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Li Z, Zhang D, Chen H, Liu Y, Wang HC. Voice Pitch Shaping and Genderization: New Needs of Cosmetic Phonoplastic Surgery. Aesthetic Plast Surg 2024:10.1007/s00266-024-03919-0. [PMID: 38565723 DOI: 10.1007/s00266-024-03919-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/08/2024] [Indexed: 04/04/2024]
Abstract
Voices can convey content, emotion, and essential information about an individual's gender and social information. Closely related to gender identification and sexual attraction, voices also positively affect many psychological factors of individuals. Surgeries have evolved from treating congenital diseases to fulfilling an individual's aesthetic needs for voice. Voice shaping is emerging as the next cosmetic surgery hotspot after skincare and appearance and body shaping. This paper summarizes the development of voice pitch shaping and genderization procedures out of the cosmetic need. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .
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Affiliation(s)
- Zhijin Li
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Dingyue Zhang
- Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Hongsai Chen
- Department of Otorhinolaryngology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ying Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639 of Zhizaoju Road, District Huangpu, Shanghai, 200011, China.
| | - Hayson Chenyu Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639 of Zhizaoju Road, District Huangpu, Shanghai, 200011, China.
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Turetta C, Colizza A, Giannini A, Ralli M, Bogani G, Laganà AS, Pecorini F, Muzii L, Paoli A, Di Donato V, De Vincentiis M. Polycystic Ovary Syndrome and Alteration of Vocal Function: A Systematic Review and Meta-Analysis. Gynecol Obstet Invest 2024; 89:22-30. [PMID: 38194939 DOI: 10.1159/000535819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/16/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is a common hormonal disorder among young women, correlated with hyperandrogenism. Among the symptoms of PCOS, vocal alterations are quite unknown. Dysphonia may be related to hyperandrogenism, and there is no consensus about its prevalence and the severity of vocal disorders, which can cause noticeable discomfort. METHODS A systematic review of the literature was conducted. Four studies on PCOS that evaluated the phonatory system were included for a total of 174 patients (96 PCOS, 78 controls), and a meta-analysis on comparable data was performed. RESULTS Four studies evaluated parameters related to vocal symptomatology, altered audiometric examination, and findings at the laryngoscopy in patients affected by PCOS versus controls. Although the individual studies showed increased incidence of alterations and a tendency to develop speech fatigue in women with PCOS, when the results of studies were pulled in meta-analysis, the overall difference was not statistically significant. The studies themselves were very different from each other; therefore, it is hard to draw any firm conclusions. DISCUSSION The aim of this study was to assess the prevalence of vocal alterations, the correlation with hyperandrogenism, the quality of life, and the voice changes after starting a therapy for PCOS. The present meta-analysis failed to find any difference in terms of PCOS and control cohort. However, the lack of high-quality studies makes it difficult to draw firm conclusions. New and larger studies or big population program data are therefore warranted.
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Affiliation(s)
- Camilla Turetta
- Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Polyclinic Umberto I, Rome, Italy
| | - Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Andrea Giannini
- Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Polyclinic Umberto I, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Giorgio Bogani
- Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Polyclinic Umberto I, Rome, Italy
| | - Antonio Simone Laganà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), Unit of Gynecologic Oncology, ARNAS "Civico, Di Cristina-Benfratelli", University of Palermo, Palermo, Italy
| | - Francesco Pecorini
- Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Polyclinic Umberto I, Rome, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Polyclinic Umberto I, Rome, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Violante Di Donato
- Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Polyclinic Umberto I, Rome, Italy
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Lester-Smith RA, Derrick E, Larson CR. Characterization of Source-Filter Interactions in Vocal Vibrato Using a Neck-Surface Vibration Sensor: A Pilot Study. J Voice 2024; 38:1-9. [PMID: 34649740 PMCID: PMC8995401 DOI: 10.1016/j.jvoice.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE Vocal vibrato is a singing technique that involves periodic modulation of fundamental frequency (fo) and intensity. The physiological sources of modulation within the speech mechanism and the interactions between the laryngeal source and vocal tract filter in vibrato are not fully understood. Therefore, the purpose of this study was to determine if differences in the rate and extent of fo and intensity modulation could be captured using simultaneously recorded signals from a neck-surface vibration sensor and a microphone, which represent features of the source before and after supraglottal vocal tract filtering. METHOD Nine classically-trained singers produced sustained vowels with vibrato while simultaneous signals were recorded using a vibration sensor and a microphone. Acoustical analyses were performed to measure the rate and extent of fo and intensity modulation for each trial. Paired-samples sign tests were