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Aires MM, de Oliveira KVG, do Amaral JB, Mônico-Neto M, Martins JRM, Santiago AL, De Biase NG. Effect of Testosterone on the Thyroarytenoid Muscle and Lamina Propria of Female Rat Vocal Folds. Laryngoscope 2024; 134:2316-2321. [PMID: 37997493 DOI: 10.1002/lary.31201] [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: 08/29/2023] [Revised: 10/22/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To analyze the effects of androgen therapy on the thyroarytenoid (TA) muscle, expression of androgen receptors (ARs) and hyaluronic acid (HA) concentration in the vocal folds (VFs) of adult female rats. METHODS Twenty-one adult female Wistar rats were divided into experimental and control groups. The experimental group received weekly intramuscular injections of nandrolone decanoate for 9 weeks. Following euthanasia and dissection of the VFs, histomorphometric analysis of the TA muscle, immunohistochemical evaluation of ARs, and measurement of HA concentration using the ELISA-like fluorimetric method were performed. RESULTS The experimental group exhibited a significantly larger mean fiber cross-sectional area in the TA muscle compared to the control group (434.3 ± 68.6 μm2 versus 305.7 ± 110.1 μm2; p = 0.029), indicating muscle hypertrophy. There was no significant difference in the number of muscle fibers. The experimental group showed higher expression of ARs in the lamina propria (62.0% ± 30.3% versus 22.0% ± 22.8%; p = 0.046) and in the TA muscle (45.0% ± 22.6% versus 18.3% ± 9.8%; p = 0.024). There was no significant difference in the concentration of HA. CONCLUSION Exposure of adult female rats to androgen therapy resulted in hypertrophy of the TA muscle and increased expression of ARs in the VFs. The TA muscle seems to be the primary target of testosterone action in the VF, and the up-regulation of ARs might contribute to the persistent deepening of the voice. LEVEL OF EVIDENCE NA Laryngoscope, 134:2316-2321, 2024.
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Affiliation(s)
- Mateus M Aires
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Faculty of Medical Sciences, Universidade de Pernambuco (UPE), Recife, Brazil
| | - Karine V G de Oliveira
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Jônatas B do Amaral
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcos Mônico-Neto
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - João Roberto M Martins
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Aline L Santiago
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Noemi G De Biase
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Pontifícia Universidade Católica de São Paulo (PUC), São Paulo, Brazil
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Papeleu T, Leyns C, Alighieri C, Vermeeren A, Motmans J, T'Sjoen G, D'haeseleer E. Voice and Communication in Transmasculine Individuals One Year Under Testosterone Therapy: A Qualitative Study. J Voice 2024:S0892-1997(24)00119-X. [PMID: 38679523 DOI: 10.1016/j.jvoice.2024.04.003] [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: 01/25/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES/HYPOTHESES The purpose of this study was to investigate voice and communication difficulties in transmasculine individuals to develop evidence-based voice and communication training programs. STUDY DESIGN Qualitative study. METHODS Eight transmasculine individuals, who had received testosterone therapy (TT) for at least 1year, were included in this study. Semistructured interviews were conducted by two experienced voice clinicians. The software program NVivo was used for transcribing and coding the interviews. Data were processed using a thematic analysis. RESULTS The thematic analysis resulted in the identification of five major themes. Most transmasculine individuals experienced a pitch decrease during the first year of TT and encountered voice-related problems, with a higher incidence during the initial period. Additionally, some participants experienced increased satisfaction with how others attributed their gender after 1year of TT. However, others still experienced a discrepancy between external gender attribution, self-attribution, and their desired attribution by others. Many participants did not receive voice and communication training. In many cases, voice had a significant impact on their well-being and daily life. CONCLUSIONS It's difficult to generalize the results of the current study, since the population of transmasculine individuals is heterogeneous in terms of their subjective gender positioning, desired gender attribution, gender attribution received from others, and gender-related aspects of their vocal situation. Some clients may express dissatisfaction with specific aspects of their voice and communication and may require professional support. Therefore, clinical practice for transmasculine individuals should adopt an individualized approach based on a comprehensive examination of the client's perspective.
