Journal of Voice最新文献

{"title":"Cervical Transmembrane Thyrohyoid Video Access for Glottic Lesion Resection: Description of a New Surgical Technique and Case Report.","authors":"Claudiney Candido Costa, Marina Nahas Dafico Bernardes, Hugo Valter Lisboa Ramos","doi":"10.1016/j.jvoice.2025.08.029","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.08.029","url":null,"abstract":"<p><strong>Introduction: </strong>In cases where laryngoscopy is difficult, part or all of the vocal cords may not be visualized with conventional laryngoscopy, making laryngeal microsurgery challenging or even impossible. It is therefore necessary to develop combined approaches, such as the use of the laryngoscope in conjunction with a high-definition (HD) endoscopic video system.</p><p><strong>Objective: </strong>Understanding alternative surgical techniques and studying the predictors of difficult laryngeal exposure risk have been become essential for the success of endoscopic laryngeal surgery in the treatment of laryngeal cancers. This case report presents an innovative technique that combines a Cervical Transmembrane Thyrohyoid Video Access (CTTVA) for resection of an anterior glottic lesion.</p><p><strong>Case report: </strong>A 54-year-old male patient with an 8-month history of dysphonia underwent videolaryngoscopy, which revealed a leukoplakic lesion on the anterior third of the left vocal fold. Direct laryngoscopy failed to allow biopsy. A 1.5 cm incision was made at the upper edge of the thyroid cartilage. After subcutaneous dissection and identification of the thyrohyoid muscle, an opening was made in the thyrohyoid membrane, providing access to the lesion, which was resected using a 0° endoscope (4 mm diameter, 17 cm length). A type III cordectomy was performed, and histopathology confirmed moderate dysplasia with clear margins.</p><p><strong>Discussion and conclusion: </strong>The patient had a high Cormack-Lehane score, limiting visualization of the anterior larynx. Early recognition of this risk allowed the surgical team to implement a novel combined approach via the thyrohyoid membrane using 0° optics. This provided excellent access to the supraglottic, glottic, and subglottic regions, enabling complete lesion resection without the need for laryngofissure or tracheostomy.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Acoustic Parameters in Healthy Young Saudi Adults: A Cross-Sectional Study.","authors":"Norah Bin Muattish, Nora AlSudairi, Ghaida Alsughayer","doi":"10.1016/j.jvoice.2025.08.028","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.08.028","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to establish a database of normative acoustic parameters in healthy young adults in Saudi Arabia.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A cross-sectional on-site instrumental assessment was conducted in a controlled research environment at the College of Applied Medical Sciences, King Saud University. Participants were categorized according to sex (male vs female) and stratified based on age into young adults (18-20 years) and adults (21-30 years). Sustained phonation, dynamic range, and frequency range were used to assess the acoustic parameters, which were calculated using multidimensional voice program software.</p><p><strong>Results: </strong>Of 351 participants assessed, 330 participants (122 males, 208 females) had complete data and were included in the final analysis. Females demonstrated significantly higher values in fundamental frequency, pitch, and amplitude (P < 0.05) than males. Males, on the other hand, showed higher values in tone, jitter, and dynamic range (P < 0.05) than females. Age-related differences were observed. In males, amplitude tremor frequency was inversely associated with age (r = -0.26; P < 0.01), whereas mean dynamic range was positively associated with age (r = 0.23; P < 0.05). Females demonstrated inverse associations for several voice parameters. Young adult males (18-20 years) had higher frequency and mean dynamic range (P = 0.02), whereas young adult females had higher values in several voice parameters (P < 0.05). Adult females had higher values in amplitude, pitch, and mean period than in the young adult age group (P < 0.01).</p><p><strong>Conclusions: </strong>These results suggest that the acoustic parameters of the voice exhibit age-related and sex-specific differences, with distinct patterns emerging between young adult and adult participants and between males and females.