Reliability and Severity Levels of the Voice-Related Experiences of Nonbinary Individuals.

Objectives: Clinicians providing gender-affirming communication services to nonbinary individuals often utilize client questionnaires. The Voice-related Experiences of Nonbinary Individuals (VENI) is the only published questionnaire exclusively for nonbinary clients. This questionnaire consists of 17 items that gain insight into the client's self-perception of voice and voice-related concerns. According to Shefcik and Tsai (2023), the VENI's content validity is good to excellent. This study evaluated the measure's reliability through internal consistency and test-retest reliability analyses and created impact ratings to support interpretation of scores.

Study design: This study utilized an online survey-based design with test-retest administration. The initial survey was administered to evaluate internal consistency and create severity scores. The retest survey was administered 3-5 weeks after the initial survey to evaluate test-retest reliability.

Methods: Fifty-five nonbinary participants with a desire to modify their voice and who were not receiving gender-affirming communication services completed the first survey. Respondents completed the VENI and self-reported the degree that their voice adversely impacts their daily life. Internal Consistency Coefficient (ICC) and item total correlations (ITC) were used to evaluate internal consistency. Thirty participants from the initial survey retook the VENI after 3-5 weeks. Intraclass correlation coefficient (ICCC), Pearson's r, and standard error of measurement (SEM) were used to evaluate test-retest reliability.

Results: ICC was α = 0.85 and ITCs ranged between r = 0.11 and 0.72. Severity scores were created through standard deviations from the mean, resulting in five classifications from "mild" to "severe." Comparison of VENI scores between test and retest resulted in Pearson's r = 0.89, P =< 0.001, SEM = 3.03, and the ICCC for the measure was 0.88.

Conclusion: The VENI has good internal consistency and strong test-retest reliability. Clients' VENI scores can be interpreted using the SEM and impact rating classifications derived from the sample analyzed in this study. This improves clinicians' ability to evaluate and monitor clients' scores. This study supports the use of the VENI as a reliable tool for high-quality, individualized interventions in clinical and research purposes.