used to analyze differences between the rate and extent of fo and intensity modulation in the vibration sensor and microphone signals. RESULTS The rate and extent of fo modulation and the extent of intensity modulation were equivalent in the vibration sensor and microphone signals, but the rate of intensity modulation was significantly higher in the microphone signal than in the vibration sensor signal. Larger differences in the rate of intensity modulation were seen with vowels that typically have smaller differences between the first and second formant frequencies. CONCLUSIONS This study demonstrated that the rate of intensity modulation at the source prior to supraglottal vocal tract filtering, as measured in neck-surface vibration sensor signals, was lower than the rate of intensity modulation after supraglottal vocal tract filtering, as measured in microphone signals. The difference in rate varied based on the vowel. These findings provide further support of the resonance-harmonics interaction in vocal vibrato. Further investigation is warranted to determine if differences in the physiological source(s) of vibrato account for inconsistent relationships between the extent of intensity modulation in neck-surface vibration sensor and microphone signals.
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Affiliation(s)
- Rosemary A Lester-Smith
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Elaina Derrick
- Department of Speech, Language and Hearing Sciences, Moody College of Communication, The University of Texas at Austin, Austin, Texas
| | - Charles R Larson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
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Hennekam S, Dumazert J. Intersectional (in)visibility of transgender individuals with an ethnic minority background throughout a gender transition: Four longitudinal case studies. GENDER WORK AND ORGANIZATION 2023. [DOI: 10.1111/gwao.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
- Sophie Hennekam
- Organizational Behavior Audencia Business School Organization Studies and Ethics Department Nantes France
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Santos RB, Lemos C, Saraiva M. Gender-Affirming Hormone Therapy: Physical and Sociopsychological Effects, Impact and Satisfaction. Cureus 2023; 15:e36484. [PMID: 37090416 PMCID: PMC10118284 DOI: 10.7759/cureus.36484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Background Gender dysphoria treatment includes gender-affirming hormone therapy (GAHT). Studies are still lacking on how to characterize its effects and impact on transgender people's lives more effectively. Aim To study the physical and psychological effects of GAHT on transgender individuals, assess its impact on their lives, and rate their overall satisfaction. Methods Participants (n = 114; ages 18-62 years; median age 24.0 (21.0 - 33.0) years) included transgender adults residing in Portugal who were undergoing or had undergone hormonal therapy for at least one uninterrupted year. Participants completed an original questionnaire. For most items, an ordinal Likert-style scale ranging from 0 (worst result) to 6 (best result) was used. Descriptive statistics and non-parametric tests, including Pearson's chi-squared test, Wilcoxon signed-rank test, and Mann-Whitney U test were used to analyze categorical and continuous variables, with a significance level set at 0.05. Outcomes The outcomes included desired physical changes rating (perception and satisfaction with changes); side effects of GAHT; the sociopsychological impact of GAHT (on self-esteem, body image, psychological wellbeing, social and family relations); overall satisfaction (with treatment results and medical follow-up). Results The changes classified as the most perceptible in those undergoing masculinizing treatment (Group M) were amenorrhea (6 (5.0-6.0) points) and clitoris enlargement (6 (5.0-6.0) points). These were also the ones rated as the most satisfactory (6 (6.0-6.0) points for amenorrhea and 6 (4.0-6.0) points for clitoris enlargement). On those undergoing feminizing therapy (Group F), the alteration voted as the most perceptible was sperm production decrease (6 (2.0-6.0) points), and the ones classified as the most satisfactory were sperm production decrease (6 (4.0-6.0) points) and spontaneous erections decrease (6 (5.0-6.0) points). Side effects were reported by 89.7% of Group M (mood swings were the most common) and 96.3% of Group F (decreased libido was the most frequent). The sociopsychological impact of hormonal treatment was significantly positive in all analyzed variables (p<0.001). Overall satisfaction with treatment results and medical follow-up were rated with 5 points and 4.5 points, respectively. Clinical implications This study provides clinicians with more evidence that GAHT may improve the physical, psychological and social health of transgender people seeking medical transition. Strengths and limitations The strengths of the current study include a high participant count relative to the target population, the acquisition of data on previously unexplored variables, and the significance of being one of the few investigations of its kind conducted in Portugal. However, the study has limitations, including differences in participant characteristics, a small sample size for some variables, potential bias due to the retrospective nature of the study, individualized treatment regimens, and the inclusion of participants from different countries, which limit the generalization of the results. Conclusions This study provides further evidence that GAHT is effective, and that its physical effects are satisfactory while resulting in mostly non-severe nor life-threatening side effects. GAHT is an important therapy in gender dysphoria and has consistent results in improving numerous sociopsychological variables.
