Background : For many transgender individuals, acquiring a voice that matches their gender is crucial to the transition process. The research indicates that an individual’s fundamental frequency (FF) must be 160–165 Hz or higher for the voice to be identified as female. As a result, the FF is primarily targeted in voice modification treatment. For example, studies show that making changes to formant frequency results in increased FF. FF in the higher end of the female range is not the only component necessary for an individual’s voice to be perceived as female. Resonance, linguistic patterns, the rate of speech and articulation must all be addressed in voice modification treatment for transwomen. However, there is little evidence regarding voice modification treatment effectiveness in the transgender population. Therefore, the purpose of this study is to assess treatment effectiveness using listener perception as an indicator of vocal femininity.
Methods : Resonance and FF were treated simultaneously in a 22-year-old transwoman. After nine treatment sessions, listener perception was used to assess treatment effectiveness. The clinician chose a 1-minute speech sample in which the client did not disclose or allude to their gender. The speech sample and survey were presented to six listeners blinded to the gender and age of the client and who were not in the field of Speech Language Pathology. Once the listeners heard the speech sample, the clinician asked the following three questions: 1) How would you describe the quality of this person’s voice?; 2) How old would you say this person is?; and 3) Was this voice pleasant or unpleasant? If the gender of voice was not disclosed via use of pronouns in their responses, a final question regarding the gender of the voice was asked.
Results : The average FF of the speech sample was 151 Hz. Two listeners used female pronouns while answering the survey questions when responding to the first three questions, therefore, the final question was not posed to those two listeners. The client’s voice was gendered as female by three out of the six listeners. One listener identified the voice as gender neutral and two listeners identified the voice as male. Five out of the six listeners rated the voice as “unpleasant”. One individual’s reason for why the voice was “unpleasant” was that he “could not tell if it was a guy or a girl.” Responses to the survey questions show similarities across all listeners. These include dysfluent speech (e.g., interjections, slow rate of speech, and hyponasality). Listeners described the voice as raspy, hoarse, and shaky.
Conclusions : Even though FF in the speech sample used fell below 160 Hz, the majority of the listeners identified the client as female or gender neutral. However, the majority of the listeners stated that the voice was unpleasant. The results of this study suggest that FF should not be the primary focus of transgender voice modification treatment. An approach encompassing articulatory patterns, resonance, and prosody in combination with FF should be considered. Further, these results suggest that listener perception may be an indicator of treatment effectiveness.