Beyond Phonosurgery: Considerations for Patient‐Reported Outcomes and Speech Therapy in Transgender Vocal Feminization

Morrison, Shane D; Crowe, Christopher S.; Rashidi, Vania; Massie, Jonathan P.; Chaiet, Scott R.; Francis, David O.

doi:10.1177/0194599817712678

Cited by 13 publications

(2 citation statements)

References 5 publications

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“…The goal of speech-language therapists and pathologists is to help TW develop voice and communication that reflects their gender identity without causing laryngeal injury, a goal that is beyond achieving fundamental frequency within the female range, 200 which is often the goal of phonosurgery. 207 Ultimately, the patient’s goals and perceptions are most important 207 and an individualized approach is preferred. Additional research can help us identify predictors of attaining the desired voice pitch among TW and which vocal therapy techniques achieve the best patient-reported outcomes.…”

Section: Part 4: Other Health Considerations For Twmentioning

confidence: 99%

Health considerations for transgender women and remaining unknowns: a narrative review

Iwamoto

Defreyne

Rothman

et al. 2019

Therapeutic Advances in Endocrinology

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Transgender (trans) women (TW) were assigned male at birth but have a female gender identity or gender expression. The literature on management and health outcomes of TW has grown recently with more publication of research. This has coincided with increasing awareness of gender diversity as communities around the world identify and address health disparities among trans people. In this narrative review, we aim to comprehensively summarize health considerations for TW and identify TW-related research areas that will provide answers to remaining unknowns surrounding TW’s health. We cover up-to-date information on: (1) feminizing gender-affirming hormone therapy (GAHT); (2) benefits associated with GAHT, particularly quality of life, mental health, breast development and bone health; (3) potential risks associated with GAHT, including cardiovascular disease and infertility; and (4) other health considerations like HIV/AIDS, breast cancer, other tumours, voice therapy, dermatology, the brain and cognition, and aging. Although equally deserving of mention, feminizing gender-affirming surgery, paediatric and adolescent populations, and gender nonbinary individuals are beyond the scope of this review. While much of the data we discuss come from Europe, the creation of a United States transgender cohort has already contributed important retrospective data that are also summarized here. Much remains to be determined regarding health considerations for TW. Patients and providers will benefit from larger and longer prospective studies involving TW, particularly regarding the effects of aging, race and ethnicity, type of hormonal treatment (e.g. different oestrogens, anti-androgens) and routes of administration (e.g. oral, parenteral, transdermal) on all the topics we address.

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Section: Part 4: Other Health Considerations For Twmentioning

confidence: 99%

Health considerations for transgender women and remaining unknowns: a narrative review

Iwamoto

Defreyne

Rothman

et al. 2019

Therapeutic Advances in Endocrinology

View full text Add to dashboard Cite

show abstract

“…Speech–language pathologists work closely with TGD individuals to help them achieve a gender congruent voice, either as an effective alternative to surgery or as a supplementary option (Morrison et al., 2017). Depending on individual goals, gender‐affirming voice and communication training with a speech–language pathologist involves modifying vocal features and communication behaviours to achieve a voice that is, perceived in the desired way (Davies et al., 2015).…”

Section: Introductionmentioning

confidence: 99%

Utilizing Virtual Reality for Gender‐Affirming Voice Training: Surveying the Attitudes and Perspectives of Potential Consumers

Smith,

Gregory,

Bryant

2023

Intl J Lang & Comm Disor

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BackgroundUndertaking voice and communication training is an important part of the gender‐affirming journey for many trans, gender‐diverse and non‐binary individuals. Training supports the alignment of voice with gender identity helping to reduce gender dysphoria as individuals are better able to connect with their voices. However, for training to be effective, regular practice is needed and the demands of training can often be difficult to meet.AimsTo investigate the interest, attitudes and perspectives on the use of immersive virtual reality (VR) to support gender‐affirming voice and communication training by transgender, gender non‐binary and gender‐diverse people, and speech–language pathologists providing gender‐affirming voice and communication training.Methods & ProceduresA mixed‐methods survey (i.e., collecting quantitative data through multiple‐choice question and qualitative data through free text questions) was hosted online from 23 August to 21 September 2021. A total of 17 questions asked about technology use, and attitudes and perspectives towards VR. The survey included video examples of three different voice‐activated VR applications to prompt participant responses about the technology.Outcomes & ResultsA total of 70 survey responses were included in the analysis. All participants had previous experience using smart phones, but only 27.2% had previously used VR. Four key themes were identified relating to potential uptake of VR in gender‐affirming voice and communication training: (1) general audience appeal, (2) perceived therapeutic value, (3) exposure to or protection from harm and (4) relatability to real life.Conclusions & ImplicationsVR games may represent a viable option to support practice of voice exercises. Gamification through VR is likely to motivate some to increase frequency of practice. VR applications that are used in voice training need to be fit‐for‐purpose, and detailed co‐design is necessary to build appropriate applications for future use. This study provides a foundation to inform the design, development and implementation of VR applications to be used in gender‐affirming voice training.WHAT THIS PAPER ADDSWhat is already known on the subject? Speech–language pathologists work closely with transgender and gender‐diverse individuals to help them achieve gender congruent voice and communication. Clients need to undertake regular and ongoing practice outside of training sessions to achieve and maintain their ideal voice. Motivation and adherence to regular practice sessions remain an ongoing challenge.What this study adds to the existing knowledge This study explores the use of immersive VR technologies to create safe, motivating and enjoyable environments to encourage regular practice of gender‐affirming voice and communication exercises. It engages stakeholders in an early‐stage participant‐involved design to gauge interest in, and perspectives on, VR and technology‐based training support tools. The results suggest that voice‐activated VR applications would highly motivate some individuals if they were appropriately designed but would not be ideal for all.What are the actual and clinical implications of this work? Immersion in VR can be a highly motivating tool to enhance adherence to practice schedules for some individuals. However, tools need to be specifically designed with outcomes in mind to be fit‐for‐purpose, to support individual goals and to minimize the risk of harm. The few existing VR voice‐activated applications that are available require further assessment, and redesign through co‐design with users to functionally and safely support gender‐affirming voice and communication training.

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Patient-Reported Outcomes and Data Collection in Treatment-Seeking Transgender and Gender Nonconforming Individuals

Goodwin,

Kapila,

Pilchman

2023

Voice and Communication in Transgender and Gender Diverse Individuals

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Beyond Phonosurgery: Considerations for Patient‐Reported Outcomes and Speech Therapy in Transgender Vocal Feminization

Cited by 13 publications

References 5 publications

Health considerations for transgender women and remaining unknowns: a narrative review

Health considerations for transgender women and remaining unknowns: a narrative review

Utilizing Virtual Reality for Gender‐Affirming Voice Training: Surveying the Attitudes and Perspectives of Potential Consumers

Patient-Reported Outcomes and Data Collection in Treatment-Seeking Transgender and Gender Nonconforming Individuals

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