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Affiliation(s)
- Rafael B Santos
- Endocrinology Department, Centro Hospitalar Universitário do Porto, Porto, PRT
| | - Carolina Lemos
- Population Studies, Instituto de Ciências Biomédicas Abel Salazar, Porto, PRT
| | - Miguel Saraiva
- Endocrinology Department, Centro Hospitalar Universitário do Porto, Porto, PRT
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McKenna VS, Gustin RL, Hobek AL, Howell RJ, Dickinson TE, Shanley SN, Patel TH. Factors Related to Treatment Attendance for Patients Seeking Gender-Affirming Voice Therapy. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:216-233. [PMID: 36584326 DOI: 10.1044/2022_ajslp-22-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate factors related to treatment attendance for patients seeking gender-affirming voice therapy (GAVT). METHOD We completed retrospective chart reviews of 50 patients (43 transgender women, three transgender men, four nonbinary patients; aged 18-67 years, M = 34.92 years, SD = 12.32 years) referred for GAVT at a Midwest outpatient center from 2016 to 2021. Data extraction included patient demographics, therapy visit specifics (e.g., number of sessions attended, treatment completion status, and in-person vs. virtual visits) and treatment timing (in relation to the onset of the COVID-19 pandemic), and psychosocial and socioeconomic information. RESULTS There was no impact of treatment-timing relative to the onset of the pandemic on any attendance measure; however, patients were 1.9 times more likely to complete therapy with each virtual telehealth session attended. Individual factors of outside social support and hormone replacement therapy were positively related to the number of therapy sessions attended, whereas insurance provider and employment status were related to therapy completion. CONCLUSIONS Telehealth attendance during the COVID-19 pandemic was positively associated with GAVT completion. Future research should investigate psychosocial and socioeconomic factors to understand how to identify patients at risk for poor treatment adherence and facilitate access to clinical care.
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Affiliation(s)
- Victoria S McKenna
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Biomedical Engineering, University of Cincinnati, OH
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, OH
| | - Renee L Gustin
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, OH
| | - Amy L Hobek
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Rebecca J Howell
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, OH
| | - Tara E Dickinson
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Savannah N Shanley
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Tulsi H Patel
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
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Bal KK, Alagoz S, Delibas V, Ortoglu F, Ceylan B, Ozdas T, Kuran G, Gorgulu O. Effects of Infertility on Voice in male patients. Indian J Otolaryngol Head Neck Surg 2022; 74:5199-5206. [PMID: 36742516 PMCID: PMC9895568 DOI: 10.1007/s12070-022-03130-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 07/10/2022] [Indexed: 02/07/2023] Open
Abstract
Purpose In this study, we aimed to determine the differences in normospermic, oligospermic and azoospermic infertile men by performing voice analysis and to discuss this in the light of the literature. Methods 71 male patients who applied to the urology clinic due to infertility and were then referred to us were included in the study. Hormone analysis and spermiogram were requested from the patients for routine infertility tests. Testosterone, Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Prolactin levels of the patients were recorded. Age and spermiogram results were recorded. According to the spermiogram results, the patients were categorized as Group 1 (azoospermic), Group 2 (oligospermic), Group 3 (normospermic). Voice Handicap Index-10 Turkish version (VHI-10) was applied to the patients and the results were recorded. Results The age of the infertile patients ranged from 20 to 37. The mean age was 28.23. The distribution of the patients was 21 patients in Group 1, 40 patients in Group 2, and 10 patients in Group 3. The mean Testosterone level of the patients was 2.78; mean FSH level 12.14; mean LH level 7.26; mean Prolactin level was 8.1. The mean VHI-10 scores of the patients were 10.52. The fundamental frequency F0 Hz (mean pitch) values of the patients were 176,468; jitter % (frequency perturbation jitter) values average 0.25; shimmer % (amplitude perturbation shimmer) values average 2,322; HNR dB values averaged 24,862. Conclusions Testosterone is more effective on the voice, especially in male individuals.It would be more logical to think that many hormones, growth factors and local factors are effective instead of a single hormone.
