Perceptual analysis of the male-to-female transgender voice after glottoplasty-the telephone test

Meister, Jonas; Kühn, Heike; Shehata‐Dieler, Wafaa; Hagen, Rudolf; Kleinsasser, N.

doi:10.1002/lary.26110

Cited by 24 publications

(20 citation statements)

References 32 publications

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“…Real or perceived impairments to voice can significantly diminish people's functionality and quality of life. For transgender individuals in particular, voice and communication have an enhanced degree of importance as a direct reflection of identity and a source of anxiety about being misidentified 19,20 . Although voice has been recognized to be of critical importance to transgender patients, fundamental understanding of transgender voice remains limited to date, and it is unclear how best to assess and follow voice changes in transgender patients during and after treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, there are few studies in the literature regarding transgender voice, and many are limited by small sample size, inconsistent methods, and lack of standardized data reporting tools 11,19,20,22–25 . Few report acoustic data, and those studies that do focus largely on time‐based acoustic measures such as jitter, shimmer, NHR, and vowel formants which have generally noted only a weak to moderate correlation 9 .…”

Section: Discussionmentioning

confidence: 99%

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Voice and Stroboscopic Characteristics in Transgender Patients Seeking Gender‐Affirming Voice Care

et al. 2020

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Objective Understanding transgender voice is in nascent stages. This study describes voice characteristics in treatment‐seeking trans women by comparing two validated questionnaires—Voice Handicap Index‐10 (VHI‐10) and Transsexual Voice Questionnaire (TVQMtF)—and reports incidence of abnormal stroboscopy findings and acoustic characteristics. Methods Retrospective review of transgender patients presenting to tertiary‐care laryngology center between February 2018–February 2019. Mean VHI‐10, TVQ, and Singing VHI‐10 (SVHI‐10) scores; audio‐perceptual grade; acoustic measures; and stroboscopy findings were analyzed. VHI‐10 and SVHI‐10 vs TVQMtF were compared. Results Sixty‐one trans female patients (mean age: 32 ± 11 years) were analyzed. Mean duration since start of transition was 41.5 ± 61 months. Sixty‐nine percent presented full‐time female in all contexts. Pathologic stroboscopy findings were found in 5%. Mean questionnaire scores were 16 ± 10 (VHI‐10), 19 ± 13 (SVHI‐10), and 81 ± 22 (TVQMtF). Correlation between VHI‐10 and SVHI‐10 versus TVQMtF was weak, R = 0.47 (P = .053) and R = 0.35 (P = .17), respectively. Mean audio‐perceptual grade was 0.27 ± 0.15. Mean Cepstral Spectral Index of Dysphonia (CSID, sustained vowel) was 8.5 ± 21.9. Mean Cepstral Peak Prominence (CPP) Fo and CPP Fo SD in rainbow passage were 157.3 ± 16 and 59.4 ± 15.9, respectively. Conclusion Trans women report perceived voice handicap in speaking and singing, which appears separate from gender‐related voice/communication concerns. This study is the first to report stroboscopy findings in transgender individuals, with 5% being abnormal. Stroboscopy is encouraged before initiating voice intervention in transgender patients. Preliminary evaluation suggests weak correlation between VHI‐10 or SVHI‐10 and TVQMtF but requires further investigation. TVQMtF may provide information which more specifically reflects voice concerns of trans women as compared to VHI‐10 and SVHI‐10. Level of Evidence 4 Laryngoscope, 131:1071–1077, 2021

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Voice and Stroboscopic Characteristics in Transgender Patients Seeking Gender‐Affirming Voice Care

et al. 2020

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“…204 Being perceived as male is negatively correlated to personal satisfaction of the voice, even if the fundamental frequency is within the female range. 205 However, Hancock and colleagues, 206 reported that QOL ratings in TW are strongly correlated with their self-rated perception of voice and only moderately related to how others perceive their voice.…”

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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“…Es ergab sich für 5 Patientinnen (23,8 %) kein stimmbezogenes Handicap. 6 Patientinnen (28,6 %) lagen im Bereich eines geringen Handicaps, ebenfalls 6 Patientinnen (28,6 %) waren der Kategorie "mittelschweres Handicap" zuzuordnen und 4 Patientinnen (19,1 %) wiesen ein hochgradiges stimmliches Handicap auf [49]. Bezogen auf eine Transsexualität wurde in der Vergangenheit die mangelnde Spezifität allgemeiner stimmbezogener Fragebögen kritisiert und hinterfragt, ob mit diesen Messinstrumenten die ganze Stimmproblematik transsexueller Patientinnen erfasst werden kann [50].…”

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“…Die Indizes von 21 transsexuellen Patientinnen nach erfolgter Glottoplastik wurden mit den altersabhängigen Staninen sowie mit den allgemeinen Durchschnittswerten der weiblichen Normierungsstichprobe verglichen. Besondere Defizite zeigten sich in der Subskala "Freunde, Bekannte und Verwandte" [49]. In der folgenden Arbeit wird ein Addendum zu den beiden Fragebögen VHI und FLZ vorgestellt, mit dem spezifische Aspekte der Stimmtherapie in der Transition von Mann zu Frau erfasst werden.…”

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Zufriedenheit nach Stimmerhöhung bei Transsexualität – Entwicklung eines Therapiealgorithmus

Meister¹,

Kuehn²,

Shehata‐Dieler³

et al. 2016

Laryngo-Rhino-Otol

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Voice feminization is an important step in the therapy of male-to-female transsexualism. Approaches are conservative voice therapy and surgical interventions. The most powerful parameter of gender perception is the fundamental frequency. Besides the vocal pitch, there are other parameters influencing gender perception of a voice, e. g. intonation, prosody or formant frequencies. In 21 male to female transgender persons after surgical elevation of the vocal pitch the Voice Handicap Index (VHI), the Life Satisfaction Questionnaire (FLZ) and a new addendum were used. A new algorithm for voice feminization in male-to-female transsexualism was deduced. After elevation of the vocal pitch, the self-confidence of the male-to-female transgender persons has increased. Despite of an elevated pitch some persons were not satisfied with their voice. Surgical intervention changes only the pitch of a voice. To change other parameters, conservative voice therapy is necessary. If the transgender persons are able to reach a satisfying female voice with conservative voice therapy alone, surgical intervention is not indicated.

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Perceptual analysis of the male-to-female transgender voice after glottoplasty-the telephone test

Abstract: NA Laryngoscope, 127:875-881, 2017.

Cited by 24 publications

References 32 publications

Voice and Stroboscopic Characteristics in Transgender Patients Seeking Gender‐Affirming Voice Care

Voice and Stroboscopic Characteristics in Transgender Patients Seeking Gender‐Affirming Voice Care

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

Zufriedenheit nach Stimmerhöhung bei Transsexualität – Entwicklung eines Therapiealgorithmus

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