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Respondent

Please tell us about yourself

If you do not identify with the sex assigned at birth, please give the term you use to describe your gender e.i. Female/male transgender, non-binary etc.
Other faith or no faith
If yes please specify
Other disability

This and the following sections will help us gather evidence on how discrimination impacts people’s lives, who is more at risk of experiencing discrimination and in which context. It will also allow us to put you in contact with organizations who might be able to intervene in your individual case, if you request to be contacted.

Please tell us about a specific case of discrimination you experienced or witnessed.

10. Have you personally experienced or witnessed the discriminatory incident?
11. Was it the first time you experienced or witnessed an experience of this kind?
Drop files here or
Max. file size: 256 MB.
    (Evidence include photo of insulting graffiti, damage to buildings, injuries, screenshot of insulting message, photo of legal documents, arrest warrants, fines etc…)

    Incident

    Other
    Give the exact date if possible
    DD slash MM slash YYYY
    15. At what time did it happen?
    :
    16. What type of discrimination was it? (click all that apply)
    Other

    Ground of Discrimination

    17. On what basis did the discrimination incident happen? Please, only tick as many answers as relevant to the incident being reported.
    [example: The individual who was discriminated against have or is perceived as having one or more of the following characteristics. The discrimination was based on their…]
    (If you do not identify with the sex assigned at birth, please give the term you use to describe your gender e.i. Female/male transgender; non-binary etc.)
    Other faith or no faith
    Other
    Please specify
    Other disability

    Motive

    18. What do you believe to be the motivation for the discrimination? (click all that apply)
    Other

    Perpetrator

    Other
    Other
    22. What was the age of perpetrator(s)? (click all that apply)
    23. What was the religion of the perpetrator(s)? (click all that apply)
    Other faith or no faith
    24. What was the ethnicity of the perpetrators? (click all that apply)
    Other

    Reporting

    25. Did you report (or are you planning to report) the incident anywhere other than here?
    26. If you have already reported (or you are planning to report) this incident elsewhere, to whom did/will you report it?
    To someone else
    27. Since you reported it, has any investigation or action been taken by those you reported it to?
    28. If you reported it but no action was taken, can you tell us why?
    Other
    29. If the incident was not reported, what were your reasons?
    Other

    Support

    30. Were you able to access any form of individual support after the incident?
    31. Which type of support did you receive/access after the incident?
    32. Which individual or organizations supported you? Multiple choice
    other
    33. To what extent do you feel the support you received was appropriate?

    Impact

    35. Do you consider that the discrimination incident has affected your economic life e.g. your education, your job, your business, your ability to access health services or buy goods?
    36. Was the incident in any way related to the novel coronavirus/Covid 19 epidemic?

    Consent

    Are you happy for us to quote parts of your answers to questions included below to clearly show how discrimination is impacting people in Pakistan? We will, of course, ensure to maintain your anonymity if we do so.
    If you face any difficulty while filling the survey form please reach out to us via email: contact@stigmasurvey.pk