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Affiliation(s)
- Kemal Koray Bal
- Otorhinolaryngology Department,Lecturer Otorhinolaryngology Specialist, University of Mersin, Mersin, Turkey
| | - Sedat Alagoz
- Otorhinolaryngology Department, Specialist Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Vedat Delibas
- Otorhinolaryngology Department,Research Assistant Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Ferhat Ortoglu
- Urology Department, Specialist Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Betul Ceylan
- Speech and Language Therapist, Otorhinolaryngology Department, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Talih Ozdas
- Otorhinolaryngology Department,Associate Professor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Gokhan Kuran
- Otorhinolaryngology Department,Associate Professor, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Orhan Gorgulu
- Otorhinolaryngology Department,Professor , Ozel Adana Ortadogu Hospital, Adana, Turkey
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Groll MD, Dahl KL, Cádiz MD, Welch B, Tracy LF, Stepp CE. Resynthesis of Transmasculine Voices to Assess Gender Perception as a Function of Testosterone Therapy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2474-2489. [PMID: 35749662 PMCID: PMC9584127 DOI: 10.1044/2022_jslhr-21-00482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/22/2021] [Accepted: 03/31/2022] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- Matti D. Groll
- Department of Biomedical Engineering, Boston University, MA
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Kimberly L. Dahl
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Manuel Díaz Cádiz
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Brett Welch
- Department of Communication Science and Disorders, University of Pittsburgh, PA
| | - Lauren F. Tracy
- Department of Otolaryngology—Head and Neck Surgery, Boston University School of Medicine, MA
| | - Cara E. Stepp
- Department of Biomedical Engineering, Boston University, MA
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- Department of Otolaryngology—Head and Neck Surgery, Boston University School of Medicine, MA
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Houle N, Goudelias D, Lerario MP, Levi SV. Effect of Anchor Term on Auditory-Perceptual Ratings of Feminine and Masculine Speakers. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2064-2080. [PMID: 35452247 PMCID: PMC9567452 DOI: 10.1044/2022_jslhr-21-00476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/10/2021] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Studies investigating auditory perception of gender expression vary greatly in the specific terms applied to gender expression in rating scales. PURPOSE This study examined the effects of different anchor terms on listeners' auditory perceptions of gender expression in phonated and whispered speech. Additionally, token and speaker cues were examined to identify predictors of the auditory-perceptual ratings. METHOD Inexperienced listeners (n = 105) completed an online rating study in which they were asked to use one of five visual analog scales (VASs) to rate cis men, cis women, and transfeminine speakers in both phonated and whispered speech. The VASs varied by anchor term (very female/very male, feminine/masculine, feminine female/masculine male, very feminine/not at all feminine, and not at all masculine/very masculine). RESULTS Linear mixed-effects models revealed significant two-way interactions of gender expression by anchor term and gender expression by condition. In general, the feminine female/masculine male scale resulted in the most extreme ratings (closest to the end points), and the feminine/masculine scale resulted in the most central ratings. As expected, for all speakers, whispered speech was rated more centrally than phonated speech. Additionally, ratings of phonated speech were predicted by mean fundamental frequency (f o) within each speaker group and by smoothed cepstral peak prominence in cisgender speakers. In contrast, ratings of whispered speech, which lacks an f o, were predicted by indicators of vocal tract resonance (second formant and speaker height). CONCLUSIONS The current results indicate that differences in the terms applied to rating scales limit generalization of results across studies. Identifying the patterns across listener ratings of gender expression provide a rationale for researchers and clinicians when making choices about terms. Additionally, beyond f o and vocal tract resonance, predictors of listener ratings vary based on the anchor terms used to describe gender expression. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19617564.
