Talk:Transgender voice therapy

Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Ajtrainor, D3ini, Kp23, Oozav. Peer reviewers: Nancy Zee.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 11:38, 17 January 2022 (UTC)

Merge
Someone, presumably unaware of this page's existence, started a new page called "voice feminization". I think the two pages should be merged, as they focus on essentially the same topic. Andrea Parton 15:59, 7 June 2006 (UTC)


 * That would be me and yes they should be merged and the one that is left should have the other point to the one that has all of the information on it. The question is, which is the better name for the concept.  Let me think for a few days and I will get back to you on this.  And thank you!  I did not know this page existed. FemVoice 02:49, 8 June 2006 (UTC)


 * I did a couple of searches and from the results the choice is obvious. I guess I don't need to think about it.  FemVoice 03:07, 8 June 2006 (UTC)


 * Results 1 - 100 of about 25,900,000 for Voice therapy
 * Results 1 - 100 of about   339,000 for Voice therapy Transgender.
 * Results 1 - 100 of about   201,000 for Voice therapy transsexual.


 * Results 1 - 100 of about   246,000 for Voice feminization
 * Results 1 - 100 of about    53,500 for Voice feminization transexual.
 * Results 1 - 100 of about    60,800 for Voice feminization Transgender.
 * Probably too late for the merge discussion however No. People with naturally high (or low) pitch need voice feminization (or voice masculinization) and the issues surrounding them compared to transgender voice therapy, although superficially similar, are not necessarily the same. AprilHare (talk) 13:45, 29 January 2009 (UTC)

Speech Rate
This article says that Men typically speak at a steady rate, while women tend to speak in shorter bursts followed by pauses. However, Kathe Perez's http://voicefeminization.com claims the opposite.

Unclear
There was a part that read "...speaking pattern uniquely." I went ahead and changed it to "...unique speech patterns," as I believe that's what what attempted. Is this correct? As a minor point, would it work better as "...individualized speech patterns?"

Incomplete?
This article seems to focus on only one aspect of voice therapy, although it implies there are two. Shouldn't there be something on voice masculization? 58.108.235.216 18:14, 10 April 2007 (UTC)
 * I wasn't aware this was a requirement for transmen as HRT is usually highly effective in providing voice masculinization through growth of the larynx thru testosterone. I'm going to be bold and add this point :) - Alison ☺ 18:22, 10 April 2007 (UTC)
 * Done! I even dug out a cite :) - Alison ☺ 18:40, 10 April 2007 (UTC)
 * The problem is not every transman takes hormones. And furthemore, transgendereds aren't the only ones who care about such things - as a budding crossdresser I'm anxious to make my voice more masculine, and obviously I don't want to take testosterone if I'm going to be switching back and forth. If there are characteristics of a feminine voice, there are characteristics of a masculine voice - I've noticed guys can sing high notes and still sound like guys, and deeper-voiced female singers still sound feminine. Thus I came here to find out what other factors besides pitch make a voice masculine or feminine and only found the feminine side. Very unbalanced. Kuronue | Talk 22:55, 23 February 2009 (UTC)
 * "Transgendereds? Don't refer to transgender people with that word. Although I agree - this article is very unbalanced and doesn't talk about masculinizing voice training at all, and it should be included. 98.245.20.67 (talk) 04:43, 3 February 2014 (UTC)
 * Part of the imbalance is probably because this article is titled "voice therapy," rather than "communication therapy." In the speech-language pathology arena, there is much more research on voice therapy for transgender women than for trans men, because the literature indicates that hormone therapy for trans men typically drops the voice to a masculine pitch range without the need for adjuvant voice therapy. Intervention offered to trans men would typically be described as transgender "communication therapy," not "voice therapy," because the therapy targets would be things like intonation, prosody, articulation, syntax, word choice, and nonverbal communication, not voice-related parameters like pitch, resonance, and vocal quality. I would actually suggest that the article title be changed to "transgender communication therapy," because a) would include both trans-feminine and trans-masculine issues, and b) there is increasing attention in the field to other aspects of communication beyond voice/pitch in transwomen. - Tuckerma (talk) 00:38, 13 December 2014 (UTC)

Broken reference
The third reference is broken. Lawrence, MD, Anne A. (January 2004). "Voice Feminization Surgery: A Critical Overview". Retrieved 2007-03-16.

Citation suggestions/review
Possible citations for the stem-cell comment? They don't specifically mention feminization or masculanization but do discuss the concept that is alluded to.

http://www.uclhospitals.brc.nihr.ac.uk/news/world%E2%80%99s-first-clinical-trial-stem-cell-voice-box

https://clinicaltrials.gov/ct2/show/NCT01977911

9/24/2016: Reference #6 links to a source which is not neutral; it is a list of someone's opinion on/personal experience with hormone therapy. There are a number of areas within this article which are not cited, including the section titled "Vocal surgeries." Within this section, much of the research is anecdotal or not properly cited. Ajtrainor (talk) 01:16, 25 September 2016 (UTC)

Critique
This article has multiple issues that need to be addressed. It is lacking in its number of references - many paragraphs do not have any citations at all, and facts are not backed up with appropriate references. For example, "Transgender women who go through puberty before transition will usually develop voices characteristic of males." should have a reliable reference attached.

