Do you agree to participate? *

By clicking “I agree,” you acknowledge that: • You are 18 years of age or older. • You understand the purpose of this study. • You voluntarily agree to participate and share your story. • You consent to your anonymized responses being used for research and design purposes. • You have read and understood the Participant Consent Agreement and agree to be bound by it, as indicated by your initials below.

I AGREE to participate

I DO NOT AGREE

Gender *

Female

Have you been a victim or survivor of gender-based violence? *

Gender-Based Violence (GBV) refers to harmful acts directed at someone based on their gender. It includes physical, sexual, emotional, psychological, or economic abuse, as well as threats of such harm. GBV can happen in both private and public spaces and may be committed by intimate partners, family members, acquaintances, or strangers. Examples include domestic violence, sexual assault, harassment, coercive control, stalking, and being denied education or resources because of gender. • 1 in 3 women globally (about 30%) experience physical or sexual violence in their lifetime, most often by an intimate partner (World Health Organization). • 1 in 4 women have experienced violence during pregnancy. • Over 70% of women in some conflict-affected or humanitarian settings report experiencing GBV. • 1 in 2 women killed worldwide are killed by their partners or family members, compared to less than 1 in 20 men. • In many countries, up to 90% of sexual harassment and assault cases go unreported due to fear, stigma, or lack of support. While GBV can affect people of all genders, women and girls are disproportionately affected due to systemic inequality, discrimination, and power imbalances.

Yes

No

I don't know

Where did the abuse take place? *

You may select more than one answer.

Indoors (home, hideout, private or closed space)

Outdoors (public space, market, gatherings/parties)

Identify the person committing the crime. *

You may select more than one answer.

Domestic partner

Parent/Step-parent

Sibling(s)

Children

Parent-in-Law

Teacher

Relative(s)

Friend(s)

Friend(s) of friend(s)

Other

Do you rely on the abuser for financial support? *

This may include help with housing, food, bills, or other basic needs.

Yes

No

Do you feel emotionally or psychologically attached or dependent on the abuser? *

This may include feelings of guilt, fear, love, hope, or difficulty imagining life without them.

Yes

No

Identify the type of violence that you have experienced the most. *

You may select more than one answer.

Physical (push, hit, slap, arm-twist, hair pull, punch, kick, drag, beaten up, choked, burnt, attacked with a knife or weapon)

Sexual (forced to have sexual intercourse, forced to perform sexual acts)

Emotional (humiliate or insult in front of others, threaten to hurt or harm, made you feel worthless)

Psychological (threats of violence, intimidation, controlling behavior)

Economic (preventing or forbidding from working, forcing to work, controlling income and other financial resources)

Violence during pregnancy

Frequency of abuse *

We understand that one time is already too much. You’re not alone.

Just once

More than once / Ongoing

Did you ever try to report the abuse or ask for help to stop it? *

Yes

No

Have you faced any consequences when trying to seek help? *

Yes

No

Do you find it difficult or uncomfortable to talk about your experience? *

This may include feelings of embarrassment, fear of being misunderstood, cultural or social stigma, or emotional pain when recalling the experience.

Yes

No

Would you be interested in participating in the in-person usability study for this VR project? *

As we continue to develop this VR experience, we are planning an in-person usability study where participants will be invited to interact with an early version of the simulation and offer feedback on the emotional tone, storytelling, and user experience. • If you choose to participate, you will be compensated for your time. • The study will take place in a safe, private setting with emotional support resources available if needed. • We will reach out to you directly with more details if you express interest.

Yes

No

Maybe - I'd like to learn more