Background and objectives:
The study aimed to develop and validate an auditory perceptual voice questionnaire for transwomen. Transwomen seek gender affirming voice services to modify their voices to match their gender identities. Typically, outcomes are measured by questionnaires and listening tools that involve listeners to identify how “feminine” or “masculine” a voice sounds. While this was common clinical practice, recent clinical approaches have moved away from expecting participants to achieve a desired standard. Instead, participants rating their own voices and meeting their own individualized goals and targets is recommended and desired. There are no patient reported outcome measures (PROMs) that can be used by transwomen to rate their own voices from an auditory-perceptual perspective. This study aims to develop and validate a questionnaire for this purpose.
Methods:
A preliminary auditory-perceptual assessment tool was developed by the investigators considering existing auditory-perceptual methods and quality-of-life scales. The voice assessment tool was sent to five speech-language pathologists and 50 transwomen to independently rate the survey questionnaire for content validity, item-agreement, ease of administration, and relevance. The questionnaire required participants to rate their voices on these parameters as they are currently and a desired target on a visual analog scale.
For the initial development of the questionnaire, email solicitations were sent to transwomen and Speech-language pathologists who are active in the clinical practice relevant to voice care for transwomen. Individuals who have a lived experience of identifying as trans at least for one year were included in the study. All participants were adults within the age range of 18-45 years. Participants rated each item with one of the following three responses: “essential,” “useful, but not essential,” or “not necessary”. In addition, participants also provided open-ended responses to three questions: 1. How “easy” is the administration of this questionnaire? 2. How relevant is this questionnaire in measuring self-reported voice quality? and 3. Any other feedback for the researchers?
Conclusions:
Based on the initial feedback, a final questionnaire has been developed which will be assessed for different test construct measures.
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