Male to female (MtF) transgender people often feel as though they can be perceived as a woman until they begin to speak (Hancock, Krissinger, & Owen, 2011). As a result, this population is becoming more represented on speech-language pathologists’ (SLPs) caseloads in an effort to feminize their voice and communication styles. There are several aspects of voice that can impact the perceived gender, including pitch, vocal quality, resonance, and prosody. Typically a higher fundamental frequency (F0), breathiness, more forward-focused resonance, a slower rate, and a smaller pitch range help the speaker to be perceived as a female (Owen & Hancock, 2010). To date there is research that supports the use of voice therapy with MtF transgender clients (Hancock et al., 2011; Owen & Hancock, 2010).
In addition to the traditional method of in-house service delivery, telepractice has become an alternative means of providing therapeutic services via videoconferencing. Benefits of telepractice include the ability to access more clients that otherwise might not be able to come in for treatment for a variety of reasons, such as location and/or disability. It has been proven to be a cost effective method that also enables clients to receive therapy in their natural environment (Theodoros, 2011). There is research available that affirms that voice therapy is just as successful over telepractice as it is when conducted in a face-to-face setting (Mashima et al., 2003). Although research does not exist regarding the delivery of transgender voice feminization therapy through videoconferencing, the following three articles investigate the areas of voice feminization therapy as well as voice therapy provided through telepractice.
Hancock and her team (2011) investigated the effect of voice perception on the quality of life (QoL) of transgender people. In this descriptive study, the researchers looked at three questions: is there a correlation between MtF transgender persons’ self-reported QoL and their self-ratings of voice; is there a correlation between MtF transgender persons’ self-reported QoL and a naïve listener’s rating of their voices; and is there a correlation between the perceived femininity and likeability between speakers and listeners? The 20 MtF transgender participants completed the Transgender Self-Evaluation Questionnaire (TSEQ), which subjectively targets QoL. Speech samples from the 20 transgender participants, as well as five cisgender women and five cisgender men, were presented to 12 male and 13 female listeners. Visual analog scales (VAS) were presented to each participant as well as each listener to evaluate femininity and likeability. The results indicated that there was a positive correlation between femininity and likeability only with the transgender participants. There was also a positive correlation between QoL and ratings for likeability and femininity, which was stronger with the self-reports.
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