Forces Affecting Voice Function in Gender Diverse People Assigned Female at Birth

David Azul; Adrienne B Hancock; Ulrika Nygren

doi:10.1016/j.jvoice.2020.01.001

Forces Affecting Voice Function in Gender Diverse People Assigned Female at Birth

J Voice. 2021 Jul;35(4):662.e15-662.e34. doi: 10.1016/j.jvoice.2020.01.001. Epub 2020 Jan 20.

Authors

David Azul¹, Adrienne B Hancock², Ulrika Nygren³

Affiliations

¹ Discipline of Speech Pathology, Rural Department of Allied Health, La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC, Australia. Electronic address: D.Azul@latrobe.edu.au.
² Department of Speech, Language, and Hearing Sciences, The George Washington University, Washington, District of Columbia.
³ Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Functional Area Speech & Language Pathology, Karolinska University Hospital, Stockholm, Sweden.

PMID: 31974036
DOI: 10.1016/j.jvoice.2020.01.001

Abstract

Objectives: The purpose of this study was to explore the factors and practices that have acted as facilitators or barriers to voice function in gender diverse people assigned female at birth (GD people^AFAB) from a participant-centered perspective and to inform the role of speech-language pathologists in supporting GD people^AFAB with developing and maintaining functional voice production.

Methods: Transcripts of semistructured interviews with 14 German-speaking GD people^AFAB were analyzed for the study objectives using a consensual approach to qualitative content analysis. The interviews and their interpretation were conceptualized as co-constructions of participants and researchers who were regarded as experts in their own right.

Results: Professional practices (testosterone treatment, professional voice support), speaker practices (self-care and voice use practices, self-evaluation of voice function), conversation partner practices, and supraindividual biocultural forces (vocal demands, normative practices, other biocultural forces) were identified as having influenced the participants' voice function. Professional voice support, a range of phonation practices, and general self- and voice care practices were frequently cited facilitators of functional voice production. The most frequent barriers to voice function included testosterone treatment, slouched posture, excess muscle tension, forceful voice use, and avoidance practices.

Conclusions: Voice function in GD people^AFAB is influenced by interactions of several forces, most of which may be shared by voice users of all genders. Professional practices should follow a person-centered approach to care in which all parties are well informed of the limitations and possibilities for any intervention, including the often-unquestioned contribution of testosterone treatment.

Keywords: Communication; Conceptual research; Interviews; Qualitative content analysis; Transgender; Transmasculine.

MeSH terms

Adult
Decision Making, Computer-Assisted
Diagnostic Self Evaluation
Female
Gender Identity*
Humans
Male
Middle Aged
Phonation
Testosterone
Voice*

Substances

Testosterone