Lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) young people of color encounter interlocking systems of social prejudice and discrimination. However, little is understood about how subjective meanings of perceived structural stigma associated with multiple marginalized social statuses influence mental health. We document how perceived stigma can shape mental health inequalities among multiply marginalized individuals if they also encounter stigmatizing societal frameworks. Data come from in-depth interviews with 41 LGBTQ+ Latino/a young adults in the Rio Grande Valley collected from 2016 to 2017. Utilizing an intersectional minority stress framework, we qualitatively examine how young people conceptualize structural stigma, their multiple social locations (e.g., sexuality, gender, race/ethnicity, age), and their mental health. Findings highlight how LGBTQ+ Latino/a young adults experience structural racism, gender policing, and anti-LGBTQ+ religious messages in relation to their mental health. This study showcases the importance of an intersectional minority stress framework for documenting processes that can shape mental health inequalities.

Purpose: This study examines communicative congruence and communicative dysphoria in adults who deny having a voice disorder. Communicative congruence is the degree to which a person's communication is consistent with their sense of self/identity. Communicative dysphoria is the psychological entropy resulting from communicative in congruence. We propose that these experiences may influence patients' psychosocial well-being and are thus relevant to the field of speech-language pathology. We hypothesized that both constructs would be normally distributed with an inverse relationship. We also hypothesized that communicative congruence would predict scores on the Center for Epidemiological Studies–Depression (CES-D) scale, subscales of the Big Five Aspect Scales (BFAS; a personality measure), and achieve convergent validity with the Vocal Congruence Scale (VCS). Method: Participants (adults 18–70 years) completed the BFAS, CES-D, VCS, and the Voice Handicap Index–10 (VHI-10) before recording a series of speech tasks. Participants' recordings were played back while they responded to questions probing their communicative congruence and communicative dysphoria. Results: The 196 participants were predominantly female (67.3%) and cisgender (96.4%). Communicative congruence was negatively skewed, and communicative dysphoria was normally distributed. Both variables significantly related to each other: More in congruence was associated with more dysphoria. Communicative congruence was inversely related to CES-D scores. The personality metatrait Plasticity related to communicative congruence, as did the domain of Extraversion and the aspects Withdrawal, Enthusiasm, and Assertiveness. Communicative congruence achieved high convergent validity with the VCS. Conclusions: Counter to our hypothesis, participants reported more congruence than incongruence, but all other hypotheses were supported. Participants who reported in congruence were more likely to report symptoms of depression. These findings suggest that even in a predominantly cisgender cohort, some individuals' mental well-being might relate to how well their communication aligns with their identity. This work may inform future investigations into these constructs and their effects on voice therapy outcomes. Supplemental Material: https://doi.org/10.23641/asha.20739967

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Purpose: The goal of this study was to use speech resynthesis to investigate the effects of changes to individual acoustic features on speech-based gender perception of transmasculine voice samples following the onset of hormone replacement therapy (HRT) with exogenous testosterone. We hypothesized that mean fundamental frequency ( f o ) would have the largest effect on gender perception of any single acoustic feature. Method: Mean f o , f o contour, and formant frequencies were calculated for three pairs of transmasculine speech samples before and after HRT onset. Sixteen speech samples with unique combinations of these acoustic features from each pair of speech samples were resynthesized. Twenty young adult listeners evaluated each synthesized speech sample for gender perception and synthetic quality. Two analyses of variance were used to investigate the effects of acoustic features on gender perception and synthetic quality. Results: Of the three acoustic features, mean f o was the only single feature that had a statistically significant effect on gender perception. Differences between the speech samples before and after HRT onset that were not captured by changes in f o and formant frequencies also had a statistically significant effect on gender perception. Conclusion: In these transmasculine voice samples, mean f o was the most important acoustic feature for voice masculinization as a result of HRT; future investigations in a larger number of transmasculine speakers and on the effects of behavioral therapy-based changes in concert with HRT is warranted.

Purpose: We present a theoretical framework that formalizes and defines the constructs of communicative congruence and communicative dysphoria that is rooted within a comprehensive and mechanistic theory of personality. Background: Voice therapists have likely encountered a patient who states that a therapeutic target voice “isn’t me.” The ability to accurately convey a person’s sense of self, or identity, through their voice, speech, and communication behaviors seems to have high relevance to both patients and clinicians alike. However, to date, we lack a mechanistic theoretical framework through which to understand and interrogate the phenomenon of congruence between one’s communication behaviors and their sense of self. Results: We review the initial notion of congruence, first proposed by Carl Rogers. We then review several theories on selfhood, identity, and personality. After reviewing these theories, we explain how our proposed constructs fit within our chosen theory, the Cybernetic Big Five Theory of Personality. We then discuss similarities and differences to a similarly named construct, the Vocal Congruence Scale. Next, we review how these constructs may come to bear on an existing theory relevant to voice therapy, the Trans Theoretical Model of Health Behavior Change. Finally, we state testable hypotheses for future exploration, which we hope will establish a foundation for future investigations into communicative congruence. Conclusion: To our knowledge, the present paper is the first to explicitly define communicative congruence and communicative dysphoria. We embed these constructs within a comprehensive and mechanistic theory of personality and, in doing so, hope to provide a rigorous and comprehensive theoretical framework that will allow us to test and better understand these proposed constructs.