Remote Voice Treatment with Transgender Individuals: A Health Care Equity Opportunity

What Do We Know About Speech-Language-Hearing Practice in Vocal Care for Transgender People? A Scoping Review

OBJECTIVE

To systematically assess the current state of speech-language-hearing (SLH) practices in health services addressing vocal care for transgender individuals, aiming to identify key themes and gaps in the existing body of knowledge.

METHODS

This scoping review was based on the Joanna Briggs Institute manual and followed the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses-Extension for Scoping Reviews. It was registered with the Open Science Framework Open Source 10.17605/OSF.IO/BUCRG.

RESULTS

Altogether, 1517 studies were found. After excluding duplicates and applying the eligibility criteria, 103 articles were chosen for the review. The studies addressed topics such as vocal training, case/experience reports, barriers to access services, SLH pathologists' and students' perception and knowledge about the transgender voice, evaluation of programs and services, transgender people's perception and knowledge about their own voice and SLH care, acoustic/auditory-perceptual evaluation, protocols, instruments, impacts of voice on quality of life, verbal and nonverbal communication, and hormone therapy and surgeries.

CONCLUSIONS

The summary of the studies reflects the diversity of methods applied in research on transgender people's communication and voice, as well as the variety of topics. Despite the increasing publications on vocal care for transgender people, it is necessary to ensure the dissemination of evidence to support effective practices that recognize and enhance the diversity of this population. Literature data have promising SLH procedures and useful protocols to assess this population. However, they do not clearly indicate what the transgender population actually wants and needs. Furthermore, the study types have not progressed in a coherent order-that is, from preliminary studies to those with more robust methods. Thus, such knowledge may lack consolidation. Many answers to questions in both clinical and academic practices are still not entirely clear. However, it is believed that the advancement of studies will clarify them.

Healthcare Disparities in Otolaryngology

Purpose of Review

The purpose of this review is to summarize some of the recent research studies on healthcare disparities across various subspecialties within otolaryngology. This review also highlights the impact of COVID-19 pandemic on disparities and proposes potential interventions to mitigate disparities.

Recent Findings

Significant healthcare disparities in care and treatment outcomes have been reported across all areas of otolaryngology. Notable differences in survival, disease recurrence, and overall mortality have been noted based on race, ethnicity, socioeconomic status (SES), insurance status, etc. This is most well-researched in head and neck cancer (HNC) within otolaryngology.

Summary

Healthcare disparities have been identified by numerous research studies within otolaryngology for many vulnerable groups that include racial and ethnic minority groups, low-income populations, and individuals from rural areas among many others. These populations continue to experience suboptimal access to timely, quality otolaryngologic care that exacerbate disparities in health outcomes.

Gender-Affirming Voice Surgery: Considerations for Surgical Intervention

The purpose of this article is to provide an overview of the current state and available evidence surrounding surgical voice care for the transgender and/or gender expansive population. The term "gender expansive" has been proposed as an inclusive term to classify those who do not identify with traditional gender roles but are otherwise not confined to one gender narrative or experience. We aim to review indications and candidacy for surgery, surgical procedure options for altering vocal pitch, and typical postoperative expectations. The role of voice therapy and considerations for perioperative care will also be discussed.