Objective: To investigate potential relationships between voice self-perception, voice symptoms, and mental disorders in transgender and non-binary individuals.

Method: This was a descriptive, quantitative, prospective study. A total of 45 individuals participated, divided as follows: 15 transgender women (TW), 15 transgender men (TM), and 15 non-binary individuals (NB). The Transgender Woman Voice Questionnaire (TWVQ), Voice Symptom Scale (VoiSS), and specific modules of the Mini International Neuropsychiatric Interview (M.I.N.I.) – Panic Disorder, Agoraphobia, Panic Disorder associated with Agoraphobia (PD+A), Social Phobia, Post-Traumatic Stress Disorder (PTSD), and Generalized Anxiety Disorder (presence of disorder=1; absence=0) were applied. Descriptive and inferential analyses were performed using the Kruskal-Wallis, Dwass-Steel-Chritchlow-Fligner, and Spearman Correlation tests (p<0.05).

Results: NB individuals had the poorest voice self-perception (_ TWVQ = 71.7), and TW individuals showed the highest score for VoiSS (_= 48.1). In the MINI protocol, TW individuals had the highest average for PTSD presence (_=0.400); TM individuals had the highest average for Social Phobia (_=0.533) and Generalized Anxiety Disorder (_=0.733), and NB individuals had the highest average for Panic Disorder (_=0.667). TW and NB groups had the same mean score (_=0.867) for Agoraphobia and for PD+A (_=0.400) Positive correlations were found between the following: overall TWVQ score and total VoiSS score (r=0.711, p<0.001); overall TWVQ score and VoiSS limitation domain (r=0.497, p<0.001); overall TWVQ score and VoiSS emotional domain (r=0.786, p<0.001); overall TWVQ score and VoiSS physical domain (r=0.429, p=0.003); overall TWVQ score and Agoraphobia (r=0.315, p=0.035); overall TWVQ score and PD+A (r=0.305, p=0.042).

Conclusion: There was a correlation between voice self-perception and voice symptoms, suggesting that poorer voice self-perception is associated with higher scores on the VoiSS. Agoraphobia and PD+A were related to poorer voice self-perception. The relationships found reinforce the importance of a multidisciplinary approach, considering that voice complaints within this population may be associated with psychological factors.