Another problematic sentence is the following: "Many in the transsexual community have previously been led to regard voice surgery as 'inadvisable', while others regard a socially acceptable standard of feminine speech to be indispensable (and further surgery an acceptable risk)." This sentence contains unnamed sources and is therefore problematic.

There is much information to be added, and with the help of my classmates and the Wiki Education Foundation, we hope to help fix some of these problems! D3ini (talk) 21:43, 24 September 2016 (UTC)

09/24/2016: Some of the "See also" links do not seem relevant to Transgender Voice Therapy, including yodeling and stuttering. The "Vocal surgeries" section does not describe the different types of surgeries, or link to further information. Ajtrainor (talk) 01:24, 25 September 2016 (UTC)

Things to add to this article include: restructuring of sections, revision of terminology used, rewriting entire sections. We are also planning on changing the title of the article from "Voice therapy (transgender)" to be "Transgender Voice Therapy". D3ini (talk) 16:27, 26 September 2016 (UTC)

Differences between male and female voices
The statement "Transgender women who go through puberty before transition will usually develop voices characteristic of males. Hormone therapy does not alter a trans woman's voice once it has masculinized;" does not seem to be referenced by a reputable source. The website http://www.tsroadmap.com/physical/hormones.html is not an official source and should maybe not be trusted. Kp23 (talk) 19:40, 25 September 2016 (UTC)

Overview
There are many facts in the overview that do not have citations to back up the information. For example, there are a lot of facts about the physiology of phonation however none of this information is cited. Kp23 (talk) 19:44, 25 September 2016 (UTC)

Overview and critique
Some of the current sources are primary sources. If possible, they should be replaced by secondary sources. Furthermore, many claims have no sources, and multiple paragraphs have no sources at all. This can be misleading for people looking to this page for medical information. More information regarding the possible procedures could also be added. Oozav (talk) 23:15, 25 September 2016 (UTC)

Working Bibliography
Suggestions for sources to be used:

Adler, R. K., Hirsch, S., & Mordaunt, M. (2012). Voice and communication therapy for the transgender/transsexual client: A comprehensive clinical guide.

Brown M, Perry A, Cheesman A & Pring T (2000). "Pitch change in male-to-female transsexuals: has phonosurgery a role to play?" International Journal of Language & Communication Disorders 35:1.

Dacakis, Georgia et al. (2012) Development and Preliminary Evaluation of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals. Journal of Voice Volume 27,( 3): 312 - 320

Davies, S. & Goldberg, J. M. (2006) Clinical Aspects of Transgender Speech Feminization and Masculinization, International Journal of Transgenderism, 9:3-4, 167-196, DOI: 10.1300/J485v09n03_08

Davies, S., Papp, V. G., & Antoni, C. (2015). Voice and Communication Change for Gender Nonconforming Individuals: Giving Voice to the Person Inside. International Journal Of Transgenderism, 16(3), 117-159. doi:10.1080/15532739.2015.1075931

Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., Fraser, L., Zucker, K. (August 01, 2012). Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. International Journal of Transgenderism, 13, 4, 165-232.

Gelfer, M. and K. Schofield (2000). "Comparison of acoustic and perceptual measures of voice in male-to-female transsexuals perceived as female versus those perceived as male," Journal of Voice 14(1).

Hancock, A. B. & Garabedian, L. M. (2013). Transgender Voice and Communication Treatment: A Retrospective Chart Review of 25 Cases. International Journal of Language and Communication Disorders. 48, 54-65, DOI: 10.1111/j.1460-6984.2012.00185.x

Hancock, A. B. & Helenius, L. (2012). Adolescent male-to-female transgender voice and communication therapy. Journal of Communication Disorders. 45, 313-324.

Irwig, M. S. (2016). Testosterone therapy for transgender men. Lancet Diabetes and Endocrinology, The. Elsevier Ltd

Mastronikolis, N. S., Remacle, M., Biagini, M., Kiagiadaki, D., & Lawson, G. (2013). Wendler Glottoplasty: An Effective Pitch Raising Surgery in Male-to-Female Transsexuals. Journal of Voice. 27, 516-522.

