Effectiveness of Speech Therapy in Trans Women.

Summary

One of the greatest hurdles in the transition of transgender persons is that voice, speech and communication are not congruent with the desired gender. Since hormone treatment does not affect the voice in male-to-female transgender persons (trans women), speech therapy is the treatment of choice to develop a more feminine communication. Speech therapy must focus on aspects of communication that play an important role in listener perceptions of the speakers gender. Results of a systematic review and meta-analysis showed that those aspects are primarily fundamental frequency of the voice and resonance. However, effectiveness studies of speech interventions in transwomen are extremely limited and show methodological limitations. The purpose of this project is to investigate the short-term and longterm impact of speech exercises for pitch and resonance on (a) acoustic voice characteristics, (b) listener perceptions of femininity using a visual analogue scale and binary gender identification (male versus female voice), and (c) self-perception and psychosocial functioning in trans women using a randomized sham-controlled trial and cross-over design.

Conditions

• Transgenderism
• Gender Dysphoria
• Speech Therapy
• Voice Disorder Due to Transsexualism

Interventions

BEHAVIORAL

Pitch Elevation Therapy

Goal: mean fundamental frequency of 180Hz (range 140 and 300Hz); Doses and duration: 5 one hour sessions (5h), 5 weeks Content: * auditory discrimination of lower and higher tones * pitch glides * pitch glides using straw phonation and resonance tube phonation * practice of higher pitch voice (target: 180Hz) in isolated vowels - syllables - mono and bisyllabic words -phrases - sentences and texts - conversation (generalization to spontaneous speech)

BEHAVIORAL

Articulation Resonance Therapy

Goal: increase in lipspreading, forward tongue carriage, larynx elevation, forward resonance, precise articulation; 5 sessions Doses and duration: 5 one hour sessions (5h), 5 weeks Content: * auditory and visual discrimination of forward vs backed tongue carriage and lip spreading vs lip rounding) * practice of technique on isolated vowels -syllables -mono and bisyllabic words - phrases - sentences and texts - conversation (generalization to spontaneous speech) * practising larynx elevation through the twang technique, isolated vowels -syllables -mono and bisyllabic words - phrases - sentences and texts - conversation (generalization to spontaneous speech) * forward resonance, focusing on oral forward resonance rather than chest resonance, isolated vowels -syllables -mono and bisyllabic words - phrases - sentences and texts - conversation (generalization to spontaneous speech) * clear, precise articulation and cork exercise

BEHAVIORAL

Sham therapy

Goal: active sham treatment, 4 sessions Doses and duration: 4 one hour and 15 minutes sessions (5h), 4 weeks Content: * providing information about vocal function, vocal surgery, vocal hygiene, transgender health care * discussing communication aspects and patterns, possible exercise contexts, communication partners, expectations of voice modification, conversational subjects * active intervention on nonverbal communication (Kinesics, gestures and sign language, facial expression, haptics, proxemics, occulsics, and physical appearance) * practising costo abdominal breathing patterns

Sponsors & Collaborators

• University Ghent

  lead OTHER

Principal Investigators

• Evelien D'haeseleer, PhD · University Ghent

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Max Age

70 Years

Sex

MALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2019-09-01

Primary Completion

2023-03-30

Completion

2023-03-30

Countries

• Belgium

Study Locations