Phonetograms, Aerodynamic Measurements, Self-Evaluations, and Auditory Perceptual Ratings of Male-to-Female Transsexual Voice

Holmberg, Eva B.; Oates, Jennifer; Dacakis, Georgia; Grant, Cameron

doi:10.1016/j.jvoice.2009.02.002

Cited by 68 publications

(32 citation statements)

References 45 publications

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“…The voice is an important gender marker [3]. There are a number of features that determine the perception of voice as feminine, namely: pitch -fundamental frequency of laryngeal tone (F0), two times higher in women than in men; formant structure characteristic for female voice; timbre; and rising intonation at the end of a sentence [10].…”

Section: Discussionmentioning

confidence: 99%

“…This fact can be particularly observed in transsexual subjects [2,4,5]. Transsexualism is a condition in which a person believes that his or her psychological gender is incongruent with their anatomic gender [6].…”

Section: Opis Przypadkumentioning

confidence: 99%

“…ing feature of male and female voices [2]. To allow the castrato to have a feminine voice, the castration had to be performed pre-pubertally and before any secretions of testosterone appeared.…”

Section: Opis Przypadkumentioning

confidence: 99%

“…Therefore, their range of voice was impressive: 3-4 octaves (normal value: 1.5) and maximal phonation time: 120 seconds (normal value: 20 seconds). Even at that time, the importance of the definitive and indelible hormonal influence of testosterone was recognised, including its impact on the voice apparatus [3].…”

Section: Opis Przypadkumentioning

confidence: 99%

See 3 more Smart Citations

Gender-related voice problems in transsexuals — therapeutical demands

Misołek

Niebudek-Bogusz

Morawska

et al. 2015

Endokrynologia Polska

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The paper presents a case study of a transsexual patient who underwent a voice pitch elevation surgery performed in Poland for the first time. The human voice is a reflection of the working of hormones and human psyche. This fact is of particular importance in transsexualism, a disorder consisting in incongruence between the individual's biological sex and their identified gender. For many transsexual people, especially of the MTF (male to female) type, who have undergone hormonal and surgical sex change, the voice still presents a major problem, causing difficulties in everyday life. Hormonal treatment does not influence feminisation of the larynx. In the described MTF case, the patient's low androphonic voice was perceived as a male voice. In order to feminise the patient's voice a phonosurgical procedure was performed: the length of the vibrating portion of the vocal folds was shortened by over 50% of their total length by means of suturing of the anterior part of the vocal fold. As a result of the surgical treatment the pitch of voice was raised considerably, with F0 of spoken voice increased from 109 Hz to 209 Hz. The voice range also changed towards female tones, from 59-146 Hz to 148-343 Hz. Pitch elevation positively influenced the patient's subjective voice assessment: total score of the Voice Handicap Index (VHI) improved from 99 to 19 points, and the score of its emotional sub-scale: 39 and 2 points, respectively. The described case of a surgical male-to-female voice change presents one of the dilemmas faced by modern medicine. StreszczeniePrzedstawiono przypadek pacjentki transseksualnej, u której po raz pierwszy w Polsce przeprowadzono zabieg chirurgiczny zmiany głosu z męskiego na żeński. Głos ludzki -drugorzędowa cecha płciowa -jest odzwierciedleniem działania hormonów i psychiki. Fakt ten nabiera szczególnego znaczenia w transseksualizmie, zaburzeniu polegającym na niezgodności płci biologicznej z płcią psychiczną. Dla wielu osób transseksualnych, szczególne w postaci transseksualizmu M/K (mężczyzna/kobieta) po hormonalnej i chirurgicznej zmianie płci biologicznej ważnym problemem nastręczającym trudności w życiu codziennym pozostaje głos, gdyż leczenie hormonalne nie wpły-wa na feminizację krtani -aparatu głosowego. W opisywanym przypadku niski androfoniczny głos pacjentki był percepowany przez otoczenie jako męski. W celu feminizacji głosu wykonano leczenie fonochirurgiczne: skrócono fałdy głosowe o ponad 50% ich długości poprzez założenie szwów zespalających w ½ przedniej części głośni. W wyniku zabiegu podwyższono znacząco głos: przedoperacyjna częstotliwość głosu mówionego wyraźnie przesunęła się po operacji w górę z wartości 109 Hz do 209 Hz. Zakres głosu także zmienił się w kierunku tonów żeńskich z 59-146 Hz do 148-343 Hz. Zmiana wysokości głosu u pacjentki wpłynęła pozytywnie na jej subiektywną ocenę głosu: wynik kwestionariusza VHI (Voice Handicap Index) poprawił się z 99 pkt -przed operacją do 19 pkt -po operacji. Na poprawę jakości życia wskazuje także spadek problemów emocjo...