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Affiliation(s)
- Nichole Houle
- Department of Speech, Language & Hearing Sciences, Boston University, MA
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Deanna Goudelias
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Mackenzie P. Lerario
- Fordham Graduate School of Social Service, Fordham University, New York, NY
- The National LGBT Cancer Network, Providence, RI
| | - Susannah V. Levi
- Department of Communicative Sciences and Disorders, New York University, NY
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Dahl KL, François FA, Buckley DP, Stepp CE. Voice and Speech Changes in Transmasculine Individuals Following Circumlaryngeal Massage and Laryngeal Reposturing. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1368-1382. [PMID: 35394801 PMCID: PMC9567379 DOI: 10.1044/2022_ajslp-21-00245] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/03/2022] [Accepted: 01/24/2022] [Indexed: 05/26/2023]
Abstract
PURPOSE The purpose of this study was to measure the short-term effects of circumlaryngeal massage and laryngeal reposturing on acoustic and perceptual characteristics of voice in transmasculine individuals. METHOD Fifteen transmasculine individuals underwent one session of sequential circumlaryngeal massage and laryngeal reposturing with a speech-language pathologist. Voice recordings were collected at three time points-baseline, postmassage, and postreposturing. Fundamental frequency (f o), formant frequencies, and relative fundamental frequency (RFF; an acoustic correlate of laryngeal tension) were measured. Estimates of vocal tract length (VTL) were derived from formant frequencies. Twelve listeners rated the perceived masculinity of participants' voices at each time point. Repeated-measures analyses of variance measured the effect of time point on f o, estimated VTL, RFF, and perceived voice masculinity. Significant effects were evaluated with post hoc Tukey's tests. RESULTS Between baseline and end of the session, f o decreased, VTL increased, and participant voices were perceived as more masculine, all with statistically significant differences. RFF did not differ significantly at any time point. Outcomes were highly variable at the individual level. CONCLUSION Circumlaryngeal massage and laryngeal reposturing have short-term effects on select acoustic (f o, estimated VTL) and perceptual characteristics (listener-assigned voice masculinity) of voice in transmasculine individuals. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19529299.
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Affiliation(s)
- Kimberly L. Dahl
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | | | - Daniel P. Buckley
- Department of Speech, Language & Hearing Sciences, Boston University, MA
- Department of Otolaryngology—Head & Neck Surgery, Boston University School of Medicine, MA
| | - Cara E. Stepp
- Department of Speech, Language & Hearing Sciences, Boston University, MA
- Department of Otolaryngology—Head & Neck Surgery, Boston University School of Medicine, MA
- Department of Biomedical Engineering, Boston University, MA
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Marsano-Cornejo MJ, Roco-Videla Á, Bascuñan-Reinoso K, Garrido-Morales V, Gonzalez-Reyes M, Gonzalez-Yañez K, Opazo-Almazabal B, Silva-Silva C. Frecuencia fundamental en hombres transexuales en diferentes etapas de tratamiento hormonal. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2022. [DOI: 10.5209/rlog.78276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
El tratamiento hormonal que reciben los hombres transexuales tiene entre sus efectos la masculinización de la voz. El objetivo de esta investigación es medir la mediana de la frecuencia fundamental en el habla (Mf0) en hombres transexuales en distintas etapas de su tratamiento hormonal y determinar si existe una alta correlación entre este parámetro y el número de dosis recibidas.
Utilizando Praat se obtuvo el valor de la Mf0 de una serie automática de palabras, su valor mínimo, máximo y rango. Grupo 1: sujetos con 11 o menos dosis de testosterona. Grupo 2: sujetos con 12 o más dosis.