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Acoustic-Based Normalization of Laryngeal EMG for Improved Interspeaker Consistency in Muscle-to-Acoustic Mapping.","authors":"Josué D Martínez, Emiro J Ibarra, Jesús A Parra, Daryush D Mehta, James T Heaton, Robert E Hillman, Michal J Plocienniczak, Jameson C Cooper, Matías Zañartu","doi":"10.1016/j.jvoice.2025.08.014","DOIUrl":"10.1016/j.jvoice.2025.08.014","url":null,"abstract":"<p><p>Understanding how intrinsic laryngeal muscle activation relates to vocal output is essential for advancing experimental voice research. However, intrasubject variability remains a major challenge when comparing EMG recordings across sessions. To address this, a normalization framework based on acoustic targets was implemented to improve the consistency of EMG-acoustic relationships across sessions. Signals from the cricothyroid (CT), thyroarytenoid (TA), and lateral cricoarytenoid (LCA) muscles were collected across four sessions from a healthy adult performing a set of phonatory and non-phonatory vocal tasks. Muscle Activation Plots (MAPs) were generated to visualize the relationship between normalized EMG activity and acoustic outcomes, specifically fundamental frequency (f_o) and sound pressure level (SPL). Compared to traditional peak-based normalization, the proposed method reduced intrasubject variability and improved inter-session consistency in the EMG-f_o relationship, as reflected by an increase in ICC from 0.52 to 0.83 and a reduction in MAE from 84.87 Hz to 19.23 Hz. These findings represent a step toward more consistent intramuscular EMG normalization and improved interpretation of muscle-specific control strategies in human voice production.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and Self-Perceived Voice Assessments in Patients With Primary Muscle Tension Dysphonia and Healthy Speakers: A Comparative and Correlative Study.","authors":"Saeideh Moayedfar, Seyyedeh Maryam Khoddami, Pejman Aghdak, Noureddin Nakhostin Ansari, Payman Dabirmoghaddam","doi":"10.1016/j.jvoice.2025.07.041","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.07.041","url":null,"abstract":"<p><strong>Objectives: </strong>Limited research has examined anxiety in muscle tension dysphonia (MTD). This study aimed to compare anxiety levels between primary MTD patients and healthy speakers. Additionally, it explored self-perceived voice characteristics and their relationship with anxiety in both groups.</p><p><strong>Methods: </strong>A total of 223 participants were recruited, including 120 primary MTD patients and 103 healthy speakers. Anxiety levels and severity were assessed using the Beck Anxiety Inventory (BAI). Self-perceived voice assessments, including voice self-assessment, vocal effort, vocal tract discomfort (VTD), vocal fatigue index (VFI), and voice-related pain scale (VRPS), were conducted to compare self-voice perceptions between the two groups. Additionally, correlations between anxiety and self-perceived voice measures were analyzed.</p><p><strong>Results: </strong>The mean BAI score was significantly higher in patients than in healthy speakers, with a weak effect size (P = 0.0001, η² = 0.122). While most participants in both groups had mild anxiety, anxiety severity was significantly associated with MTD status (P = 0.0001). Significant differences were found between the two groups in voice self-assessment (P = 0.0001) and in vocal effort, VTD, VFI, and VRPS scores (P < 0.05). The Bonferroni correction (α = 0.007) indicated significant positive correlations for the VTD frequency (r = 0.34, P = 0.001) and the VTD severity (r = 0.34, P = 0.001) in the healthy speakers. Comparison with patients showed that three measures (all positive) were significant in the patient group. Comparison using Fisher's z tests revealed no statistically significant differences between two groups for any individual measure (all > 0.05).</p><p><strong>Conclusion: </strong>Given the higher anxiety levels in primary MTD patients compared with healthy individuals, a psychogenic or multidisciplinary approach can be integrated into their assessment and voice therapy. The findings should be interpreted with consideration of the absence of additional tools for anxiety assessment and the presence of disordered control groups.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Prognosis Analysis of Dysphonia in Live Streamers.","authors":"Qingcui Wang, Yuhong Lin, Liyu Cheng, Wen Xu","doi":"10.1016/j.jvoice.2025.08.026","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.08.026","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the clinical characteristics, influencing factors, and prognosis of dysphonia in live streamers.