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Section: Discussionmentioning

confidence: 99%

Section: Opis Przypadkumentioning

confidence: 99%

Section: Opis Przypadkumentioning

confidence: 99%

Section: Opis Przypadkumentioning

confidence: 99%

See 2 more Smart Citations

Gender-related voice problems in transsexuals — therapeutical demands

Misołek

Niebudek-Bogusz

Morawska

et al. 2015

Endokrynologia Polska

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show abstract

“…For MTF TG individuals, one vocal behavior typically targeted in therapy has been vocal pitch. This selection is based on previous research, [13][14][15][16][17] which showed that raising pitch was important to perception of an MTF TG speaker as female. In addition, vowel formant frequencies are also frequently targeted, based on research which has showed that TG individuals perceived as female typically have higher vowel formant frequencies than those perceived inconsistently or as male (eg, Refs 15,18,19 ).…”

Section: Introductionmentioning

confidence: 99%

A Preliminary Study on the Use of Vocal Function Exercises to Improve Voice in Male-to-Female Transgender Clients

Gelfer

Dong

2013

Journal of Voice

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Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

et al. 2023

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ImportanceGender-affirming care is a key clinical area that can benefit from implementation of patient-reported outcome measures (PROMs). Identifying barriers to and enablers of PROM implementation is needed to develop an evidence-based implementation strategy.ObjectiveTo identify (1) PROMs previously implemented for gender-affirming care and constructs measured, (2) how patients completed PROMs and how results were reported and used, and (3) barriers to and enablers of PROM implementation.Evidence ReviewIn this systematic review, PubMed, Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science were searched from inception to October 25, 2021, and updated on December 16, 2022. Gray literature was searched through gray literature database, online search engine, and targeted website searching. Inclusion criteria were (1) original articles of (2) a formally developed PROM or ad hoc instrument administered for gender-affirming care to (3) patients accessing gender-affirming care. The Critical Appraisal Skills Programme tool was used to evaluate quality of included studies. This review was registered on PROSPERO (CRD42021233080).FindingsIn total, 286 studies were included, representing 85 395 transgender and nonbinary patients from more than 30 countries. A total of 205 different PROMs were used in gender-affirming care. No studies described using an implementation science theory, model, or framework to support PROM deployment. Key barriers to PROM implementation included issues with evidence strength and quality of the PROM, engaging participants, and PROM complexity. Key enablers of PROM implementation included using PROMs validated for gender-affirming care, implementing PROMs able to be deployed online or in person, implementing PROMs that are shorter and reduce patient burden, engaging key stakeholders and participants as part of developing an implementation plan, and organizational climate.Conclusions and RelevanceIn this systematic review of barriers to and enablers of PROM implementation in gender-affirming care, PROM implementation was inconsistent and did not follow evidence-based approaches in implementation science. There was also a lack of patient input in creating implementation strategies, suggesting a need for patient-centered approaches to PROM implementation. Frameworks created from these results can be used to develop evidence-based PROM implementation initiatives for gender-affirming care and have potential generalizability for other clinical areas interested in implementing PROMs.

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Phonetograms, Aerodynamic Measurements, Self-Evaluations, and Auditory Perceptual Ratings of Male-to-Female Transsexual Voice

Cited by 68 publications

References 45 publications

Gender-related voice problems in transsexuals — therapeutical demands

Gender-related voice problems in transsexuals — therapeutical demands

A Preliminary Study on the Use of Vocal Function Exercises to Improve Voice in Male-to-Female Transgender Clients

Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

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