Factors Associated With Loss of Follow‐Up in Transgender Patients Receiving Vocal Therapy

Abstract

ObjectivesOptimal vocal care for transgender patients necessitates regular follow‐up. Factors associated with loss of follow‐up in voice patients have never been investigated. In this study, we report a case series of transgender patients seeking vocal care at our institution and compare those who were and were not lost to follow‐up.MethodsCharts of transgender patients diagnosed with gender dysphoria who sought vocal care at our institution from January 2018 through May 2022 were reviewed. A chronological timeline of each patient's care at our vocal clinic was recorded. Loss of follow‐up was defined as instances in which patients were not yet satisfied with their vocal outcomes and expressed interest in scheduling a subsequent visit but had not yet done so. Logistic regressions were performed to identify factors associated with loss of follow‐up.ResultsOf 73 patients identified, 59 (80.8%) were assigned male at birth, and 72 (98.6%) were non‐Hispanic White. Loss of follow‐up occurred in 35 (47.9%) patients. Patients who received vocal surgery were significantly less likely to be lost to follow‐up (OR: 0.16 (0.03, 0.79); p = 0.03). The availability of telemedicine options for vocal care was protective against loss of follow‐up (OR: 0.09 (0.02, 0.44); p = 0.003). Patients who received other non‐voice gender‐affirming treatments concomitant to their vocal care were more likely to be lost to follow‐up (OR: 4.44 (1.35, 14.59); p = 0.01).ConclusionLoss of follow‐up in transgender patients receiving vocal care is common. Providing telemedicine options and encouraging patients to complete vocal care prior to or after receiving other non‐voice gender‐affirming treatments may help increase rates of follow‐up.Level of Evidence4 Laryngoscope, 133:3061–3067, 2023