Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for t...

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Treatment goals for clients included in this study were consistent with those goals most often recommended in the research literature regarding voice and communication treatment for transgender clients. Voice and communication treatment resulted in gains in areas important to listeners' perception of gender. Further research is warranted to determine efficacy of specific treatment protocols and potentially influential factors such as initial voice and communication status.

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Forty participants (20 male) had 3-minute conversations with trained male and female communication partners in a repeated-measures, within-subject design. Eighty 3-minute conversations were transcribed and coded for dependent clauses, fillers, tag questions, intensive adverbs, negations, hedges, personal pronouns, self-references, justifiers, and interruptions. Results suggest no significant changes in language based on speaker gender. However, when speaking with a female, participants interrupted more and used more dependent clauses than when speaking with a male. There was no significant interaction to suggest that the language differences based on communication partner was specific to one gender group. These results are discussed in context of previous research, communication accommodation theory, and general process model for gendered language.

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Voice therapy, especially during male-to-female transition, typically targets acoustic measures of voice. Self-perception of femininity may be a valuable measure to incorporate into clinical protocols and empirical investigations of treatment efficacy. Speech samples of 20 male-to-female transgender and 10 cisgender speakers were rated by speakers and 25 listeners. Mean fundamental frequency (Fo) and semitone range, but not perturbations, of the speaker's voice were strongly related to speaker-and listener-rated femininity. Listener-rated femininity strongly correlated with speaker's self-rated femininity. Results of this study provide guidance and methodology for incorporating the speaker's self-perceptions of overall and vocal femininity into voice therapy.

Script training was successful and functional for clients with AOS. Clients reported increased confidence, speaking ease, and speech naturalness. Although scripts did not become errorless, clients retained their scripts and reported using them frequently. Whether principles of motor learning may have promoted the long-term retention of scripts exhibited by participants must be determined through future research.