"To speak or not to speak": Voice satisfaction in adolescents with gender dysphoria

Standardized questionnaire data and clinical observations in the national gender identity development service (GIDS) for young people in the UK suggested that dissatisfaction in relation to the voice was a common presentation... [ view full abstract ]

Standardized questionnaire data and clinical observations in the national gender identity development service (GIDS) for young people in the UK suggested that dissatisfaction in relation to the voice was a common presentation in adolescents who had been assigned male or female at birth.

As part of their routine assessment, 704 adolescent assigned females at birth and 362 adolescent assigned males at birth completed the Body Image Scale (BIS) (Lindgren and Pauly 1975) from 2012 to 2016.This data demonstrated that 77% of assigned males at birth rated that they were either dissatisfied or very dissatisfied with their voice. Similarly, 80% of assigned females at birth also said that they were either dissatisfied or very dissatisfied with their voice. Gender Identity Services for adults typically offer voice coaching or therapy particularly for those assigned male at birth.

The current audit aimed to gather more detailed information regarding voice dissatisfaction in adolescents with gender dysphoria in order to explore whether there was a need for the GIDS to provide additional support in... [ view full abstract ]

The current audit aimed to gather more detailed information regarding voice dissatisfaction in adolescents with gender dysphoria in order to explore whether there was a need for the GIDS to provide additional support in relation to voice dissatisfaction and also aimed to gain a better understanding of the various coping strategies young people utilise to manage any distress related to their voice.

The Transsexual Voice Questionnaire (TVQ) (Dacakis and Davies 2012), a standardised questionnaire for adults who identify as male to female (MtF) was adapted (with permission from the author) to ensure suitability for... [ view full abstract ]

The Transsexual Voice Questionnaire (TVQ) (Dacakis and Davies 2012), a standardised questionnaire for adults who identify as male to female (MtF) was adapted (with permission from the author) to ensure suitability for adolescents and also adapted to include a version for those assigned female at birth.

Further questions were added to capture the breadth of strategies young people utilise to manage their distress.

Voice questionnaires were added to the standard outcome measure packs in 2015 at the GIDS Leeds satellite service which covers the north of England. The TVQ was administered with young people over the age of 12 as part of their initial assessment.

Adapted Transsexual Voice Questionnaire (TVQ) (Dacakis and Davies 2012) [ view full abstract ]

Adapted Transsexual Voice Questionnaire (TVQ) (Dacakis and Davies 2012)

Results of 204 adapted TVQ, demonstrate that concerns about the voice have a negative impact on social functioning. The service found that adolescents assigned female at birth were as distressed as adolescents assigned males... [ view full abstract ]

Results of 204 adapted TVQ, demonstrate that concerns about the voice have a negative impact on social functioning. The service found that adolescents assigned female at birth were as distressed as adolescents assigned males at birth. This paper will discuss the results and implications.

Further results to date have highlighted that coping strategies used by adolescents with gender dysphoria fall into two main categories; avoidant behaviour, for example not using their voice and adaptive behaviour, for example, changing the pitch of their voice or using voice coaching programmes.

Service data from the BIS demonstrated that 77% of assigned males and 80% of assigned females are dissatisfied with their current voice. This current survey has demonstrated a negative impact for both assigned males and... [ view full abstract ]

Service data from the BIS demonstrated that 77% of assigned males and 80% of assigned females are dissatisfied with their current voice. This current survey has demonstrated a negative impact for both assigned males and assigned females on their social functioning and that young people use two main types of coping strategy; avoidance of using their voice and/or using their voice in different ways. The survey highlighted that adolescents with gender dysphoria would benefit from additional support in relation to managing voice dissatisfaction. The clinical implications of the survey will be discussed.