Self-Perception and Listener Perceptions at Long-Term Follow-Up of a Gender-Affirming Voice Training Program for Transgender Women.

Abstract

Introduction: Many transgender individuals find their voice often not matching their gender identity. By using gender-affirming voice training, voice and communication specialists help transgender women find a voice that aligns with their gender identity. Short-term outcomes of voice training programs showed progress in listener perception, self-perception, and satisfaction of transgender women's voices. While some long-term results have been reported, most of these studies were retrospective. This prospective study examines the long-term effects, 3 months and 1 year after gender-affirming voice training in transgender women, on satisfaction, self-perception, and listeners' perception.

Methods and materials: Thirty transgender women followed a 10-week gender-affirming voice training program consisting of pitch elevation and articulation-resonance training. Self-perception and satisfaction of the transgender women were measured by the Trans Women Voice Questionnaire and a visual analogue scale where they had to score their current and ideal voice. Thirty nine listeners rated the trans women's voice samples by using a visual analogue scale ranging from very masculine to very feminine. Immediately after training, 3 months and 1 year after training, measurements were performed.

Results and discussion: Concerning self-perception and satisfaction of the voice, the effects observed immediately after training remained stable in the follow-up period. Thus, 3 months and 1 year after training, the participants perceived the voice-related impact on their daily life equal to the impact just after training discharge. Significant decreases in femininity ratings of listeners' perceptions were reported immediately after training and 3 months after training, although still being in the gender-ambiguous zone. No significant changes were reported between the 3 months and 1 year follow-up. Future studies should implement longer follow-up periods and qualitative components.