cross only one option!
b) »More than one answer is possible« You may cross more than one option!
c) »(0) – (1) – (2) – (3) – (4)« [Scale value:(0)=zero; (4)=very clear] please cross one scale value!
d) »Open answer – using only a few key words« Please write a short description here.

1. Part of the questionnaire

0. Who was the victim of the violent incident?

»more than one answer is possible«

0. No answer

1. Me

2. My friend/partner

3. I was a witness of a violent incident that was committed against someone known to me.

4. I was a witness of a violent incident that was committed against someone I didn’t know.

5. I heard about the violent incident from a third party.

6. Other, namely:

1. How would you categorise the violent incident?

»more than one answer is possible«

1a. Please give a short description of the incident here:

The date, time, and for how long the incident lasted,
The order of events,
In what way did the violence against the person happen, (types of violence? types of Injury?),
Please describe the place where the incident took place,
Please describe the person(s) who did the violent act(s),
If you are not the victim of the violent incident then please describe the victim (e.g. age, where they come from etc.)

2. How long did the incident last (from what time to what time)?

2.1 From date and time
Date:

Time:

2.2 Until date and time
Date:

Time:

3. Were weapons used (if so which)

»only one answer«

0. No answer

1. No

2. Yes

3.2. Which wappons?

4. Were there injuries

»only one answer«

0. No answer

1. No

2. Yes

4.2a. If yes, who was hurt?

1. Me

2. Another person

4.2b. If yes, what kinds of injuries?

5. Was anyone else a victim of the incident or in any way affected by it E.g. friends or acquaintances?

»only one answer«

0. No answer

1. No

2. Yes

5.2. If yes how many?

6. For how long afterwards were you affected by the incident?

»only one answer«

7. In which city and neighbourhood/borough did the incident take place?

»only 1 Answer«

0. No answer

1. Berlin

2. Other place

7.1a. If in Berlin, in which Berlin district? ?

7.2a. If not in Berlin, in which State of Germany?

7.2b. If not in Berlin, in which city, district and region?

8. What was the location of the incident?

E.g. Street name, post/zip-code, in my/someone’s home, in the Metro/Tube/Subway etc.

9. Was the incident in your view anti gay/lesbian/trans*?

»only one answer«

0. No answer

1. No

2. Yes

3. I don't know because:

9.1. If no, how could you recognize the fact that the act was anti-gay/lebsbian/trans*?

»more than one answer is possible«

1. The wrongdoer(s) made statements

2. The wrongdoer(s) knew that I am gay/lesbian/trans*

3. Because of my/the victim’s visibility as a gay/lesbian/trans* e.g. publicly walking hand in hand, or kissing.

4. Because of the clothes I/the victim was wearing e.g. typical gay/lesbian “scene” fashion

5. The crime happened at or near a known gay/lesbian/trans meeting-point/club/bar/party or event.

6. The incident happened at a time when a public gay/lesbian/trans* event or festival took place e.g. Gay Pride

7. The wrongdoer showed sexual interest in me

8. You can give here a description of the particular attributes of the wrongdoer:

10. How many wrongdoers were there (estimate if not known exactly)?

11. How old were the wrongdoers (estimate if not known exactly)?

12. Sex of the wrongdoers?

(Sexes)

13. Were the wrongdoers known to you?

»only one answer«

0. No answer

1. No, strangers

2. Yes, known to me, in particular: (e.g.. Neighbours, fellow students, work colleagues etc.)

13.2. Yes, known to me, in particular:

14. Have you been to the police about the incident?

»only one answer«

0. No answer

1. No

2. Yes

14.1. If no, which answer best fits your case:

1. Because the police wouldn’t be able to find the wrongdoer

2. I don’t want the police to have my personal data

3. The police wouldn’t be able to deal with the case.

4. It would have been too stressful for me.

5. Other, namely:

14.2. If yes , have you been filed charges?

»only one answer«

1. No

2. Yes

15. After a violent incident many victims feel partly responsible that the incident happened. Is that the case with you?

»only one answer«

0. No answer

1. No

2. Yes

15.2. If yes, what reasons do you have for these feelings?

16. Afterwards, did you have the possibility to speak at length about the incident with someone you could trust?

»only one answer«

0. No answer

1. No

2. Yes

16.2. If yes, who was it?

»more than one answer is possible«

17. If yes would you say that their support was helpful?

»only one answer« (0= no help; 4=very helpful)

18. Do you think that the incident led to a change in your behaviour?

»only one answer«

0. No answer

1. No

2. Yes

18.2. If no, because...?

18b. If yes, which of the following best fits your case?

»more than one answer is possible«

1. I am now more alert and cautious

2. I do not present myself as gay so publicly

3. I avoid behaving in a way that identifies me publicly as gay/bisexual/trans*

4. I am now more careful when flirting or making new acquaintances

5. I am better prepared for danger

6. I am looking to move home/ I have moved home

7. I avoided a particular place for a long time

8. I continue to avoid particular places

9. Other, namely:

19. Before the incident had you already been discriminated against, insulted, deliberately annoyed by someone, threatened, injured or robbed?

»only one answer«

0. No answer

1. No, not until now

2. Yes, already once

3. Yes, more than once

Thank you for the information that you entered.

We would also like you to fill in Part 2 In case you have doubts about answering these questions you can skip them.

Part 2. – Personal Questions

20a. How would Du describe your sexual identity?

»nur 1 Antwort«

20b. How would Du describe your sexual orientation?

»nur 1 Antwort«

20c. How would you describe yourself furthermore?

»nur 1 Antwort«

0. No answer

1. I am cis

2. I am trans*

3. Other, namely:

21. How old are you?

22. Are you in a long-term relationship?

»only one answer«

23. What educational qualifications do you have?

»only one answer«

0. No answer

1. None

2. School certificates at age approx 16

3. Technical school certificates at age approx 18

4. High school certificates at age approx 18 e.g. A levels, IB, Abitur

5. University degree/diploma e.g. BSc

6. Post graduate degree e.g. MBA, MSc., PhD

7. Other, namely:

24. Current occupation?

»only one answer«

25. What is the population of your town?

»only one answer«

26. Where is your main residence?

»only one answer«

0. No answer

1. In Berlin

2. In the state of Brandenburg

3. Other place:

26a. If “Berlin” what part?

26b. If not Berlin, which place?

(Local area/City/County/Country)

27. What is your passport nationality?

27a. Another nationality

(e.g. also dual citizenship, then "German and ...")

28. Are you an active member of one of the following groups?

»more than one answer is possible«

29. May we contact you for further questions? *(required)

»only one answer«

1. No

2. Yes

So that we can contact you, please leave us your first name, telephone number and email.

My first name*

My phone number

My mail address*

Privacy Police of MANEO

I have read the Privacy Policy note *

My contact data may be used to answer questions and provide feedback *

30. Where did you find out about MANEO / Violent Incident Telephone?

A brief description, e.g. gay magazine, someone told me, ..

31. Final comments?

Open answer, use only a few key words