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A Look at Baseline Characteristics of Transgender Patients seeking Gender-Affirming Voice Treatment

by Linda Kossoff •

What are the baseline characteristics of transgender patients seeking gender-affirming voice treatment, and how do current voice handicap measures relate to self-reported quality of life?

BOTTOM LINE

Treatment-seeking transgender women perceive voice handicap in speaking and singing that appears separate from gender-related voice/communication concerns, and further investigation is required to understand whether some currently available questionnaires should be used.

BACKGROUND: Voice is a direct reflection of identity among transgender individuals. As such, it is an area of risk for being misgendered and may impact these individuals’ gender dysphoria. Fundamental understanding of transgender voice care is limited, and it is unclear how best to assess and follow voice changes during and after treatment.

STUDY DESIGN: Retrospective review.

SETTING: Department of Otolaryngology–Head and Neck Surgery, University of California-San Francisco, Calif.

SYNOPSIS: Researchers completed retrospective chart reviews on 61 trans women patients who presented to a single tertiary-care laryngology center between February 2018 and February 2019 and received a multidisciplinary evaluation. Researchers compared and analyzed Mean Voice Handicap Index-10 (VHI-10), TVQ, and Singing VHI-10 (SVHI-10) questionnaire scores; audio-perceptual grades; acoustic measures; and stroboscopy findings. Questionnaires focused on patients’ self-perception of voice handicap in speaking and singing. Auditory-perception evaluation was completed using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) according to standard protocol. Software programs analyzed connected speech and sustained /a/. Abnormal stroboscopy findings (bilateral mid-membranous vocal fold lesions, bilateral vocal fold edema, saccular cyst) were identified in 5% of patients. Authors noted a broad range of questionnaire responses due to the high variability of patients’ experience. They added that their data may allow for an enhanced understanding of the discrete acoustic measures that could aid in evaluation and quantification of gender-affirming voice treatment. Study limitations included drawbacks associated with the study’s retrospective nature, including incomplete data sets, and a focus on trans women only.

CITATION: Young VN, Yousef A, Zhao NW, et al. Voice and stroboscopic characteristics in transgender patients seeking gender-affirming voice care. Laryngoscope. 2021;131:1071-1077.