Mapping Procedures Used by Brazilian Speech-Language Pathologists in Vocal Assessment and Gender-Affirming Voice Therapy of Transgender Women.

Abstract

Objective: To map the procedures used by Brazilian speech-language pathologists (SLPs) in vocal assessment and gender-affirming voice therapy of transgender women.

Methods: The survey included 52 SLPs, with a mean age of 39.50 years, who worked with voice in Brazilewing method, vowel-only reading, and who had treated transgender women in the previous 12 months. They were recruited through social media and answered a digital form via Google Forms, with questions about their professional profile, the care provided to transgender women, and the procedures and strategies used in vocal assessment and gender-affirming voice therapy. Data were collected between August 2022 and March 2023.

Results: Most SLPs were cisgender women specializing in voice, with a mean experience of 15.67 years. Transgender women seen by SLP were predominantly adults. Multidimensional vocal assessments are most common, but they do not necessarily include aerodynamic assessments. Gender-affirming voice therapy sessions were primarily individualized. The SLPs' most used therapeutic strategies were diaphagmatic-abdominal breathing, fricative sounds, tongue or lip trill, humming, resonance tube phonation in water-low resistance, chewing technique, jaw opening exercise, tongue mobility exercise, tongue rotation in the oral vestibule with humming, tongue snap with humming, yawn-sigh technique, auditory repetition, in-ear monitors, pitch and loudness modulation, overarticulation, chant speech, chewing method, vowel-only reading, guidance, awareness and proprioception, supportive approach, and vocal hygiene. There was good satisfaction among SLPs with the therapeutic strategies used in gender-affirming voice therapy, except for respiratory level, where satisfaction was average.

Conclusion: The most used assessment procedures, satisfaction, and therapeutic strategies are related to the main vocal characteristics that contribute to gender identification through the voice.