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Affiliation(s)
- Tine Papeleu
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Clara Leyns
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - Cassandra Alighieri
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Amber Vermeeren
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Joz Motmans
- Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - Guy T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium; Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Evelien D'haeseleer
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Musical Department, Royal Conservatory Brussels, Brussels, Belgium
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Södersten M, Oates J, Sand A, Granqvist S, Quinn S, Dacakis G, Nygren U. Gender-Affirming Voice Training for Trans Women: Acoustic Outcomes and Their Associations With Listener Perceptions Related to Gender. J Voice 2024:S0892-1997(24)00023-7. [PMID: 38503674 DOI: 10.1016/j.jvoice.2024.02.003] [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: 11/29/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVES To investigate acoustic outcomes of gender-affirming voice training for trans women wanting to develop a female sounding voice and to describe what happens acoustically when male sounding voices become more female sounding. STUDY DESIGN Prospective treatment study with repeated measures. METHODS N = 74 trans women completed a voice training program of 8-12 sessions and had their voices audio recorded twice before and twice after training. Reference data were obtained from N = 40 cisgender speakers. Fundamental frequency (fo), formant frequencies (F1-F4), sound pressure level (Leq), and level difference between first and second harmonic (L1-L2) were extracted from a reading passage and spontaneous speech. N = 79 naive listeners provided gender-related ratings of participants' audio recordings. A linear mixed-effects model was used to estimate average training effects. Individual level analyses determined how changes in acoustic data were related to listeners' ratings. RESULTS Group data showed substantial training effects on fo (average, minimum, and maximum) and formant frequencies. Individual data demonstrated that many participants also increased Leq and some increased L1-L2. Measures that most strongly predicted listener ratings of a female sounding voice were: fo, average formant frequency, and Leq. CONCLUSIONS This is the largest prospective study reporting on acoustic outcomes of gender-affirming voice training for trans women. We confirm findings from previous smaller scale studies by demonstrating that listener perceptions of male and female sounding voices are related to acoustic voice features, and that voice training for trans women wanting to sound female is associated with desirable acoustic changes, indicating training effectiveness. Although acoustic measures can be a valuable indicator of training effectiveness, particularly from the perspective of clinicians and researchers, we contend that a combination of outcome measures, including client perspectives, are needed to provide comprehensive evaluation of gender-affirming voice training that is relevant for all stakeholders.
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Affiliation(s)
- Maria Södersten
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden.
| | - Jennifer Oates
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Anders Sand
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Svante Granqvist
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Sterling Quinn
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Georgia Dacakis
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Ulrika Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
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C R, F U, F H, S Z, C S. An Old Myth: Prediction of the Correct Singing Voice Classification. True or not? J Voice 2023; 37:968.e13-968.e18. [PMID: 34158209 DOI: 10.1016/j.jvoice.2021.04.029] [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: 02/26/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Predicting the correct singing voice classification based on laryngoscopy is an old myth. The aim of this study was to evaluate if a professional phoniatrician/laryngologist can predict the correct singing voice classification only from laryngoscopy and to analyze different anatomical parameters between professional sopranos and altos to determine whether a multivariate analysis of anatomical parameters can predict the singing register. STUDY DESIGN Prospective study METHODS: We included 49 professional female singers (25 sopranos, 24 altos). Laryngoscopic images were shown to professional phoniatricians/laryngologists to rate whether it they show a soprano or an alto. In addition, a high-resolution computer tomography (HRCT) scan was performed during singing of ƒ0 by each singer. DICOM scan data were rendered and 3D-visualized using the software MIMICS. In all singers, we measured the length of the vocal folds of the glottis, the distance from the anterior commissure orthogonally to the vertebral spine, and the antero-posterior distance of the subglottis/trachea 1 cm and 2 cm below the glottis. We also measured the length and volume of the resonance space. RESULTS It was not possible to predict the singing voice classification only from laryngoscopy. In the HRCT images, sopranos had significantly shorter vocal folds, a shorter glottal length, a shorter distance from the anterior commissure to the spine, and a shorter resonance space. When combining all parameters, the chance of correctly predicting a soprano was 74.1% and an alto 68.2%. CONCLUSION Although there are anatomical differences between sopranos and altos, prediction of the singing voice classification from laryngoscopy or HRCT is not reliable enough for clinical use.
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Affiliation(s)
- Rast C
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland
| | - Unteregger F
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland
| | - Honegger F
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland
| | - Zwicky S
- Zurich University of the Arts, Department of Music and Private ENT Practice, Schlieren, Switzerland
| | - Storck C
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland.
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Stogowska E, Kamiński KA, Ziółko B, Kowalska I. Voice changes in reproductive disorders, thyroid disorders and diabetes: a review. Endocr Connect 2022; 11:EC-21-0505.R1. [PMID: 35148272 PMCID: PMC8942322 DOI: 10.1530/ec-21-0505] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/11/2022] [Indexed: 11/12/2022]
Abstract
The subject of vocal changes accompanying pathological conditions, although still not well explored, seems to be promising. The discovery of laryngeal receptors for sex hormones and thyroid hormones can strongly support the hypothesis of changes in voice due to various endocrinopathies. On the other hand, the impairment of the proper function of the vocal apparatus can also be caused in the process of the microvasculature complications of diabetes mellitus. This review was a comprehensive summary of the accessible literature concerning the influence of selected endocrinopathies on subjective and objective voice parameters. We analysed a total number of 16 English-language research papers from the PubMed database, released between 2008 and 2021, describing vocal changes in reproductive disorders such as polycystic ovary syndrome and congenital adrenal hyperplasia, thyroid disorders in shape of hypo- or hyperthyroidism and type 2 diabetes mellitus. The vast majority of the analysed articles proved some changes in voice in all mentioned conditions, although the detailed affected vocal parameters frequently differed between research. We assume that the main cause of the observed conflicting results might stem from non-homogeneous methodology designs of the analysed studies.
