Efficacy of intensive voice feminisation therapy in a transgender young offender

Quinn, Sterling; Swain, Nathaniel

doi:10.1016/j.jcomdis.2018.02.001

Cited by 24 publications

(32 citation statements)

References 53 publications

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“…The average experience in years was 15 for primary clinicians and 22 for substitute clinicians. The average number of clients seen in the year before the project was 18 (15)(16)(17)(18)(19)(20) for primary clinicians and 24 for substitute clinicians. While Group A and B had different primary clinicians, all clinicians worked from the same training manual, provided clients with the same hand-outs and training material, observed each other conducting training, and met frequently to discuss clinical concerns.…”

Section: Data Sources and Participantsmentioning

confidence: 99%

“…Trans Participant Self-Ratings versus Listener Ratings Studies investigating direct rating of trans voices have found that ratings made by naïve listeners, clinically experienced listeners, and trans individuals themselves generally correlate with one another [14,15,20,21]. However, the strength of this correlation has been found to vary from moderate [15] to strong [22] and may be stronger for some speaking tasks (e.g., reading compared to spontaneous speech) [20]. It is also notable that ratings made by different groups -even when they do correlate with one another -may vary in how strongly they correlate with a trans individual's self-reported satisfaction with their voice.…”

Section: Past Research Investigating Perceptual Ratings Of Voice and ...mentioning

confidence: 99%

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Perceived Gender and Client Satisfaction in Transgender Voice Work: Comparing Self and Listener Rating Scales across a Training Program

Quinn

Oates

Dacakis³

2021

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Background/Aim: Scales used to collect perceptual ratings related to a speaker’s gender are widely used in gender affirming voice training for trans individuals. Such scales may be used as outcome measures to gain insight into whether training has helped clients meet personal goals related to gender expression. These scales are also widely used in general research investigating the relationship between vocal characteristics and perceptions of speaker gender. However, past studies in these areas have varied in the terminology used to label rating scales and the impact of this variation is currently unknown. Additionally, research has not yet fully explored the relationship between self- and listener-ratings of trans participant voices and trans participant satisfaction with voice, and whether or not these relationships change after trans participants undertake gender affirming voice training. This research paper aimed to explore these relationships and address these research gaps. Methods: A group of 34 trans participants were asked to rate their voices before and after participating in gender affirming voice training. Trans participant voice samples from before and after training were also presented to a group of 25 listeners for rating. Perceptual ratings were made on two Visual Analogue Scales (VAS) with anchors ‘very feminine/very masculine’ and ‘very female/very male’. Trans participants also rated their satisfaction with their current voice on a VAS with anchors ‘very satisfied/very unsatisfied’. Correlation coefficients were calculated to investigate the relationship between collected ratings. Results: Differences in scale labels were found to have minimal impact on ratings made by both trans participants and listeners. Trans participant self-ratings were found to correlate with listener ratings, but this correlation was not strong Trans participant self-ratings had a consistently stronger relationship with their self-rated vocal satisfaction. The study contributed new findings that these differences may be more pronounced after trans participants have completed voice training. Discussion/conclusion: This study suggests that results from past studies that have used differently labelled scales to collect ratings related to gender perception based on voice are suitable to compare. This study also discusses the implications reported differences between trans participant self-ratings and listener ratings may have for research and clinical practice.

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Section: Data Sources and Participantsmentioning

confidence: 99%

Section: Past Research Investigating Perceptual Ratings Of Voice and ...mentioning

confidence: 99%

Perceived Gender and Client Satisfaction in Transgender Voice Work: Comparing Self and Listener Rating Scales across a Training Program

Quinn

Oates

Dacakis³

2021

Folia Phoniatr Logop

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“…Anterior carriage of the tongue, and increased lip spreading are known methods of modifying the vocal tract to alter formants (Quinn and Swain, 2018). While these practices were discussed in training sessions, decreases in F1 and F2 may be the result of various circumstances.…”

Section: Summary Of Resultsmentioning

confidence: 99%

“…Gorham-Rowan and Morris (2006) revealed that ratings of trans women by unfamiliar listeners were most likely to be identified as female when speaking with an SFF of 160 Hz and greater. Increasing pitch along with other voice and speech modification strategies, such as modifying loudness (Hancock & Garabedian, 2012), modifying (Quinn & Swain, 2018), and following healthy vocal hygiene practices have been shown to increase the likelihood of gender congruent speech perception (Dahl and Mahler, 2019).…”

Section: Voice and Gender Identificationmentioning

confidence: 99%

“…While vowel productions provide a great deal of insight into the acoustic characteristics of an individual's voice, it does not measure other aspects of speech, which contribute to gendered communication. (Quinn and Swain, 2018). In this study, spontaneous speech samples were useful for measuring changes in pitch during a less structured task.…”

Section: Limitationsmentioning

confidence: 99%

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Acoustic and Perceptual Outcomes of Vocal Training for Transgender Women

Yehle¹

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This study investigated the acoustic and perceptual outcomes of a specific six-week voice training protocol for transgender women, by analyzing acoustic features of speech and voice. The authors sought to establish statistical and clinical significance between speaking fundamental frequency and self-perceptual ratings of communicative experiences, pre-and post-training. Methods: Speech samples were collected from 10 transgender women. Acoustic variables analyzed for this research include: fundamental frequency (F0) of vowel prolongation, speaking fundamental frequency (SFF) of spontaneous speech, formants (F1 and F2), pitch perturbation quotient (PPQ), relative average perturbation (RAP), noise-to-harmonic ratio (NHR), and intensity. Participants also completed a selfevaluation of communicative experiences using a five-point scale from the Transsexual Voice Questionnaire, Male-to-Female (TVQMtF). Speech samples were collected pre-and post-training to establish statistical and clinical significance. Results: Statistically and clinically significant gains were found between pre-and post-training in the areas of F0 in vowel prolongation, and SFF during spontaneous speech. There were generally medium effect sizes for F1 and F2, PPQ, RAP, NHR, and intensity. These analyses were limited by sample size. Results suggest that F0 of vowel prolongation, SFF, SFF variation, formant modification, and intensity are suitable targets for evidence-based practices for transgender women. iii ACKNOWLEDGMENTS I would like to thank everyone who provided support and guidance to complete this thesis. All mistakes are mine alone. I would first like to thank my advisor and academic supervisor Dr. Leslie Mahler. Her patience, thoughtfulness, and confidence in my abilities helped me to persevere throughout this process. Thank you to Kimberly Dahl, your hard work has provided an opportunity for which I will be eternally grateful. Thank you to Madison Turner, for all of her hard work and patience, I hope this experience was of value. Thanks are due to my thesis committee, from whom I have learned to better myself personally and professionally. I would also like to thank my husband, whose unwavering patience and support has allowed me to change careers, and work toward my personal and professional goals. Lastly, I am most thankful of all of the participants who found time to take part in this research. The opportunity to meet these individuals is something I will cherish the most from this experience.

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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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Efficacy of intensive voice feminisation therapy in a transgender young offender

Cited by 24 publications

References 53 publications

Perceived Gender and Client Satisfaction in Transgender Voice Work: Comparing Self and Listener Rating Scales across a Training Program

Perceived Gender and Client Satisfaction in Transgender Voice Work: Comparing Self and Listener Rating Scales across a Training Program

Acoustic and Perceptual Outcomes of Vocal Training for Transgender Women

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

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