Voice Perceptions and Quality of Life of Transgender People

Published:November 08, 2010DOI:https://doi.org/10.1016/j.jvoice.2010.07.013

      Summary

      Despite the plethora of research documenting that the voice and quality of life (QoL) are related, the exact nature of this relationship is vague. Studies have not addressed people who consider their voice to influence their life and identity, but would not be considered to have a voice “disorder” (e.g., transgender individuals). Individuals seeking vocal feminization may or may not have vocal pathology and often have concerns not addressed on the standard psychosocial measures of voice impact. Recent development of a voice-related QoL measure specific to the needs of transgender care (Transgender Self-Evaluation Questionnaire [TSEQ]) affords opportunity to explore relationships between self-perceived QoL and perceptions of femininity and likability associated with transgender voice. Twenty male-to-female transgender individuals living as a female 100% of the time completed the TSEQ and contributed a speech sample describing Norman Rockwell’s “The Waiting Room” picture. Twenty-five undergraduate listeners rated voice femininity and voice likability after audio-only presentation of each speech sample. Speakers also self-rated their voices on these parameters. For male-to-female transgender clients, QoL is moderately correlated with how others perceive their voice. QoL ratings correlate more strongly with speaker’s self-rated perception of voice compared with others’ perceptions, more so for likability than femininity. This study complements previous research reports that subjective measures from clients and listeners may be valuable for evaluating the effectiveness of treatment in terms of how treatment influences voice-related QoL issues for transgender people.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Voice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Adler R.K.
        • Hirsch S.
        • Mordaunt M.
        Voice and Communication Therapy for the Transgender/Transsexual Client: A Comprehensive Clinical Guide.
        Plural Publishing, San Diego, CA2006
        • Gelfer M.P.
        Voice treatment for the male-to-female transgendered client.
        Am J Speech Lang Pathol. 1999; 8: 201-208
        • Murry T.
        • Medrado R.
        • Hogikyan N.D.
        • Aviv J.E.
        The relationship between ratings of voice quality and quality of life measures.
        J Voice. 2004; 18: 183-192
        • Karnell M.P.
        • Melton S.D.
        • Childes J.M.
        • Coleman T.C.
        • Dailey S.A.
        • Hoffman H.T.
        Reliability of clinician-based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders.
        J Voice. 2007; 21: 576-590
        • Schindler A.
        • Bottero A.
        • Capaccio P.
        • Ginocchio D.
        • Adorni F.
        • Ottaviani F.
        Vocal improvement after voice therapy in unilateral vocal fold paralysis.
        J Voice. 2008; 22: 113-118
        • Kasama S.T.
        • Brasolotto A.G.
        Vocal perception and life quality.
        Pro Fono. 2007; 19: 19-28
        • Liu C.Y.
        • Yu J.M.
        • Wang N.M.
        • et al.
        Emotional symptoms are secondary to the voice disorder in patients with spasmodic dysphonia.
        Gen Hosp Psychiatry. 1998; 20: 255-259
        • Ohlwein S.
        • Kruse E.
        • Steiner W.
        • Kiese-Himmel C.
        Voice function and quality of life—patients with laryngeal carcinoma following minimal-invasive laser surgery and function voice rehabilitation.
        Laryngorhinootologie. 2005; 84: 253-260
        • Van Borsel J.
        • De Cuypere G.
        • Van den Berghe H.
        Physical appearance and voice in male-to-female transsexuals.
        J Voice. 2001; 15: 570-575
        • Jacobson B.H.
        • Johnson A.
        • Grywalski C.
        • Silbergliet A.
        • Jacobson G.
        • Benninger M.S.
        • Newman C.W.
        The Voice Handicap Index: development and validation.
        Am J Speech Lang Pathol. 1997; 6: 66-70
        • Jacobson B.H.
        • White J.
        Multidisciplinary approach to treatment.
        in: Benninger M.S. Jacobson B.H. Johnson A.F. Vocal Arts Medicine: The Care and Prevention of Professional Voice Disorders. Thieme Medical Publishers, New York, NY1993: 318-343
        • Webb A.L.
        • Carding P.N.
        • Deary I.J.
        • MacKenzie K.
        • Steen I.N.
        • Wilson J.A.
        Optimising outcome assessment of voice interventions, I: reliability and validity of three self-reported scales.
        J Laryngol Otol. 2007; 121: 763-767
        • Andrews M.
        Manual of Voice Treatment: Pediatrics Through Geriatrics.
        2nd ed. Singular Publishing Group, San Diego, CA1999
      1. Hancock A, Owen K, Siegfriedt L, Brundage S. Reliability and validity of the transgender self-evaluation questionnaire. Paper presented at: Voice Foundation’s Annual Symposium; 2009; Philadelphia, PA.

        • McNeill E.J.M.
        • Wilson J.A.
        • Clark S.
        • Deakin J.
        Perception of voice in the transgender client.
        J Voice. 2008; 22: 727-733
        • Lewis C.
        Gender: a state of body or a state of mind?.
        GEMSNEWS. 1994; 17: 45
        • Kent R.
        • Ball M.
        Voice Quality Measurement.
        Singular Publishing, San Diego, CA2000
        • Hollien H.
        • Gelfer M.P.
        • Carlson T.
        Listening preferences for voice types as a function of age.
        J Commun Disord. 1991; 24: 157-171
      2. Rockwell N (Painter). The waiting room [online image]. Retrieved October 1, 2008, from Google Images. Available at: http://sladept.com/artwork/5575

        • Campbell W.
        • Lewis S.
        Visual analogue measurement of pain.
        Ulster Med J. 1990; 59: 149-154
        • Grant S.
        • Aitchison T.
        • Henderson E.
        • Christie J.
        • Zare S.
        • McMurray J.
        • Dargie H.
        A comparison of the reproducibility and the sensitivity to change of visual analogue scales, Borg scales, and Likert scales in normal subjects during submaximal exercise.
        Chest. 1999; 116: 1208-1217
        • Rammstedt B.
        • Rammsayer T.
        Gender differences in self-estimated intelligence and their relation to gender-role orientation.
        Eur J Pers. 2002; 16: 369-382
        • Van Borsel J.
        • Van Eynde E.
        • De Cuypere G.
        • Bonte K.
        Feminine after cricothyroid approximation?.
        J Voice. 2008; 22: 379-384
        • Sheskin D.
        Handbook of Parametric and Nonparametric Statistical Procedures.
        3rd ed. Chapman & Hall/CRC, Boca Raton, LA2003
      3. Owen K, Hancock A. The role of self- and listener perceptions of femininity in voice therapy. International Journal of Transgenderism. [in press].

        • De Bruin M.D.
        • Coerts M.J.
        • Greven A.J.
        Speech therapy in the management of male-to-female transsexuals.
        Folia Phoniatr Logop. 2009; 52: 220-227
        • Gorham-Rowan M.
        • Morris R.
        Aerodynamic analysis of male-to-female transgender voice.
        J Voice. 2006; 20: 251-262
        • Wolfe V.I.
        • Ratusnik D.L.
        • Smith F.H.
        • Northrop G.E.
        Intonation and fundamental frequency in male-to-female transsexuals.
        J Speech Hear Disord. 1990; 55: 43-50
        • Krom G.
        Consistency and reliability of voice quality ratings for different types of speech fragments.
        J Speech Hear Res. 1994; 7: 985