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  • 1.
    Holmberg, Jenny
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Linander, Ida
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Södersten, Maria
    Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Medical Unit Speech-Language Pathology, Karolinska University Hospital, Stockholm, Sweden.
    Karlsson, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Exploring motives and perceived barriers for voice modification: the views of transgender and gender-diverse voice clients2023In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 66, no 7, p. 2246-2259Article in journal (Refereed)
    Abstract [en]

    Purpose: To date, transgender and gender-diverse voice clients' perceptions and individual goals have been missing in discussions and research on gender-affirming voice therapy. Little is, therefore, known about the client's expectations of therapy outcomes and how these are met by treatments developed from views of vocal gender as perceived by cisgender persons. This study aimed to explore clients' individual motives and perceived barriers to undertaking gender-affirming voice therapy.

    Method: Individual, semistructured interviews with 15 transgender and gender-diverse voice clients considering voice therapy were conducted and explored using qualitative content analysis.

    Results: Three themes were identified during the analysis of the participants' narratives. In the first theme, “the incongruent voice setting the rules,” the contribution of the voice on the experienced gender dysphoria is put in focus. The second theme, “to reach a voice of my own choice,” centers around anticipated personal gains using a modified voice. The third theme, “a voice out of reach,” relates to worries and restricting factors for not being able to reach one's set goals for voice modification.

    Conclusions: The interviews clearly indicate a need for a person-centered voice therapy that starts from the individuals' expressed motives for modifying the voice yet also are affirmative of anticipated difficulties related to voice modification. We recommend that these themes should form the basis of the pretherapy joint discussion between the voice client and the speech-language pathologist to ensure therapy goals that are realistic and relevant to the client.

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  • 2.
    Nylén, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Holmberg, Jenny
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Södersten, Maria
    Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Medical Unit Allied Health Professionals, Section Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden.
    Acoustic cues to femininity and masculinity in spontaneous speech2024In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 155, no 5, p. 3090-3100Article in journal (Refereed)
    Abstract [en]

    The perceived level of femininity and masculinity is a prominent property by which a speaker’s voice is indexed, and a vocal expression incongruent with the speaker’s gender identity can greatly contribute to gender dysphoria. Our understanding of the acoustic cues to the levels of masculinity and femininity perceived by listeners in voices is not well developed, and an increased understanding of them would benefit communication of therapy goals and evaluation in gender-affirming voice training. We developed a voice bank with 132 voices with a range of levels of femininity and masculinity expressed in the voice, as rated by 121 listeners in independent, individually randomized perceptual evaluations. Acoustic models were developed from measures identified as markers of femininity or masculinity in the literature using penalized regression and tenfold cross-validation procedures. The 223 most important acoustic cues explained 89% and 87% of the variance in the perceived level of femininity and masculinity in the evaluation set, respectively. The median fo was confirmed to provide the primary cue, but other acoustic properties must be considered in accurate models of femininity and masculinity perception. The developed models are proposed to afford communication and evaluation of gender-affirming voice training goals and improve voice synthesis efforts.

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