On the Varied and Complex Factors Affecting Gender Diverse People's Vocal Situations: Implications for Clinical Practice

Abstract

Gender diverse people who do not or do not only identify with the gender category assigned to them at birth may experience various difficulties with their vocal communication. In this paper, I will explore the different needs and expectations with regards to professional voice support in this population and outline the implications for clinical practice. In my discussion, I will draw on an understanding of gender diverse people's vocal situations that is informed by constructionist theories of gender and by changes to the conceptualization of gender diversity included in the seventh version of the Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People (Coleman et al., 2012). This theoretical perspective calls attention to a range of factors voice clinicians need to consider when planning and implementing intervention with gender diverse people. The most important of these factors are the client's subjective gender positioning or identity, the client's preferences for and against treatment options, and the extent to which the different treatment options can be regarded as suitable for developing the client's vocal gender presentation and improving the agreement between how the client wishes to be perceived and addressed in terms of gender and the gender attributions the client receives from others.

Gender-related aspects of transmasculine people's vocal situations: insights from a qualitative content analysis of interview transcripts

“…On the other hand, it could be argued that speakers hear their own voice differently from external observers (Haskell ) and that individual listeners more generally follow different internal standards of gender when attributing gender to voices (as discussed, e.g., in Azul ). The latter reasoning could also explain the high percentage of participants who reported having received varying gender attributions to their voice from different people.…”

“…In recent years, however, researchers have begun to acknowledge that it is not appropriate to assume that people who do not identify with the gender assigned to them at birth necessarily identify with the so-called opposite gender. Rather, it is now increasingly recognized that unambiguously male or female gender identities are just two of the many options of how people may position themselves with regards to gender and that none of these positionings in themselves can be regarded as a sign of mental health or illness (e.g., , Azul 2015b, Coleman et al 2012, Davies et al 2015, Smith et al 2014. A specific objective of the present study was therefore to explore how the participants identified with regards to gender and how they wished to be perceived and addressed by others.…”

Perceived Gender and Client Satisfaction in Transgender Voice Work: Comparing Self and Listener Rating Scales across a Training Program

“…As highlighted, this is the primary reason that studies in this area (including the current paper) typically assess listener reliability using intra-rater measures only (e.g., [20, 33, 34]). However, it must be acknowledged that understandings of gender as a whole, different categories for describing gender, and what characteristics are associated with these categories are both socially constructed and highly subjective [41]. Both trans participants and listeners in the current study (as well as past studies) likely differed in their own individual understandings of these concepts.…”

“…As discussed, newer models for providing gender affirming voice intervention highlight the varied and complex factors that contribute to listener attributions of gender in communication [11]. Past studies investigating how listeners attribute gender to speakers do typically demonstrate variation both between and within individuals, indicating that “different listeners may draw on different standards of vocal gender presentation when attributing gender to voices and that, for some listeners, internal standards of vocal gender may be changeable” [41]. As highlighted, this is the primary reason that studies in this area (including the current paper) typically assess listener reliability using intra-rater measures only (e.g., [20, 33, 34]).…”

Gender Affirming Voicework: An Introduction for Music Therapy

“…Literature that considered the singing voice focused on vocal masculinization and the experiences of trans men (and nonbinary, female-assigned persons). David Azul (2016Azul ( ,, 2013Azul ( ,, 2015 along with Ulrika Nygren, Maria Södersten, and Christiane Neuschaefer-Rube (2017) have emphasized the need to understand this diversity of vocal experiences and the need for client-centered perspectives in speech therapy, especially when considering vocal masculinization and the experiences of trans men and nonbinary, female-assigned people given their overwhelming lack of discussion regarding their experiences. Clinical guidelines in speech therapy suggest a very fixed understanding of the voice (e.g., the emphasis on a singular, consistent vocal pattern).…”