Mapping Procedures Used by Brazilian Speech-Language Pathologists in Vocal Assessment and Gender-Affirming Voice Therapy of Transgender Women.

OBJECTIVE

To map the procedures used by Brazilian speech-language pathologists (SLPs) in vocal assessment and gender-affirming voice therapy of transgender women.

METHODS

The survey included 52 SLPs, with a mean age of 39.50 years, who worked with voice in Brazilewing method, vowel-only reading, and who had treated transgender women in the previous 12 months. They were recruited through social media and answered a digital form via Google Forms, with questions about their professional profile, the care provided to transgender women, and the procedures and strategies used in vocal assessment and gender-affirming voice therapy. Data were collected between August 2022 and March 2023.

RESULTS

Most SLPs were cisgender women specializing in voice, with a mean experience of 15.67 years. Transgender women seen by SLP were predominantly adults. Multidimensional vocal assessments are most common, but they do not necessarily include aerodynamic assessments. Gender-affirming voice therapy sessions were primarily individualized. The SLPs' most used therapeutic strategies were diaphagmatic-abdominal breathing, fricative sounds, tongue or lip trill, humming, resonance tube phonation in water-low resistance, chewing technique, jaw opening exercise, tongue mobility exercise, tongue rotation in the oral vestibule with humming, tongue snap with humming, yawn-sigh technique, auditory repetition, in-ear monitors, pitch and loudness modulation, overarticulation, chant speech, chewing method, vowel-only reading, guidance, awareness and proprioception, supportive approach, and vocal hygiene. There was good satisfaction among SLPs with the therapeutic strategies used in gender-affirming voice therapy, except for respiratory level, where satisfaction was average.

CONCLUSION

The most used assessment procedures, satisfaction, and therapeutic strategies are related to the main vocal characteristics that contribute to gender identification through the voice.