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Affiliation(s)
- Ewa Stogowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Karol Adam Kamiński
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | | | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland
- Correspondence should be addressed to I Kowalska:
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Kishimoto AO, Kishimoto Y, Shi X, Hutchinson EB, Zhang H, Shi Y, Oliveira G, Li L, Welham NV, Rowland IJ. High-resolution magnetic resonance and mass spectrometry imaging of the human larynx. J Anat 2021; 239:545-556. [PMID: 34032275 DOI: 10.1111/joa.13451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/21/2021] [Indexed: 12/16/2022] Open
Abstract
High-resolution, noninvasive and nondestructive imaging of the subepithelial structures of the larynx would enhance microanatomic tissue assessment and clinical decision making; similarly, in situ molecular profiling of laryngeal tissue would enhance biomarker discovery and pathology readout. Towards these goals, we assessed the capabilities of high-resolution magnetic resonance imaging (MRI) and matrix-assisted laser desorption/ionisation-mass spectrometry (MALDI-MS) imaging of rarely reported paediatric and adult cadaveric larynges that contained pathologies. The donors were a 13-month-old male, a 10-year-old female with an infraglottic mucus retention cyst and a 74-year-old female with advanced polypoid degeneration and a mucus retention cyst. MR and molecular imaging data were corroborated using whole-organ histology. Our MR protocols imaged the larynges at 45-117 μm2 in-plane resolution and capably resolved microanatomic structures that have not been previously reported radiographically-such as the vocal fold superficial lamina propria, vocal ligament and macula flavae; age-related tissue features-such as intramuscular fat deposition and cartilage ossification; and the lesions. Diffusion tensor imaging characterised differences in water diffusivity, primary tissue fibre orientation, and fractional anisotropy between the intrinsic laryngeal muscles, mucosae and lesions. MALDI-MS imaging revealed peptide signatures and putative protein assignments for the polypoid degeneration lesion and the N-glycan constituents of one mucus retention cyst. These imaging approaches have immediate application in experimental research and, with ongoing technology development, potential for future clinical application.
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Affiliation(s)
| | - Yo Kishimoto
- Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Xudong Shi
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Hua Zhang
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Yatao Shi
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Gisele Oliveira
- Graduate Program in Speech-Language Pathology, Touro College, Brooklyn, NY, USA
| | - Lingjun Li
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA.,Department of Chemistry, University of Wisconsin-Madison, Madison, WI, USA
| | - Nathan V Welham
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
| | - Ian J Rowland
- Department of Entomology, University of Wisconsin-Madison, Madison, WI, USA
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Nygren U, Södersten M, Thyen U, Köhler B, Nordenskjöld A. Voice dissatisfaction in individuals with a disorder of sex development. Clin Endocrinol (Oxf) 2019; 91:219-227. [PMID: 31026085 DOI: 10.1111/cen.14000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Changes of sex hormone levels in disorders of sex development (DSD) can affect the body, including the vocal folds, during and after foetal development. The voice is a gender characteristic that may also be affected. There is a lack of knowledge on voice alteration in DSD. To explore this in different forms of DSD, we describe the prevalence of voice alterations and investigate patient satisfaction with voice. DESIGN The study is part of dsd-LIFE, a multicentre cross-sectional clinical evaluation project assessing the long-term outcomes of surgical, hormonal and psychological interventions in individuals with DSD. PATIENTS The study included 1040 individuals with different forms of DSD, that is Turner and Klinefelter syndromes, different degrees of gonadal dysgenesis and 46 XY DSD. Participants were recruited through patient advocacy groups and health care. MEASUREMENTS Satisfaction with voice, Adam's apple, if patient's self-identified gender was mistaken on the phone leading to distress. RESULTS A vast majority of the participants with DSD (between 58.3% to 82% in various groups) were not satisfied with their voice, and approximately 15% (n = 147) were mistaken on the phone in accordance with self-identified gender. For 102 participants, this caused distress. CONCLUSIONS We have identified that voice problems are a cause of distress in all forms of DSD. This result needs to be confirmed and compared with controls. We recommend that evaluation of the voice should be included in future international guidelines for management of DSD.
