The goal is to conduct a longitudinal analysis of the short and longer term mental and physical health outcomes among transgender individuals, who underwent or are undergoing hormonal and/or surgical reassignment interventions. Currently, Emory University and several advocacy groups are conducting a survey of transgender individuals to determine the research questions they think are most important to study. Those questions relate to: effects of hormonal treatment alone and/or that treatment plus surgical reassignment on mental health, how either hormonal gender reassignment and/or surgical reassignment and hormonal therapy together effect need for anti-anxiety and/or antidepressant medications, and effects of hormonal and/or surgical reassignment on risks of HIV, cancer, STI, heart disease and diabetes. Surveys and EMR reviewed will then be used to explore the questions deemed most important by survey respondents. Transgender individuals and clinicians will be involved.