The Effect of Formant Biofeedback on the Feminization of Voice in Transgender Women

Kawitzky, Deanna; McAllister, Tara

doi:10.1016/j.jvoice.2018.07.017

Cited by 37 publications

(13 citation statements)

References 42 publications

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“…10 Other authors and clinicians continue to use oral resonance therapy and formant biofeedback therapy in behavioral modification sessions. 11,12,13 Hancock et al, understanding the limitations of fundamental frequency as a sole factor for voice gender recognition, studied intonation as a function of voice-gender recognition in a cohort is cis-male, cis-female, trans-male, and trans-female speakers. The results showed that speakers perceived as females by listeners had more "upward intonation" and a larger utterance semitone range in all groups of speakers.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of an Artificial Intelligence Tool to Fundamental Frequency as an Outcome Measure in People Seeking a More Feminine Voice

et al. 2021

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Objectives/Hypothesis: An artificial intelligence (AI) tool was developed using audio clips of cis-male and cis-female voices based on spectral analysis to assess %probability of a voice being perceived as female (%Prob♀). This program was validated with 92% accuracy in cisgender speakers. The aim of the study was to assess the relationship of f o on %Prob♀ by a validated AI tool in a cohort of trans females who underwent intervention to feminize their voice with behavioral modification and/or surgery.Study Design: Cohort study. Methods: Fundamental frequency (f o ) from prolonged vowel sounds (f o /a/) and f o from spontaneous speech (f o -sp) were measured using the Kay Pentax Computerized Speech Lab (Montvale, NJ) in trans females postintervention. The same voice samples were analyzed by the AI tool for %Prob♀. Chi-square analysis and regression models were performed accepting >50% Prob♀ as female voice.Results: Forty-two patients were available for analysis after intervention. f o -sp post-treatment was positively correlated with %Prob♀ (R = 0.645 [P < .001]). Chi-square analysis showed a significant association between AI %Prob♀ >50% for the speech samples and f o -sp >160 Hz (P < .01). Sixteen of 42 patients reached an f o -sp >160 Hz. Of these, the AI program only perceived nine patients as female (>50 %Prob♀).Conclusion: Patients with f o -sp >160 Hz after feminization treatments are not necessarily perceived as having a high probability of being female by a validated AI tool. AI may represent a useful outcome measurement tool for patients undergoing gender affirming voice care.

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Section: Discussionmentioning

confidence: 99%

A Comparison of an Artificial Intelligence Tool to Fundamental Frequency as an Outcome Measure in People Seeking a More Feminine Voice

et al. 2021

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“…10,26,27 However, these outcomes may not accurately reflect client satisfaction or voice-related quality of life. Listeners' perceptions of gender do correlate with F 0 , formant frequency, and intonation patterns 7,8,[28][29][30][31][32][33] (with F 0 the strongest predictor of gender perception 34 ), but F 0 does not necessarily correlate with voice satisfaction 35 or voice-related quality of life. 36,37 Furthermore, correct gendering does not always translate to higher voice satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Gender‐Affirming Voice and Communication Modification for Transgender Individuals

et al. 2021

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Objectives: Transgender individuals' voices are closely related to gender identity. A primary goal of gender-affirming voice modification is to help individuals alter their voices to improve gender congruence; however, there is a paucity of research to support this approach. This study aimed to evaluate the outcomes of a 12-week gender-affirming voice and communication modification program.Study Design: Retrospective cohort study. Methods: A retrospective consecutive case series of transgender women enrolled in a voice and communication modification program was performed. Demographics, Trans Woman Voice Questionnaire (TWVQ), fundamental frequency (F 0 ), and frequency range were collected before and after the program. A Wilcoxon signed-rank test assessed changes in outcomes. Spearman's rank-order correlation coefficients quantified associations between self-reported outcomes and acoustic measures.Results: A total of 16 trans women individuals were enrolled. The mean age was 31.5 years. After program completion, TWVQ improved 20.4 points, F 0 increased 26.5 Hz (spontaneous speech) and 25.7 Hz (reading), and the range increased 24.7 Hz (spontaneous speech) and 0.1 Hz (reading). None of the changes in acoustic measures significantly correlated with improvement in TWVQ scores in the cohort.Conclusion: Trans women experience improvements in self-reported outcomes and changes in acoustic measures after completing a gender-affirming voice and communication modification program. Individuals may experience significant improvement in subjective outcomes despite small changes in acoustic measures and vice versa.

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“…공명 음성(resonant voice)은 잘 뻗어 나가고 산출하기 편하며, 마 스크라 불리는 코와 입 주변 부위가 진동하는 감각을 동반하는 음 성을 말한다 (Smith, Finnegan, & Karnell, 2005;Titze, 2001) (Song, Sim, & Choi, 2000). (Kawitzky & McAllister, 2020;Ribeiro et al, 2019;Schalling, Gustafsson, Ternström, Wilén, & Södersten, 2013) (Allen, 2007;Yorkston, Spencer, & Duffy, 2003). 통계적으로 유의한 차이가 있었다(p =.002) (Figure 4).…”

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Clinical Applications of Facial Sensor Biofeedback: Implications for Voice Therapy or Vocal Training

An¹,

Choi²,

Lee³

et al. 2022

Commun Sci Disord

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Objectives: Biofeedback therapy is a training technique that has a positive effect on the voice. In order to conduct resonant voice therapy or tube phonation more effectively, it is important for the patient to feel the vibration sensation in a specific part of the facial structures. Therefore, in this study, the clinical basis for facial vibration was presented by quantifying the vibration site and magnitude using vibration sensors during various semi-occluded vocal tract phonations.Methods: A total of 38 normal young adults without dysphonia participated in this study. Recording was performed a total of 6 times for each type of phonation, in the order of /a/ phonation, Kazoo, lip trill, humming, straw phonation, and tube phonation in water at the comfortable level using newly developed facial vibration sensor.Results: There was a significant difference in the magnitude of vibration according to body parts (cheek, nose, neck) during resonant voice or tube phonation; the largest amplitude presented in the nose during humming whereas lip trill, straw, kazoo, and tube phonation in water presented in the cheek. There were also significant differences in the magnitude of vibration among the voice therapy exercises or vocal training techniques (/a/ phonation, Kazoo, lip trill, humming, straw phonation, and tube phonation in water; with greater amplitude in dual sources such as lip trill and water resistance phonation than in single source phonations.Conclusion: The facial vibration sensor could provide clinical evidence for facial vibration sensation during semi-occluded vocal tract phonation. It can also provide biofeedback and monitor whether patients can perform semi-occluded vocal tract phonation properly.

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The Effect of Formant Biofeedback on the Feminization of Voice in Transgender Women

Cited by 37 publications

References 42 publications

A Comparison of an Artificial Intelligence Tool to Fundamental Frequency as an Outcome Measure in People Seeking a More Feminine Voice

A Comparison of an Artificial Intelligence Tool to Fundamental Frequency as an Outcome Measure in People Seeking a More Feminine Voice

Outcomes of Gender‐Affirming Voice and Communication Modification for Transgender Individuals

Clinical Applications of Facial Sensor Biofeedback: Implications for Voice Therapy or Vocal Training

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