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Trans, Voice, Feminization, Voice therapy, glottoplasty, transgender, speech, speech therapy



Purpose: Transgender individuals often seek to alter their vocal characteristics. For Male to Female (MtF) transgender individuals, attaining a feminine voice may be particularly challenging. The objective of this systematic review is to determine whether MtF transgender individuals who receive voice feminization therapy alone or Wendler’s Glottoplasty (WG) surgical intervention with subsequent voice therapy yield greater outcomes in frequency and self-perception.

Method: A systematic review of the literature was conducted by using PubMed and Ovid to search terms pertaining to voice feminization. The articles were reviewed and appraised by the authors for inclusionary criteria, exclusionary criteria, and quality. Inclusionary criteria included: 1) adult MtF Transgender individuals, 2) pre and post measures of fundamental frequency (fo), 3) post puberty age, 4) measure of perception of femininity, and 5) patients who underwent WG (articles pertaining to surgical intervention only).

Results: A total of 82 articles were identified and 12 met inclusionary criteria for this systematic review. Overall, the quality of the studies was moderate. Outcome measures included frequency range and frequency gain. The authors were unable to compare measurements of self-perception and perception of femininity due to the variability in assessments.

Conclusions: Patients who opted for surgical intervention experienced a greater increase in fo but a decrease in frequency range. Conversely, patients who participated in voice feminization therapy alone were found to exhibit smaller gains in fo and an increase in frequency range. This implies that both voice feminization therapy and surgical intervention are effective methods for increasing the frequency of voice. Limitations of this research include the subjective nature of self-perception measures, variability in measurements of perception of femininity, and overall limited research regarding this population.

Voice Feminization: Voice Therapy vs. Surgical Intervention: A Systematic Review