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the basic characteristics, occupational features, voice quality assessment, stroboscopy, and prognosis of 43 live streamers who sought medical attention for dysphonia.</p><p><strong>Results: </strong>Twenty-seven female (62.79%) and 16 male (37.21%) patients were included, with an average age of 36.81 ± 8.97 years and a median course of 6 months. All patients presented with the chief complaint of hoarseness. Triggers were phonotrauma in 35 (81.40%), unclear in 6 (13.95%), and infections in 2 (4.65%). Thirty-seven patients (86.05%) were full-time streamers. The streaming duration was 2.93 ± 2.46 years, with the daily vocal use of 4.58 ± 1.55 hours and streaming frequency of 6.35 ± 1.11 days per week. Forty-one (95.35%) required high volume, and 37 (86.05%) required rapid speech. Audio-perceptual analysis showed 1.42 ± 0.52 in G and R scales and 0.41 ± 0.37 in B scale. Objective analysis revealed increased jitter (1.96% ± 1.33%), shimmer (6.52% ± 2.29%), and reduced maximum phonation time (12.67 ± 5.93 seconds). Laryngoscopy revealed polyps in 15 patients (34.88%), Reinke's edema in 14 (32.56%), cysts in 6 (13.95%), chronic hypertrophic laryngitis in 4 (9.30%), leukoplakia in 3 (6.98%), and scarring in four patients (9.30%). Of the 14 patients who underwent surgery, 13 (92.86%) significantly improved. Among 29 conservatively managed patients, 14 (48.28%) improved, with few received vocal training and education.</p><p><strong>Conclusions: </strong>Long-term, high-frequency, high-volume, and fast-paced vocal use may contribute to dysphonia in live streamers. Benign proliferative lesions are common voice disorders in the current treatment-seeking population. Surgery may improve voice quality, but its recurrence rate is unclear. Proper vocal training and education are crucial for live streamers and may enhance their prognosis.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With the Risk of Voice Disorders in Teachers From Urban and Rural Schools in Minas Gerais, Brazil.","authors":"Dâmaris Poliana Lacerda Vieira, Luiza Augusta Rossi-Barbosa, Desirée Sant'Ana Haikal, Adriane Mesquita de Medeiros","doi":"10.1016/j.jvoice.2025.08.022","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.08.022","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the association between the risk of voice disorders and sociodemographic, work, and general health factors in urban and rural school teachers.</p><p><strong>Methods: </strong>This is an observational, cross-sectional, analytical study with 1705 teachers from urban schools and 202 from rural schools teaching elementary and high school in Minas Gerais, Brazil. The exclusion criteria were being retired or no longer teaching and/or not accepting to participate in the study. Data were collected using an electronic questionnaire sent to the school boards by the State Department of Education, which forwarded it to the teachers. The study variables were sociodemographic and occupational factors, mental health, voice-related factors, and the Screening Index for Voice Disorder, which defined their risk of voice disorder. Descriptive and association analyses were performed using Pearson's chi-square test, Fisher's exact test, and logistic regression, considering a 0.05 significance level.</p><p><strong>Results: </strong>Voice disorders among urban school teachers were statistically significantly associated with sex, employment status, psychosocial aspects of work, common mental disorders (CMD), smoking, and vocal warm-ups. Moreover, both urban and rural school teachers were strongly statistically associated with sleep loss, respiratory problems, and gastroesophageal reflux.</p><p><strong>Conclusion: </strong>The risk of voice disorders in urban and rural school teachers was associated with other health problems. In urban schools, being male, not smoking, being hired/designated, having a low-stress job or active work, not having CMD, and performing vocal warm-ups were protective factors for the risk of voice disorders.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Mandarin Pronunciation on Bel Canto Singing: A Study on the Challenges Faced by Chinese Singers in Adapting to Western Vocal Techniques.","authors":"Yuwen Sun","doi":"10.1016/j.jvoice.