Voice-Related Quality of Life and Psychological Well-being in Transgender and Gender Diverse Adults: Associations with Gender-Affirming Care.
Source: PubMed, NCBI / U.S. National Library of Medicine
Voice is important in gender expression and embodiment. This study examined associations between gender-affirming care and both voice-related quality of life (QOL) and psychological well-being in transgender and gender-diverse (TGD) people. Cross-sectional survey. Online platform (Prolific). TGD adults with voice concerns completed the Trans Woman Voice Questionnaire (TWVQ), adapted TVQ Female to Male (FtM) (TVQ), and/or Voice-related Experiences of Nonbinary Individuals (VENI). Psychological well-being was assessed with the Scale of Positive and Negative Experience and Flourishing Scales. Gender-affirming care included mental health therapy, counseling, speech therapy, hormone therapy, and surgery. Descriptive statistics and multiple linear regression/ANOVA analyses were performed. Among 313 participants (mean age 26 years), 40% were nonbinary, 28% trans women, and 23% trans men. Common interventions were mental health therapy (n = 197), hormone therapy (n = 118), and counseling (n = 87). Phonosurgery was rare (n = 1). Those with gender care counseling had lower TVQscores (P = 0.03) than those planning it. Those on hormone therapy had lower TWVQ and TVQscores than those who were planning it (P = 0.03; P = 0.0002). Engagement with speech therapy was associated with lower TWVQ and TVQscores than those who planned to do so. Those interested in phonosurgery had higher TWVQ and TVQscores than those not interested (P = 0.02; P = 0.
Abstract
Voice is important in gender expression and embodiment. This study examined associations between gender-affirming care and both voice-related quality of life (QOL) and psychological well-being in transgender and gender-diverse (TGD) people. Cross-sectional survey. Online platform (Prolific). TGD adults with voice concerns completed the Trans Woman Voice Questionnaire (TWVQ), adapted TVQ Female to Male (FtM) (TVQ), and/or Voice-related Experiences of Nonbinary Individuals (VENI). Psychological well-being was assessed with the Scale of Positive and Negative Experience and Flourishing Scales. Gender-affirming care included mental health therapy, counseling, speech therapy, hormone therapy, and surgery. Descriptive statistics and multiple linear regression/ANOVA analyses were performed. Among 313 participants (mean age 26 years), 40% were nonbinary, 28% trans women, and 23% trans men. Common interventions were mental health therapy (n = 197), hormone therapy (n = 118), and counseling (n = 87). Phonosurgery was rare (n = 1). Those with gender care counseling had lower TVQscores (P = 0.03) than those planning it. Those on hormone therapy had lower TWVQ and TVQscores than those who were planning it (P = 0.03; P = 0.0002). Engagement with speech therapy was associated with lower TWVQ and TVQscores than those who planned to do so. Those interested in phonosurgery had higher TWVQ and TVQscores than those not interested (P = 0.02; P = 0.0004). TGD adults who completed hormone therapy, counseling, and speech therapy had better voice-related QOL than those still deciding or planning. Those planning phonosurgery had worse scores, suggesting motivation for surgery. Findings highlight the voice-related quality of life benefits of gender-affirming interventions and the importance of voice-related goals in care.