Measuring Bullying, Victimization, Perpetration, and Bystander ...

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5. In the past year, how often have you been physically harassed (shoved, pushed, etc.) at
your school because of…
a. your sexual orientation? Frequently Often Sometimes Rarely Never
b. your gender? Frequently Often Sometimes Rarely Never
c. how you express your gender? Frequently Often Sometimes Rarely Never
d. your race or ethnicity? Frequently Often Sometimes Rarely Never
e. your disability or because people
think you have a disability?
f. your religion or because people
think you are of a certain religion?
Frequently Often Sometimes Rarely Never
Frequently Often Sometimes Rarely Never
6. In the past year, how often have you been physically assaulted (punched, kicked,
injured with a weapon) at your school because of…
a. your sexual orientation? Frequently Often Sometimes Rarely Never
b. your gender? Frequently Often Sometimes Rarely Never
c. how you express your gender? Frequently Often Sometimes Rarely Never
d. your race or ethnicity? Frequently Often Sometimes Rarely Never
e. your disability or because people
think you have a disability?
f. your religion or because people
think you are of a certain religion?
Frequently Often Sometimes Rarely Never
Frequently Often Sometimes Rarely Never
7. How often have you been sexually harassed at your school, such as sexual remarks made
toward you or someone touching your body inappropriately?
Frequently Often Sometimes Rarely Never
8. In the past year, how often have you had mean rumors or lies spread about you in school?
Frequently Often Sometimes Rarely Never
9. In the past year, how often have you had your property stolen or deliberately damaged,
such as your car, clothing, or books in school?
Frequently Often Sometimes Rarely Never
10. In the past year, how often have you received harassing or threatening emails, instant
messages (IMs), or text messages from students at your school?
Frequently Often Sometimes Rarely Never
SECTION F
These next questions ask about who you talk to when you have experienced harassment or assault in
your school, regardless of whether it was related to your sexual orientation, race/ethnicity, gender, or
gender expression. If you have not experienced any incidents of harassment in school this past year, please
skip to Section G.