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.08.019","url":null,"abstract":"<p><strong>Introduction: </strong>Due to its tonal and syllabic structures, Chinese speakers may encounter unique difficulties when learning native Western operatic techniques. These challenges are particularly evident in balancing pitch control, subglottic pressure, and vowel production. The present study examines how native language influences vocal performance, using the Italian art song Caro mio ben as a test piece for singers from different language backgrounds.</p><p><strong>Methods: </strong>A total of 16 sopranos performed the Italian art song Caro mio ben, eight Native Chinese singers (C), and eight Non-Native Chinese singers (NC). Using the pYIN algorithm in Librosa, fundamental frequency (F0) was continuously extracted for each singer. Additionally, formant values (F1, F2) of selected sustained vowels were manually measured using Praat. Pitch accuracy was quantified through absolute pitch deviation (Hz and cents), while vowel articulation was assessed via vowel space distribution. Group comparisons were also performed using the Mann-Whitney U test due to the small sample size.</p><p><strong>Results: </strong>The two groups had similar average pitch accuracy overall, but group C showed greater pitch consistency across different notes. Meanwhile, the F1/F2 values of the group NC singers varied more, suggesting that they had different vowel articulation strategies. These differences are speculated to stem from the underlying speech motor patterns of native singers, which shape vowel articulation in singing.</p><p><strong>Discussion: </strong>Although both groups were able to achieve comparable pitch accuracy, the influence of native speech habits was still evident in articulation patterns and pitch stability. These findings highlight the role of speech motor memory in shaping operatic vocal performance. This study contributes to our understanding of vocal techniques across languages and may provide training strategies for cross-language singers.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aging and Voice: A Pilot Study Investigating Aerodynamic and Acoustic Measurements in Older Adults.","authors":"Elif Ezgi Işik, Merve Sapmaz Atalar, Mehmet Emrah Cangï, Ömer Necati Develïoğlu, Fatma Esen Aydinli","doi":"10.1016/j.jvoice.2025.08.027","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.08.027","url":null,"abstract":"<p><strong>Objectives: </strong>In individuals over 65, age is an essential factor in voice changes. Acoustic and aerodynamic norms guide clinicians in interpreting clinical voice assessment results. This study aimed to present aerodynamic-acoustic voice measurements in older individuals with no voice complaints. It was also aimed to compare the objective voice parameters between different older age groups and genders.</p><p><strong>Methods: </strong>Total of 70 participants from the young old (65-74 years), middle old (75-84 years), and old old age groups (>85 years) without voice complaints were included. Participants were recruited from a nursing home. Participants were asked to perform prolonged phonation of /a/, /s/, and /z/. The PRAAT program was used in the analysis.</p><p><strong>Results: </strong>The mean aerodynamic-acoustic analysis results for the young, middle, and old-old age groups are presented, respectively. For maximum phonation time (MPT), it is 16.6, 11.18, and 7.56 seconds. For the s/z ratio, it is 1.03, 1.31, and 1.22. Fundamental frequency (F0) is 202.18, 193.37, and 229.13 for females and 150.44, 128.22, and 144.25 Hz for males. Standard deviation of fundamental frequency (SDF0) is 2.09, 8.88, and 6.34. Jitter percentage (jit%) is 0.48, 0.65, and 0.48. Shimmer percentage (shim%) is 2.64, 3.58, and 3.3. Harmonic-to-noise ratio (HNR) is 22.38, 20.95, and 20.88. The mean MPT score of the young-old group was significantly higher than those of the middle and old (P < 0.05). The mean SDF0 of the middle-old group was significantly higher than that of the young-old (P < 0.05).</p><p><strong>Conclusions: </strong>The differences in the mean acoustic-aerodynamic voice parameters between age groups are thought to substantially reflect the characteristics of the physiological aging process with different acoustic variables at different periods. It was also found that the overall stability control in vocal fold vibration decreases with aging, as shown by changes in SDF0 and MPT.