Efficacy and Patient Satisfaction in Voice Feminization Procedures: A Systematic Review and Meta-Analysis.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-05-01 Epub Date: 2025-02-18 DOI:10.1002/ohn.1173

Kristopher Lanham, Bradley A Melnick, Madeline J O'Connor, Angelica Bartler, Rolando J Casas Fuentes, Kelly C Ho, Robert D Galiano

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引用次数: 0

Abstract

Objective: To evaluate the efficacy and quality of life impact of voice feminization interventions in transgender women.

Data sources: We searched PubMed, EMBASE, Scopus, and Web of Science for RCTs and retrospective studies published between 2008 and 2023 that quantitatively evaluated any voice feminization procedure.

Review methods: Studies in English reporting quantitative measures of efficacy were included. Studies using qualitative methodology were excluded. Risk of bias was assessed using Cochran tools and a random-effects model was applied using inverse-variance pooling. Primary outcomes were fundamental frequency [F0]/speaking fundamental frequency [SF0] and patient-reported outcomes (PROs) (PROSPERO: CRD42023476192).

Results: Twenty-four studies involving 893 participants showed significant SF0 improvements for voice therapy (VT, g = 0.86, [0.46, 1.26], P < .0001), Wendler glottoplasty (WG, g = 1.21, [0.65, 1.77], P < .0001), feminization laryngoplasty (FL, g = 3.05, [2.24, 3.86], P < .0001), and laser reduction glottoplasty (LRG, g = 12.28, [8.19, 15.64], P < .0001). PROs indicated enhanced quality of life for VT (g = 1.32, [0.68, 1.96], P < .0001), WG (g = 1.82, [1.07, 2.57], P < .0001), and LRG (g = 1.90, [0.72, 3.07], P = .0015), with a strong correlation between pitch alteration and QoL (r² = 0.83, P = .0001).

Conclusion: Our results indicate that both VT and surgical procedures enhance vocal pitch and strongly correlate with improved QoL. Our findings validate the role of voice feminization in gender-affirming care, though methodological limitations prevent evaluation of newer interventions.

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语音女性化手术的疗效与患者满意度：系统回顾与元分析。

目的：评价嗓音女性化干预对跨性别女性生活质量的影响。数据来源：我们检索了PubMed、EMBASE、Scopus和Web of Science，检索了2008年至2023年间发表的定量评估任何语音女性化过程的随机对照试验和回顾性研究。回顾方法：纳入了英文报告疗效定量测量的研究。采用定性方法的研究被排除在外。偏倚风险采用科克伦工具评估，随机效应模型采用反方差池。主要终点为基频[F0]/说话基频[SF0]和患者报告终点（PROs）（PROSPERO: CRD42023476192）。结果：24项涉及893名参与者的研究显示，语音治疗显著改善了SF0 (VT, g = 0.86, [0.46, 1.26]， P结论：我们的研究结果表明，VT和外科手术都能提高音高，并与改善的生活质量密切相关。我们的研究结果证实了声音女性化在性别肯定护理中的作用，尽管方法上的限制阻碍了对新干预措施的评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.