Oates J & Dacakis G (1983). "Speech pathology considerations in the management of transsexualism: a review." British Journal of Disorders of Communication 18(3). --> an older reference, but one of the few reviews I was able to find

Orloff, L. A., Mann, A. P., Damrose, J. F., & Goldman, S. N. (2006). Laser-assisted voice adjustment (LAVA) in transsexuals. The Laryngoscope. 116, 655–660. DOI: 10.1097/01.mlg.0000205198.65797.59

Spencer, L. (1988). "Speech characteristics of male-to-female transsexuals: a perceptual and acoustic study." Folia Phoniatrica 40.

Van Damme S., Cosyns, M., Deman S., Van den Eede, Z., & Van Borsel, J. (2016). The Effectiveness of Pitch-raising Surgery in Male-to-Female Transsexuals: A Systematic Review. Journal of Voice. Article in Press.

Wolfe V, Rutusnik D, Smith F, & Northrop F. (1990). "Intonation and fundamental frequency in male-to-female transsexuals." Journal of Speech and Hearing Disorders 55(1).

Yang. C. Y., Palmer, A. D., Murray. K. D., Meltzer. T. R., & Cohen. J. I. (2002). Cricothyroid approximation to elevate vocal pitch in male-to-female transsexuals: results of surgery. Annals of Otology, Rhinology & Laryngology. 111, 477-485.

See also: http://www.wpath.org/ World Professional Association for Transgender Health http://transhealth.ucsf.edu/ University of California, San Francisco Center of Excellence for Transgender Health

D3ini (talk) 17:08, 26 September 2016 (UTC) Kp23 (talk) 18:18, 1 October 2016 (UTC) Ajtrainor (talk) 01:23, 3 October 2016 (UTC)

Plan to Improve Article
New Structure of Article: Voice Feminization, Voice Masculinization, Therapeutic Techniques , Surgical Techniques, Controversy, Effect of Hormones - might be able to merge into feminization/masculinization

Other things to fix: Change title of article to "Transgender voice therapy". It does not make sense for the title to be Voice Therapy in general, if only transgender voice therapy is being discussed

Terminology? Are feminization and masculinization the most up-to-date terms?,

Revise “See Also” section - take out yodelling,

Improve sources & citations,

More material relevant to topic,

Link to phonation article, take out paragraph explaining it,

Add pictures

Kp23 (talk) 18:23, 1 October 2016 (UTC)

Should there be a section regarding the acoustic differences between masculine and feminine voices? Might be helpful for discussion about therapy techniques. The article as it is mentions some possible controversies surrounding surgery. Does anyone know more about this? Ajtrainor (talk) 01:28, 3 October 2016 (UTC)

Probably more of a problem with SLP than with this article, but..
There is a lot of misinformation. I mean, I believe that most of what is said in this article is actually what SLPs believe, but much of it is inaccurate or incomplete. I don't know whether there are really many sources that would be considered reputable out there yet to back these things up, but pitch (fundamental frequency) is not only not the most important factor (at least particularly in femme voice), but is also NOT generally even a necessary factor, unlike the article says (though it can be a helpful factor to a degree, but only if used in conjunction with timbral modifications).

(I am going to mostly speak about femme voice as that's what I mainly know.)

This article does not make a single mention of larynx raising (used to decrease vocal tract length, basically the most important part of femme voice and generally an absolute must), makes not a single mention of "open quotient" (nor even of "tone" or "timbre"), and focuses heavily on pitch raising, which as I mentioned is actually (and perhaps counter intuitively) one of the LEAST important aspects, all things considered. Focusing on raising pitch can lead to poor results and frustration, and opting to do vocal surgery which can be risky and is generally also unnecessary with proper voice training.

I realize this is what SLPs actually believe, but it might be nice if there was some way (that fits with Wikipedia's standards/rules) of making it apparent to the reader at the very least that there is some serious controversy surrounding this. And at least some mention of timbral modifications (shortening of VTL, increasing of open quotient, etc.). SLPs and therefore also this article rely too much on the concept of "vocal resonance" which is borderline unscientific.

I'll try to dig up some sources on some of this stuff if I can, though such endeavors are not necessarily my forte (and neither is Wikipedia editing in general). But I wanted to mention some of this stuff in the talk page and see if we can get some discussion of these issues happening. — Preceding unsigned comment added by 98.171.179.71 (talk) 16:16, 29 July 2018 (UTC)

Agreed. It is good to see that this comment was made back in 2018, which was in terms of transgender resources a very different time (though nowhere nearly as much as, say, 2012). Laryngeal raising, oropharyngeal closure, slight decompression of the voice’s phonation, and slight addition of twang as well as use of thin folds for chest voice (m1) with a cherry on top of practicing higher pitches are all very important aspects of voice feminization, and they are all understated or ignored here still. Non-hormonal voice masculinization has also not been noted as physically more limited due to fundamental frequency and maximal size of the larynx. There has been a transvoice revolution taking place since the late 2010s and this article is in many ways obsolesced by it. CPGACoast (talk) 14:30, 4 April 2021 (UTC)