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Limits in Explaining and Acoustic Modeling of Voice Characteristics.","authors":"Jana Wiechmann, Petra Wagner","doi":"10.1016/j.jvoice.2025.07.036","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.07.036","url":null,"abstract":"<p><p>To this day, the assessment of human voices remains a challenge due to (i) inconsistencies in subjective ratings and (ii) the lack of objective measurements for the perceptual impressions of voice characteristics. This can lead to significant consequences in applied fields such as speech therapy, where the assessment of voices is crucial for a successful treatment. In this paper, we address the explanation of voice and its characteristics from two different angles: In a first study, 22 speech therapists in training assessed a set of 20 non-pathological voices regarding 20 voice characteristics before and after receiving an expert explanation. Although the expert explanation did not lead to an improvement in overall rating performance, the analysis still yielded valuable insights into the particular challenges for novice voice practitioners in their characterization of voices. A second study aimed at a better understanding of the link between perceived voice characteristics and acoustic features. A data set of 295 voice samples of the same corpus was labeled by an expert with regard to the same 20 voice characteristics as in the first study. Afterwards, we analyzed the speech samples using a set of acoustic features, which were then used as predictors in statistical models of the annotated characteristics. This analysis yielded a unique set of significant acoustic features as main effects predicting each individual voice characteristic, although the model fits were overall modest. Furthermore, all of the voice characteristic models showed interactions with the speakers' gender. These results suggest a necessity for paying special attention to gender differences when assessing voice. Interestingly, we obtained a tendency for a higher model accuracy for those voice characteristics that have also shown to be rated more accurately and consistently by human listeners.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Experiences of Transgender and Gender Diverse Individuals After Intonation Training for a More Masculine-Sounding Voice: A Qualitative Study.","authors":"Tine Papeleu, Clara Leyns, Joz Motmans, Jeroen Vervalcke, Mauro Kerckhof, Evelien D'haeseleer","doi":"10.1016/j.jvoice.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.08.001","url":null,"abstract":"<p><strong>Introduction: </strong>A significant challenge for some transgender and gender diverse (TGD) individuals is that their voice and communication do not align with their gender identity or the way they wish to be perceived. Voice and communication training (VCT) can address key factors that are the most salient in gender perception, such as pitch, resonance, articulation, and intonation. While intonation training has proven its benefits for developing a feminine-sounding voice, its impact on achieving a masculine-sounding voice remains underexplored. This study examined TGD individuals' experiences with utilizing intonation training to develop a more masculine-sounding voice. MATERIALS AND METHODS: Ten TGD individuals participated in 4 or 8 weeks of VCT focused on achieving a more masculine-sounding voice and communication style, such as intonation patterns. Semistructured interviews were conducted and transcribed. Data were coded using NVivo 11 and data were analyzed using Reflexive Thematic Analysis. Trustworthiness was supported through investigator triangulation, member checking, and audit trail.</p><p><strong>Results: </strong>Three themes were identified: finding your voice as a journey of personal growth, the challenges and successes of practicing, and the role of the context in voice development. Participants evaluated the training positively, although more than half reported limited vocal change and found the sessions intense. Experiences with voice-related misgendering varied. About half reported a decrease in instances where others perceived or addressed them as the wrong gender based on their voice, while others saw no change. Several participants indicated a need for GAHT and/or additional VCT.</p><p><strong>Conclusions: </strong>VCT targeting intonation may support TGD individuals in seeking a more masculine-sounding voice, though outcomes vary. An individualized, client-centered approach is essential to align voice with gender expression.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}