Los valores encontrados son comparables con los esperados para hombres no transgéneros. No se encontraron diferencias significativas respecto a la Mf0, Mf0min, Mf0máx y rango, al comparar los grupos 1 y 2. Existe una correlación baja entre el número de dosis y la Mf0.
Existe una asociación entre el tratamiento hormonal y la masculinización de la voz, sin embargo, no existe evidencia que señale que a mayor número de dosis de hormonas exista una mayor masculinización de la voz. Se necesita realizar nuevas investigaciones con población más grande para verificar estos resultados.
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Mann CC, Karsten AM. Assessment and Treatment of Prosody Behavior in Individuals with Level 1 Autism: A Review and Call for Research. Anal Verbal Behav 2021; 37:171-193. [PMID: 35141105 PMCID: PMC8789987 DOI: 10.1007/s40616-021-00154-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 01/19/2023] Open
Abstract
Differences in prosody behavior between individuals with autism spectrum disorder (ASD) and their typically developing peers have been considered a central feature of ASD since the earliest clinical descriptions of the disorder (e.g., Kanner, 1943/1973). Prosody includes pitch and volume among other dimensions of vocal-verbal behavior that discriminate responses of the listener; thus, people with ASD whose prosody has confusing or off-putting effects may have fewer social opportunities at work, at school, or in the community. The purpose of this review is to examine the state of the literature intervening on prosody with individuals with ASD and to provide recommendations for researchers who are interested in contributing to the scientific understanding of prosody.
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Affiliation(s)
- Charlotte C. Mann
- Department of Psychology, Western New England University, Springfield, MA, USA
- Department of Counseling and Applied Behavioral Studies, University of Saint Joseph, 1678 Asylum Ave, West Hartford, CT 06117 USA
| | - Amanda M. Karsten
- Department of Psychology, Western New England University, Springfield, MA, USA
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13
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Brown KM, Dahl KL, Cler GJ, Stepp CE. Listener Age and Gender Diversity: Effects on Voice-based Perception of Gender. J Voice 2021; 35:739-745. [PMID: 32165021 PMCID: PMC7483284 DOI: 10.1016/j.jvoice.2020.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE An important clinical outcome of voice masculinization treatments in transmasculine speakers is voice-based perception of gender. Rigorous assessments of voice treatment that utilize ratings of perception of gender typically do not control for demographic characteristics of the listeners. The objective of the present study was to determine the effect of listeners' age and gender diversity on voice-based judgments of speaker gender. METHODS Speech stimuli were produced by a single transmasculine individual over approximately one year of hormone replacement therapy, during which he experienced significant changes in his voice. Three groups of listeners rated speech stimuli on a visual analog scale with anchors ranging from "definitely male" to "guessing male" to "guessing female" to "definitely female." Listener groups were N = 10 cisgender young adults, N = 10 cisgender older adults, and N = 10 gender diverse individuals. RESULTS All groups rated the speaker as consistently female through week 14 of hormone replacement therapy and consistently male after week 28. Mean responses of the three groups of listeners were highly correlated (Pearson's correlations all r > 0.97). CONCLUSION Given reasonable group sizes, average ratings of gender perception of a transmasculine speaker are not highly influenced by varying listener age and gender minority status.
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Affiliation(s)
- Katherine M Brown
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts
| | - Kimberly L Dahl
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts
| | - Gabriel J Cler
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Cara E Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts; Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts; Department of Biomedical Engineering, Boston University, Boston, Massachusetts.