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Affiliation(s)
- Ulrika Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Functional Area Speech & Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Södersten
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Functional Area Speech & Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Ute Thyen
- Klinik fur Kinder- und Jugendmedizin, Universitat zu Lubeck, Lubeck, Germany
| | - Birgit Köhler
- Klinik für Pädiatrische Endokrinologie und Diabetologie, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Agneta Nordenskjöld
- Department of Women's and Children's Health, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Paediatric Surgery, Karolinska University Hospital, Stockholm, Sweden
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Kishimoto AO, Kishimoto Y, Young DL, Zhang J, Rowland IJ, Welham NV. High- and ultrahigh-field magnetic resonance imaging of naïve, injured and scarred vocal fold mucosae in rats. Dis Model Mech 2016; 9:1397-1403. [PMID: 27638667 PMCID: PMC5117232 DOI: 10.1242/dmm.026526] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/10/2016] [Indexed: 12/16/2022] Open
Abstract
Subepithelial changes to the vocal fold mucosa, such as fibrosis, are difficult to identify using visual assessment of the tissue surface. Moreover, without suspicion of neoplasm, mucosal biopsy is not a viable clinical option, as it carries its own risk of iatrogenic injury and scar formation. Given these challenges, we assessed the ability of high- (4.7 T) and ultrahigh-field (9.4 T) magnetic resonance imaging to resolve key vocal fold subepithelial tissue structures in the rat, an important and widely used preclinical model in vocal fold biology. We conducted serial in vivo and ex vivo imaging, evaluated an array of acquisition sequences and contrast agents, and successfully resolved key anatomic features of naïve, acutely injured, and chronically scarred vocal fold mucosae on the ex vivo scans. Naïve lamina propria was hyperintense on T1-weighted imaging with gadobenate dimeglumine contrast enhancement, whereas chronic scar was characterized by reduced lamina propria T1 signal intensity and mucosal volume. Acutely injured mucosa was hypointense on T2-weighted imaging; lesion volume steadily increased, peaked at 5 days post-injury, and then decreased – consistent with the physiology of acute, followed by subacute, hemorrhage and associated changes in the magnetic state of hemoglobin and its degradation products. Intravenous administration of superparamagnetic iron oxide conferred no T2 contrast enhancement during the acute injury period. These findings confirm that magnetic resonance imaging can resolve anatomic substructures within naïve vocal fold mucosa, qualitative and quantitative features of acute injury, and the presence of chronic scar. Summary: Magnetic resonance imaging is shown to allow the nondestructive assessment of acute injury and scar formation in vocal fold mucosa, as demonstrated ex vivo using a preclinical rat model.
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Affiliation(s)
- Ayami Ohno Kishimoto
- Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - Yo Kishimoto
- Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - David L Young
- Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - Jinjin Zhang
- Department of Radiology and Center for Magnetic Resonance Research, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA
| | - Ian J Rowland
- Department of Entomology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Nathan V Welham
- Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
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Azul D, Nygren U, Södersten M, Neuschaefer-Rube C. Transmasculine People's Voice Function: A Review of the Currently Available Evidence. J Voice 2016; 31:261.e9-261.e23. [PMID: 27318608 DOI: 10.1016/j.jvoice.2016.05.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/04/2016] [Accepted: 05/06/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aims to evaluate the currently available discursive and empirical data relating to those aspects of transmasculine people's vocal situations that are not primarily gender-related, to identify restrictions to voice function that have been observed in this population, and to make suggestions for future voice research and clinical practice. METHODS We conducted a comprehensive review of the voice literature. Publications were identified by searching six electronic databases and bibliographies of relevant articles. Twenty-two publications met inclusion criteria. Discourses and empirical data were analyzed for factors and practices that impact on voice function and for indications of voice function-related problems in transmasculine people. The quality of the evidence was appraised. RESULTS The extent and quality of studies investigating transmasculine people's voice function was found to be limited. There was mixed evidence to suggest that transmasculine people might experience restrictions to a range of domains of voice function, including vocal power, vocal control/stability, glottal function, pitch range/variability, vocal endurance, and voice quality. CONCLUSIONS More research into the different factors and practices affecting transmasculine people's voice function that takes account of a range of parameters of voice function and considers participants' self-evaluations is needed to establish how functional voice production can be best supported in this population.
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Affiliation(s)
- David Azul
- Discipline of Speech Pathology, Department of Community and Allied Health, La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, Victoria, Australia.
| | - Ulrika Nygren
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, and Department of Speech and Language Pathology, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Maria Södersten
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, and Department of Speech and Language Pathology, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Christiane Neuschaefer-Rube
- Clinic of Phoniatrics, Pedaudiology and Communication Disorders, Medical Faculty and University Hospital of the RWTH Aachen University, Aachen, Germany
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