Voice–Gender Incongruence and Voice Health Information–Seeking Behaviors in the Transgender Community

Abstract

Purpose Voice–gender incongruence has predominantly been investigated in the past through the perspective of feminine-identifying individuals seeking feminine-sounding voices. The purpose of this study was to determine the prevalence of self-reported voice–gender incongruence in the transgender, nonbinary, and gender-nonconforming (TNG) community and to describe health information–seeking behaviors exhibited when individuals attempt to address their voice and communication challenges. Method An online survey was designed with questions targeting the self-reported prevalence of voice–gender incongruence, characteristics of this complaint, and health information–seeking behaviors. Valid standardized measures, including the Voice Handicap Index and the Barriers to Help-Seeking Scale, were also included. Results Four hundred five participants were sorted into three groups based on gender identity (feminine, masculine, gender-neutral) to facilitate comparative analysis. Ninety-six percent of participants reported the experience of voice–gender incongruence in the past, and 88% reported that they currently experience voice–gender incongruence. There were no significant differences in reported voice–gender incongruence between groups. Voice Handicap Index scores were significantly higher for those who currently experience voice–gender incongruence ( p < .0001) and reflected differences in how much this concern bothers participants, as rated on a Likert scale, ranging from no problem to a very big problem ( p < .0001). Barriers to Help-Seeking Scale scores indicated that the masculine group perceived greater barriers to seeking help as compared to the feminine group. Discussion We present foundational evidence for the prevalence of voice–gender incongruence within the TNG community and barriers encountered when individuals attempt to access care. Future work should investigate the specific needs of subgroups within the TNG community and whether those who desire feminine-, masculine-, and/or androgynous-sounding voices experience voice–gender incongruence and access to services differently. Supplemental Material https://doi.org/10.23641/asha.12462422