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14
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Hodges-Simeon CR, Grail GPO, Albert G, Groll MD, Stepp CE, Carré JM, Arnocky SA. Testosterone therapy masculinizes speech and gender presentation in transgender men. Sci Rep 2021; 11:3494. [PMID: 33568701 PMCID: PMC7876019 DOI: 10.1038/s41598-021-82134-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/09/2020] [Indexed: 11/18/2022] Open
Abstract
Voice is one of the most noticeably dimorphic traits in humans and plays a central role in gender presentation. Transgender males seeking to align internal identity and external gender expression frequently undergo testosterone (T) therapy to masculinize their voices and other traits. We aimed to determine the importance of changes in vocal masculinity for transgender men and to determine the effectiveness of T therapy at masculinizing three speech parameters: fundamental frequency (i.e., pitch) mean and variation (fo and fo-SD) and estimated vocal tract length (VTL) derived from formant frequencies. Thirty transgender men aged 20 to 40 rated their satisfaction with traits prior to and after T therapy and contributed speech samples and salivary T. Similar-aged cisgender men and women contributed speech samples for comparison. We show that transmen viewed voice change as critical to transition success compared to other masculine traits. However, T therapy may not be sufficient to fully masculinize speech: while fo and fo-SD were largely indistinguishable from cismen, VTL was intermediate between cismen and ciswomen. fo was correlated with salivary T, and VTL associated with T therapy duration. This argues for additional approaches, such as behavior therapy and/or longer duration of hormone therapy, to improve speech transition.
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Affiliation(s)
- Carolyn R Hodges-Simeon
- Department of Anthropology, Boston University, 232 Bay Stated Rd., Room 102-B, Boston, MA, 02215, USA.
| | - Graham P O Grail
- Department of Anthropology, Boston University, 232 Bay Stated Rd., Room 102-B, Boston, MA, 02215, USA
- Department of Forensic Sciences, George Washington University, Washington, D.C., USA
| | - Graham Albert
- Department of Anthropology, Boston University, 232 Bay Stated Rd., Room 102-B, Boston, MA, 02215, USA
| | - Matti D Groll
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, USA
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Cara E Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, USA
- Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Justin M Carré
- Department of Psychology, Nipissing University, North Bay, ON, Canada
| | - Steven A Arnocky
- Department of Psychology, Nipissing University, North Bay, ON, Canada
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15
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Fortin CN, Moravek MB. Medical transition for gender diverse patients. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2020; 9:166-177. [PMID: 36714061 PMCID: PMC9881054 DOI: 10.1007/s13669-020-00297-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Purpose of review The purpose of this review is to provide an up-to-date overview of gender-affirming hormone therapy, including the various hormone regimens available, the efficacy and potential risks of these treatments, and considerations for surveillance and long-term care. Recent findings Recent studies reaffirm that hormone therapy has positive physical and psychological effects for many transgender individuals. The overall risks of treatment are low. Transgender women may have an increased risk of venous thromboembolism and breast cancer based on recent cohort studies, but these findings have yet to be confirmed with randomized controlled trials. Important long-term considerations include metabolic, cardiovascular, and skeletal health. Summary High-quality, long-term studies on the effectiveness and safety of various gender-affirming hormone treatment regimens are lacking, but the currently available evidence suggests that it is overall safe and effective with appropriate oversight.
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Affiliation(s)
| | - Molly B. Moravek
- Corresponding author: L4001 Women’s Hospital, 1500 E Medical Center Dr, Ann Arbor, MI,
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16
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Transmasculine Voice Modification: A Case Study. J Voice 2019; 34:903-910. [PMID: 31153772 DOI: 10.1016/j.jvoice.2019.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 11/22/2022]
Abstract
This case study measured the effects of manual laryngeal therapy on the fundamental frequency (fo), formant frequencies, estimated vocal tract length, and listener perception of masculinity of a 32-year-old transmasculine individual. The participant began testosterone therapy 1.5 years prior to the study. Two therapy approaches were administered sequentially in a single session: (1) passive circumlaryngeal massage and manual laryngeal reposturing, and (2) active laryngeal reposturing with voicing. Acoustic recordings were collected before and after each treatment and 3 days after the session. Speaking fo decreased from 124 Hz to 120 Hz after passive training, and to 108 Hz after active training. Estimated vocal tract length increased from 17.0 cm to 17.3 cm after passive training, and to 19.4 cm after active training. Eight listeners evaluated the masculinity of the participant's speech; his voice was rated as most masculine at the end of the training session. All measures returned to baseline at follow-up. Overall, both acoustic and perceptual changes were observed in one transmasculine individual who participated in manual laryngeal therapy, even after significant testosterone-induced voice changes had already occurred; however, changes were not maintained in the follow-up. This study adds to scant literature on effective approaches to and proposed outcome measures for voice masculinization in transmasculine individuals.
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